BILL NUMBER: AB 591 AMENDED
BILL TEXT
AMENDED IN SENATE JULY 23, 2009
AMENDED IN ASSEMBLY JUNE 1, 2009
AMENDED IN ASSEMBLY APRIL 15, 2009
INTRODUCED BY Assembly Member De La Torre
FEBRUARY 25, 2009
An act to add Section 1385.5 Sections
1385.5 and 1363.08 to the Health and Safety Code, and to amend
Section 754 of, and to add Section 10113.96
Sections 10113.96 and 10123.133 to, the Insurance Code,
relating to insurance.
LEGISLATIVE COUNSEL'S DIGEST
AB 591, as amended, De La Torre. Insurance: referral fees: health
plans and insurance: filings. filings:
identification cards.
Existing law, the Knox-Keene Health Care Service Plan Act of
1975, provides for the licensure and regulation of health care
service plans by the Department of Managed Health Care and makes a
willful violation of the act a crime. Existing law also provides for
the regulation of health insurers by the Department of Insurance.
This bill would require health care service plans and
to annually file with the Department of Managed Health
Care a copy of each of their plan contracts issued or outstanding in
this state as of the end of the previous calendar year and a list of
the marketing names used for those contracts, if any. The bill would
require health insurers to annually file with the
Director of the Department of Managed Health Care or the
Insurance Commissioner a list of their health care service
plan products or health insurance policies issued or
outstanding in this state in the previous calendar year with more
than 50,000 subscribers and enrollees or insureds,
including the form number and marketing name for those
products or policies. The bill would require the
departments Department of Insurance to use those
form numbers and marketing names when tracking the associated
plans and products or insurers and policies.
The bill would also require a health care service plan or health
insurer that issues identification cards to enrollees or insureds to
include certain additional information in those cards and would
require a plan or insurer to update cards issued to enrollees or
insureds prior to January 1, 2010, with this additional information,
as specified.
Because a willful violation of the bill's requirements with
respect to health care service plans would be a crime, the bill would
impose a state-mandated local program.
Under existing law, it is unlawful for a person to solicit,
receive, offer, or pay a referral fee for the referral of an
individual for the furnishing of services or goods for which the
person knows or should have known that whole or partial reimbursement
is or may be made by an insurer. Existing law makes a violation of
those provisions a misdemeanor, punishable by a fine not to exceed
$1,000 for each violation.
This bill would increase that penalty to $5,000 for each
violation.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1385.5 is added to the
Health and Safety Code, to read:
1385.5. (a) A health care service plan shall, by June 30 of each
year, file with the department a list of its health care service plan
products with more than 50,000 subscribers and enrollees issued or
outstanding in this state as of the end of the previous calendar
year. This list shall identify each type of product by the form
number approved by the department and by marketing name.
(b) The department shall use the form number and marketing name
provided pursuant to subdivision (a) when tracking the associated
health care service plan product or health care service plan under
this chapter.
(c) The filing required by this section shall be in addition to
the annual filing required under Section 1358.225.
SECTION 1. Section 1385.5 is added to the
Health and Safety Code , to read:
1385.5. A health care service plan shall, by June 30 of each
year, file with the department a copy of each of its plan contracts
issued or outstanding in this state as of the end of the previous
calendar year and a list of the marketing names used for those
contracts, if any.
SEC. 2. Section 1363.08 is added to the
Health and Safety Code , to read:
1363.08. If a health care service plan issues identification
cards to enrollees, the cards shall identify the department as the
entity that regulates the plan and shall include, but not be limited
to, the appropriate telephone number of the department that an
enrollee may call for purposes of obtaining assistance or information
about submitting a grievance to either the plan or the department
pursuant to subdivision (b) of Section 1368. A plan shall update
identification cards issued to enrollees prior to January 1, 2010,
with the information required by this section during the plan's next
annual reissuance of the cards or, if the plan does not annually
reissue cards, by July 1, 2010.
SEC. 2. SEC. 3. Section 754 of the
Insurance Code is amended to read:
754. (a) It is unlawful for any person to solicit, receive,
offer, or pay any referral fee for the referral of an individual for
the furnishing of services or goods for which the person knows or
should have known that whole or partial reimbursement is or may be
made, directly or indirectly, by any insurer. As used in this
section, a referral fee is a fee paid by a person furnishing goods or
services to another in return for the referral of an individual to
that person for the furnishing of services or goods. It includes any
referral fee, kickback, bribe, or rebate, whether made directly or
indirectly, overtly or covertly, or in cash or in kind. This
subdivision does not apply to any of the following:
(1) Discounts or similar reductions in prices.
(2) Referral fees between attorneys if legal services are provided
pursuant to a contingency fee arrangement if any referral fee is
consistent with the Rules of Professional Conduct of the State Bar of
California.
(b) This section applies to all forms of insurance covering a
motor vehicle, including commercial and personal lines, and
comprehensive coverage, property damage coverage, collision coverage,
and liability coverage.
(c) A violation of this section is a misdemeanor punishable by a
fine not to exceed five thousand dollars ($5,000) for each violation.
Proceedings to enforce this section may be brought by any district
attorney or other prosecuting attorney.
SEC. 3. SEC. 4. Section 10113.96 is
added to the Insurance Code, to read:
10113.96. (a) A health insurer shall, by June 30 of each year,
file with the commissioner a list of its health insurance polices
with more than 50,000 insureds issued or outstanding in this state as
of the end of the previous calendar year. This list shall identify
each type of policy by the form number approved by the department and
by marketing name.
(b) The department shall use the form number and marketing name
provided pursuant to subdivision (a) when tracking the associated
health insurance policy or health insurer under this part.
(c) The filing required by this section shall be in addition to
the annual filing required under Section 10192.13.
SEC. 5. Section 10123.133 is added to the
Insurance Code , to read:
10123.133. If a health insurer issues identification cards to
insureds, the cards shall identify the department as the entity that
regulates the insurer and shall include, but not be limited to, the
toll-free telephone number of the unit of the department that deals
with consumer affairs. A health insurer shall update identification
cards issued to insureds prior to January 1, 2010, with the
information required by this section during the insurer's next annual
reissuance of the cards or, if the insurer does not annually reissue
cards, by July 1, 2010.
SEC. 4. SEC. 6. No reimbursement is
required by this act pursuant to Section 6 of Article XIII B of the
California Constitution because the only costs that may be incurred
by a local agency or school district will be incurred because this
act creates a new crime or infraction, eliminates a crime or
infraction, or changes the penalty for a crime or infraction, within
the meaning of Section 17556 of the Government Code, or changes the
definition of a crime within the meaning of Section 6 of Article XIII
B of the California Constitution.