SB 1365, as amended, Hernandez. Hospitals.
Under existing law, health facilities, including general acute care hospitals, are licensed and regulated by the State Department of Public Health. Existing law prohibits a health facility from charging, billing, or otherwise soliciting payment from a patient on behalf of, or referring a patient to, another health facility in which the health facility has a significant beneficial interest, except as provided. A violation of these provisions is a crime.
This bill would require a general acute carebegin delete hospitalend deletebegin insert hospital, except as specified,end insert
to provide abegin delete specifiedend deletebegin insert delineatedend insert notice to each patient scheduled for a service in a hospital-based outpatient clinic, as defined, when that service is available in a nonhospital-based location. By expanding the application of an existing crime, the bill would create a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.
The people of the State of California do enact as follows:
Section 1323.1 is added to the Health and Safety
2Code, immediately following Section 1323, to read:
(a) A general acute care hospital shall notify each
4patient scheduled for a service in a hospital-based outpatient clinic
5when that service is available in another location that is not
6hospital-based. The notification shall be in substantially the
7following form:
8The location where you are being scheduled to receive services
9is a hospital-based clinic, and, therefore, may have higher costs.
10The same service may be available at another location within our
11health system that is not hospital-based, which may cost less. Check
12with the [insert name of office] at [insert telephone number] for
13another location within our health system, or check with your
14health insurance company, for
more information about other
15locations that may cost less.
16(b) For purposes of this section, a “hospital-based outpatient
17clinic” means a department of a provider, as defined in Section
18413.65(a)(2) of Title 42 of the Code of Federal Regulations, that
19is not located on the campus of that provider.
20
(c) This section shall not apply to a general acute care hospital
21operated by a nonprofit corporation under common control with
22a nonprofit health care service plan licensed pursuant to the
23Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2
24(commencing with Section 1340) of Division 2) that exclusively
25contracts with no more than two medical groups in the state to
26provide and arrange for medical services for the enrollees of the
27health care service plan, so
long as the cost-sharing design does
28not vary based on whether the care is provided in a hospital-based
29clinic or a medical office building.
No reimbursement is required by this act pursuant to
31Section 6 of Article XIII B of the California Constitution because
32the only costs that may be incurred by a local agency or school
33district will be incurred because this act creates a new crime or
P3 1infraction, eliminates a crime or infraction, or changes the penalty
2for a crime or infraction, within the meaning of Section 17556 of
3the Government Code, or changes the definition of a crime within
4the meaning of Section 6 of Article XIII B of the California
5Constitution.
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