BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 171
                                                                  Page  1

          Date of Hearing:   April 29, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                  AB 171 (Jones) - As Introduced:  January 29, 2009 

          Policy Committee:                              Business &  
          Professions  Vote:                            11-0
                        Judiciary                                 10-0

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill establishes requirements for the use of third-party  
          credit lines for dental services unless specified requirements  
          are met. Specifically, this bill: 

          1)Prohibits charging services to open-ended credit unless a  
            patient is provided with, prior to treatment, the services to  
            be rendered, the costs of treatment, any charges to be made in  
            advance of treatment, and the provision of a written treatment  
            plan. 

          2)Specifies the contents of a written notice to be provided to  
            patients. 

          3)Prohibits the use of third-party credit for patient whose  
            primary language is other than English unless the patient is  
            given a notice in one of the Medi-Cal threshold languages. 

          4)Prohibits for the arrangement of third-party credit if a  
            patient is anesthetized. 

           FISCAL EFFECT  

          No direct fiscal impact to the California Department of Consumer  
          Affairs (DCA) to continue oversight of professionals under the  
          jurisdiction of the California Dental Board. 

           COMMENTS  

           1)Rationale  . This bill is sponsored by the Western Center on Law  








                                                                  AB 171
                                                                  Page  2

            and Poverty (WCLP) to limit the use of lines of credit for  
            funding dental services without patients' knowledge or consent  
            and to establish standards for when such credit lines are  
            used. According to author, low-income dental patients have  
            been enrolled in credit card arrangements unknowingly when  
            presented with documents they think are a part of a payment  
            plan. WCLP has received several complaints from elderly,  
            low-income, and limited English-speaking patients, who  
            received dental services with out-of-pocket costs of several  
            thousand dollars. These charges were applied to lines of  
            credit with annual interest rates as high as 25%.
           
           2)Background  . The American Dental Association (ADA) indicates  
            that in addition to accepting insurance, cash, checks, and  
            major credit cards, most dental practices today also offer  
            monthly payment plans through third-party creditors arranged  
            in the dental practice setting. The ADA endorses CareCredit, a  
            medical credit card provider owned by GE Money and used by a  
            majority of dental offices.  Other medical credit card  
            providers include CapitalOne Healthcare Finance, Chase  
            HealthAdvance, and Citi Health Card.  The interest rates on  
            these credit cards range from 24% to 28% and have credit card  
            limits as high as $40,000.  

          Uninsured and underinsured Californians are at-risk for medical  
            debt which may lead to medical bankruptcy, one of the most  
            common reasons individuals declare bankruptcy. Medical credit  
            card debt is a significant factor contributing to escalating  
            rates of medical bankruptcy for a variety of Californians.  
            Individuals accumulate these various kinds of debt when  
            significant health services are required and coverage is  
            either not available or not robust enough to fully cover  
            costs. This bill reduces the risks created by third-party  
            credits cards in connection with dental services. 

           3)Related Legislation  . SB 1633 (Kuehl) in 2008 was similar to  
            this bill. SB 1633 was vetoed with a generic message about the  
            delay in budget enactment. 


           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081