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
                                                                  Page  2

            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 


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