BILL ANALYSIS
AB 56
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 56 (Portantino)
As Amended September 1, 2009
Majority vote
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|ASSEMBLY: |50-26|(June 3, 2009) |SENATE: |24-13|(September 2, |
| | | | | |2009) |
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Original Committee Reference: HEALTH
SUMMARY : Requires health insurers to provide coverage for
mammography upon provider referral by July 1, 2010, and requires
health plans and health insurers to notify subscribers or
policyholders of recommended timelines for testing.
The Senate amendments :
1)Add physician assistants to the list of providers eligible to
make a referral for a covered mammography beginning July 1,
2010, to the extent allowed by their scope of practice.
2)Expand the method by which health plans and health insurers
may notify a subscriber or policyholder of recommended
timelines for an individual to undergo tests for the screening
or diagnosis of breast cancer.
3)Exclude self-insured employee welfare benefit plans from the
requirement to provide mammography beginning July 1, 2010.
4)Make other technical and clarifying changes.
EXISTING LAW :
1)Provides for the regulation of health plans by the Department
of Managed Health Care and health insurers by the California
Department of Insurance.
2)Requires health plans to cover mammography for screening or
diagnostic purposes upon the referral of the patient's
physician, nurse practitioner, or certified nurse-midwife.
3)Requires health insurance policies to provide coverage for a
baseline mammogram for women age 35-39, inclusive; a mammogram
AB 56
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for women age 40-49, inclusive, every two years or more,
depending on a physician's recommendation; and, a mammogram
every year for women age 50 and over; for breast cancer
screening or diagnostic purposes.
AS PASSED BY THE ASSEMBLY , this bill was substantially similar
to the version approved by the Senate.
FISCAL EFFECT : According to the Senate Appropriations
Committee, to the extent that this bill increases the number of
mammograms annually, there would be costs to Medi-Cal, Access
for Infants and Mothers (AIM), and the Major Risk Medical
Insurance Program (MRMIP). This could result in up to
approximately $375,000 in additional costs, using the 20,000
additional mammograms as the high end estimate of additional
mammograms resulting from this bill's provisions. There would
also be minor and absorbable costs to the state-payer portion of
the California Public Employees Retirement System and no fiscal
impact on the Healthy Families Program.
Analysis Prepared by : Cassie Rafanan / HEALTH / (916)
319-2097
FN: 0002798