SB 1252, as introduced, Stone. Health care costs: patient notification.
Existing law provides for the licensure and regulation by the State Department of Public Health of health facilities, including general acute care hospitals and surgical clinics. The Medical Board of California licenses and regulates physicians and surgeons, and the Osteopathic Medical Board of California licenses and regulates osteopathic physicians and surgeons.
This bill would require, when a medical procedure is scheduled to be performed on a patient, the general acute care hospital, surgical clinic, and the attending physician, as applicable, to notify the patient, in writing, of the net costs to the patient for the medical procedure being done, as provided. For complex medical procedures or screenings involving multiple physicians, the general acute care hospital, surgical clinic, and attending physician, as applicable, would be required to disclose, in writing, if any of the physicians providing medical services to the patient are not contracted with the patient’s health care service plan or health insurer and the costs for which the patient would be responsible as a result. The bill would provide that a violation of these provisions by a physician and surgeon or osteopathic physician and surgeon would constitute unprofessional conduct, as provided.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 2320 is added to the Business and
2Professions Code, to read:
(a) A violation of Section 1289.6 of the Health and
4Safety Code constitutes unprofessional conduct.
5(b) Section 2314 does not apply to a violation under this section.
Section 1289.6 is added to the Health and Safety Code,
7to read:
(a) When a medical procedure is scheduled to be
9performed on a patient, the general acute care hospital, surgical
10clinic, and the attending physician, as applicable, shall notify the
11patient, in writing, of all of the following:
12(1) The net costs to the patient for the medical procedure being
13done, including, but not limited to, all of the following:
14(A) Applicable copayment, coinsurance, or deductible.
15(B) The full cost of the medical procedure.
16(C) The range of costs for a stay in a general acute care hospital
17or surgical clinic.
18(2) A complete and precise breakdown of the costs the patient’s
19health care service plan or health insurer will pay and the costs for
20which the patient will be responsible.
21(b) For complex medical procedures or screenings involving
22multiple physicians, the general acute care hospital, surgical clinic,
23and attending physician, as applicable, shall disclose, in writing,
24if any of the physicians providing medical services to the patient
25are not contracted with the patient’s health care service plan or
26health insurer and the costs for which the patient will be responsible
27as a result.
28(c) A violations of this section shall be exempt from the
29provisions of Section 1290.
30(d) A violation of this section by an attending physician shall
31be punishable pursuant to
Section 2320 of the Business and
32Professions Code.
33(e) For purposes of this section, the following terms have the
34following meanings:
35(1) “Attending physician” means a physician and surgeon or an
36osteopathic physician and surgeon, licensed by the Medical Board
37of California or the Osteopathic Medical Board of California
38pursuant to Chapter 5 (commencing with Section 2000) of Division
P3 12 of the Business and Professions Code), who scheduled the
2medical procedure.
3(2) “General acute care hospital” has the same definition as
4Section 1250.
5(3) “Surgical clinic” has the same definition as subdivision (b)
6of Section 1204.
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