BILL ANALYSIS
AB 113
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 113 (Portantino)
As Amended August 16, 2010
Majority vote
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|ASSEMBLY: |68-0 |(January 27, |SENATE: |31-1 |(August 18, |
| | |2010) | | |2010) |
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Original Committee Reference: TRANS.
SUMMARY : Requires health care service plan (health plan)
contracts and health insurance policies that are issued,
amended, delivered, or renewed on or after July 1, 2011, to
provide coverage for mammography for screening or diagnostic
purposes upon referral of certain health care professionals,
regardless of age.
The Senate amendments :
1)Delete the provisions in the Assembly version that would have
required health plans and health insurers to provide
subscribers and policyholders with information regarding
recommended timelines for breast cancer screening or
diagnosis, as specified.
2)Make technical changes, including sunsetting health insurer
provisions in existing law consistent with the date the
provisions provided for in this bill would begin.
AS PASSED BY THE ASSEMBLY , this bill required health plan
contracts and health insurance policies that are issued,
amended, delivered, or renewed on or after July 1, 2011, to
provide mammography coverage, upon referral of certain health
care professionals, regardless of age.
FISCAL EFFECT : According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS : According to the author, this bill is needed to
remove the age based utilization of mammograms contained in the
Insurance Code. The author believes that a woman's decision to
have a mammogram should be based upon the specific risks of the
woman, and in consultation with her physician, rather than
AB 113
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dictated by statute based on her age. The author points out
that, for many high risk women, their risk of developing breast
cancer is not solely related to their age, and high risk women
can, and often do, develop cancer at an earlier age than the
general population. The author adds that the requirement in
this bill that will have insurance companies provide information
to women on when to begin screening for breast cancer will
increase the number of women receiving mammograms, save lives,
and reduce treatment costs. Providing this information will be
easy to do, is almost cost free and will increase insurance
company Healthcare Effectiveness Data and Information Set
scores.
Several organizations have adopted evidence-based national
recommendations for breast cancer screening, including the U.S.
Preventive Services Task Force (USPSTF), convened by the U.S.
Department of Health and Human Services, the American Cancer
Society, the American College of Radiology, the American College
of Obstetrician-Gynecologists, and the American College of
Physicians. Generally these guidelines recommend that
mammography be performed every one to two years beginning at age
40; or 50 for those women of average risk for breast cancer. By
and large, routine baseline mammograms in women younger than 40
years are not recommended. In November 2009, USPSTF issued new
screening guidelines that recommend against routine screening
mammography in women ages 40 to 49. The guidelines instead
recommend screening every other year for women ages 50 to 74.
The recommendations state that the decision to start regular,
biennial screening mammography before the age of 50 years should
be an individual one and take patient context into account,
including the patient's values regarding specific benefits and
harms.
Pursuant to AB 1996 (Thomson), Chapter 795, Statutes of 2002,
and SB 1704 (Kuehl), Chapter 684, Statutes of 2006, which ask
the University of California to assess legislation proposing a
mandated benefit or service, or the repeal of a mandated benefit
or service, California Health Benefits Review Program (CHBRP)
provided an analysis of the public health, medical, and economic
impacts of last year's AB 56 (Portantino), which contains
substantially similar provisions to this bill. Please see the
Assembly Health Committee analysis for a summary of CHBRP's
analysis.
AB 113
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Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097
FN: 0006237