BILL NUMBER: SB 1092	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  JUNE 19, 2002
	AMENDED IN ASSEMBLY  MAY 30, 2002
	AMENDED IN SENATE  APRIL 17, 2001

INTRODUCED BY   Senator Sher

                        FEBRUARY 23, 2001

   An act to  add Section 1348.9 to the Health and Safety Code,
relating to health care service plans.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1092, as amended, Sher.  Health care service plans.
   Existing law, the Knox-Keene Health Care Service Plan Act of 1975,
provides for the regulation of health care service plans by the
Department of Managed Health Care.  Existing law requires each plan
licensed by the department to pay various fees associated with the
department's regulatory activities, including a share of costs and
expenses associated with financial examinations, grievances, and
complaints.
   This bill would require the Director of Managed Health Care to
adopt regulations on or before July 1, 2003, to establish the
Consumer Participation Program, which would allow for the director to
award reasonable advocacy and witness fees to any person who
demonstrates that the person represents the interests of consumers
and who has made a substantial contribution on behalf of consumers to
the adoption of any order, regulation, or decision made by the
director, other than the resolution of individual grievances,
complaints, or cases.  The bill would provide that fees awarded under
these provisions would be considered costs and expenses of the
department that may be recovered from health care service plans 
but would prohibit an increase in the amount of the fees.  The bill
would also require the department to report to the Legislature before
March 1, 2004, and annually thereafter, specified information
concerning the Consumer Participation Program  .
   Vote:  majority.  Appropriation:  no.  Fiscal committee:  yes.
State-mandated local program:  no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  (a) The Legislature finds and declares that consumer
participation programs at the Public Utilities Commission and the
Department of Insurance have been a cost-effective and successful
means of encouraging consumer protection, expertise, and
participation in rate setting and adjudicatory and quasi-legislative
proceedings.
   (b) The Legislature further finds and declares that by ensuring
that these proceedings have the benefit of consumer expertise and
evidence, consumer participation programs have saved California
taxpayers billions of dollars and have significantly improved the
decisions made by the affected agencies.
   (c) It is the intent of the Legislature to establish a consumer
participation program administered by the Department of Managed
Health Care that will promote the interests and effective
representation of consumers and assist the department in ensuring
affordable and effective delivery of health care to the people of
this state who are eligible to enroll in or subscribe to a health
care service plan or a specialized health care service plan.
   (d) It is further the intent of the Legislature that this act
shall be administered in a manner that encourages the effective and
efficient participation of all organizations representing the
interests of consumers that have a stake in the regulation of health
care service plans or specialized health care service plans.
  SEC. 2.  Section 1348.9 is added to the Health and Safety Code, to
read:
   1348.9.  (a) On or before July 1, 2003, the director shall adopt
regulations to establish the Consumer Participation Program, which
shall allow for the director to award reasonable advocacy and witness
fees to any person who demonstrates that the person represents the
interests of consumers and who has made a substantial contribution on
behalf of consumers to the adoption of any order, regulation, or
decision made by the director.
   (b) The regulations adopted by the director shall include
specifications for eligibility of participation, rates of
compensation, and procedures for seeking compensation.
   (c) This section shall apply to all proceedings of the department,
but shall not apply to resolution of individual grievances,
complaints, or cases.
   (d) Fees awarded pursuant to this section  may not exceed
three hundred fifty thousand dollars ($350,000) each fiscal year.
   (e) The fees awarded pursuant to this section  shall be
considered costs and expenses pursuant to Section 1356  and shall
be paid from the assessment made under that section.
Notwithstanding the provisions of this subdivision, the amount of the
assessment shall not be increased to pay the fees awarded under this
section.
   (f) The department shall report to the appropriate policy and
fiscal committees of the Legislature before March 1, 2004, and
annually thereafter, the following information:
   (1) The amount of reasonable advocacy and witness fees awarded
each fiscal year.
   (2) The individuals or organization to whom advocacy and witness
fees were awarded pursuant to this section.
   (3) The orders, decisions, and regulations pursuant to which the
advocacy and witness fees were awarded  .