BILL ANALYSIS
AB 98
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 98 (De La Torre)
As Amended September 4, 2009
Majority vote
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|ASSEMBLY: |50-27|(June 2, 2009) |SENATE: |23-11|(September 9, |
| | | | | |2009) |
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Original Committee Reference: HEALTH
SUMMARY : Requires individual or group health insurance policies
on file with the California Department of Insurance (CDI) as of
January 1, 2010, to cover maternity services, as defined, by
March 1, 2010, and requires new policies submitted to CDI after
January 1, 2010, to cover maternity services.
The Senate amendments :
1)Require existing individual or group health insurers to submit
to CDI, on or before March 1, 2010, a revised policy form that
covers maternity services.
2)Require, pursuant to 1) above, the corresponding policy to
take effect 30 days after CDI approves the revised form.
3)Specify that new individual or group health insurance policies
submitted to CDI after January 1, 2010, must include a
maternity services benefit.
EXISTING LAW :
1)Provides for the regulation of health plans by the Department
of Managed Health Care under the Knox-Keene Health Care
Service Plan Act of 1975 (Knox-Keene) and for the regulation
of health insurers by CDI under the Insurance Code.
2)Provides, under Knox-Keene, that health plans must provide all
medically necessary basic health care services, including
maternity services necessary to prevent serious deterioration
of the health of the enrollee or the enrollee's fetus, and
preventive health care services, specifically including
prenatal care.
AB 98
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3)Prohibits health plans and health insurers from issuing
contracts and policies that contain a copayment or deductible
for inpatient hospital or ambulatory care maternity services
that exceed the most common amount charged for the same type
of care and services provided for other covered medical
conditions.
4)Prohibits health plans and health insurers providing maternity
benefits for a person covered continuously from conception
from attaching any exclusions, reductions, or limitations to
coverage for involuntary complications of pregnancy unless
those provisions apply to all of the benefits paid by the plan
or insurer.
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, CDI would incur costs of approximately $216,000 in
fiscal years 2009-10 and 2010-2011 to fund staff counsel to
implement this bill. Ongoing costs to CDI would be absorbable.
COMMENTS : The Senate version differs from the Assembly-approved
version in that the Senate amendments specify an implementation
date for revision of existing policies and provide that all
future new policies include a maternity services benefit.
Analysis Prepared by : Cassie Rafanan / HEALTH / (916)
319-2097
FN: 0003077