BILL NUMBER: AB 602	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JUNE 18, 2009
	AMENDED IN ASSEMBLY  MARCH 25, 2009

INTRODUCED BY   Assembly Member Price

                        FEBRUARY 25, 2009

    An act to amend Sections 2550 and 2551 of the Business
and Professions Code, relating to dispensing opticians. 
 An act to add Section 1367.225 to the He   alth and
Safety Code, and to add Section 10123.197 to the Insurance Code,
relating to health care coverage. 



	LEGISLATIVE COUNSEL'S DIGEST


   AB 602, as amended, Price.  Dispensing opticians.
  Health care coverage: prescriptions.  
   Existing law, the Knox-Keene Health Care Service Plan Act of 1975,
provides for the regulation of health care service plans by the
Department of Managed Health Care and makes a willful violation of
the act's requirements a crime. Existing law provides for the
regulation of health insurers by the Department of Insurance.
Existing law requires a health care service plan contract or a health
insurance policy that covers prescription drug benefits to provide
specified coverage to subscribers, enrollees, and insureds. 

   This bill would prohibit a health care service plan or a health
insurer covering prescription drug benefits from requiring prior
authorization criteria that requires the trial and failure of more
than 2 formulary alternatives for pain treatment in advance of
providing access to the prescribed drug, or requiring an enrollee or
insured to try and fail on pain medication supported only by an
off-label indication before providing access to a pain medication
supported by an FDA-approved indication. The bill would specify that
these provisions do not apply to a health benefit plan, health care
service plan contract, or health insurance policy with or purchased
by the Board of Administration of the Public Employees' Retirement
System.  
   Because a willful violation of the bill's requirements with
respect to health care service plans would be a crime, it would
impose a state-mandated local program.  
   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.  
   Existing law provides that the right to dispense, sell, or furnish
prescription lenses at retail to the person named in a prescription
is limited to physicians and surgeons, optometrists, and registered
dispensing opticians. Existing law provides for the regulation of
dispensing opticians by the Medical Board of California, and requires
a person engaging in the business of a dispensing optician to be
registered with the board.  
   This bill would require a person engaging in the business of a
dispensing optician to be registered biennially with the Medical
Board of California. The bill would also authorize a dispensing
optician, upon registration, to provide a mailing address to the
board that is different from the address of the optician's place of
business, and, if provided, would require the board to send all
further application and renewal materials to that address. 

   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program:  no   yes  .


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 1367.225 is added to the 
 Health and Safety Code   , to read:  
   1367.225.  (a) A health care service plan that covers prescription
drug benefits shall not do either of the following:
   (1) Require prior authorization criteria that requires the trial
and failure of more than two formulary alternatives for pain
treatment in advance of providing the enrollee with access to a
prescribed drug. Each treatment alternative shall last no longer than
seven days.
   (2) Require an enrollee to try and fail on pain medication
supported only by an off-label indication before providing access to
a pain medication supported by an FDA-approved indication.
   (b) This section shall not apply to a health benefit plan or
health care service plan contract entered into with the Board of
Administration of the Public Employees' Retirement System pursuant to
the Public Employees' Medical and Hospital Care Act (Part 5
(commencing with Section 22750) of Division 5 of Title 2 of the
Government Code). 
   SEC. 2.    Section 10123.197 is added to the 
 Insurance Code   , to read:  
   10123.197.  (a) A health insurer that covers prescription drug
benefits shall not do any of the following:
   (1) Require prior authorization criteria that requires the trial
and failure of more than two formulary alternatives for pain
treatment in advance of providing the insured with access to or
coverage for a prescribed drug. Each treatment alternative shall last
no longer than seven days.
   (2) Require an insured to try and fail on pain medication
supported only by an off-label indication before providing access to
a pain medication supported by an FDA-approved indication.
   (b) This section shall not apply to a health benefit plan or
policy of health insurance purchased by the Board of Administration
of the Public Employees' Retirement System pursuant to the Public
Employees' Medical and Hospital Care Act (Part 5 (commencing with
Section 22750) of Division 5 of Title 2 of the Government Code).

   SEC. 3.    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.  
  SECTION 1.    Section 2550 of the Business and
Professions Code is amended to read:
   2550.  Individuals, corporations, and firms engaged in the
business of filling prescriptions of physicians and surgeons licensed
by the Medical Board of California or optometrists licensed by the
State Board of Optometry for prescription lenses and kindred
products, and, as incidental to the filling of those prescriptions,
doing any or all of the following acts, either singly or in
combination with others, taking facial measurements, fitting and
adjusting those lenses and fitting and adjusting spectacle frames,
shall be known as dispensing opticians and shall not engage in that
business unless biennially registered with the Medical Board of
California.  
  SEC. 2.    Section 2551 of the Business and
Professions Code is amended to read:
   2551.  Individuals, corporations, and firms shall make application
for registration and shall not engage in that business prior to
being issued a certificate of registration. Application for that
registration shall be on forms prescribed by the board, shall bear
the signature of the individual, or general partners if a
partnership, or the president or secretary if a corporation, and
shall contain the name under which he or she, they, or it proposes to
do business and the business address. Separate applications shall be
made for each place of business and each application must be
accompanied by the application fee prescribed by Section 2565.An
individual, corporation, or firm may provide an address to the board
at which to receive application and renewal materials that is
different from the address provided for the place of business. If
provided, the board shall send all further application and renewal
materials to that address.