BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                   AB 730|
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                                 THIRD READING


          Bill No:  AB 730
          Author:   De La Torre (D)
          Amended:  8/18/09 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  : 8-3, 7/8/09
          AYES:  Alquist, Cedillo, DeSaulnier, Leno, Maldonado,  
            Negrete McLeod, Pavley, Wolk
          NOES:  Strickland, Aanestad, Cox

           SENATE JUDICIARY COMMITTEE  :  3-2, 7/14/09
          AYES:  Corbett, Florez, Leno
          NOES:  Harman, Walters

           SENATE APPROPRIATIONS COMMITTEE  :  8-5, 8/24/09
          AYES:  Kehoe, Corbett, Hancock, Leno, Oropeza, Price, Wolk,  
            Yee
          NOES:  Cox, Denham, Runner, Walters, Wyland

           ASSEMBLY FLOOR  :  53-23, 5/28/09 - See last page for vote


           SUBJECT  :    Health insurance:  unlawful postclaims  
          underwriting of                                         
          policies:  penalties

           SOURCE  :     Department of Insurance


           DIGEST  :    This bill increases the maximum civil penalty  
          for health insurance post-claims underwriting from $118 per  
          violation to $5,000 per violation.  The bill also increases  
                                                           CONTINUED





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          that amount to $10,000 for each act of post-claims  
          underwriting that the insurer knew was unlawful.

           ANALYSIS  :    Existing law prohibits health care service  
          plans and health insurers from engaging in "post-claims  
          underwriting," which is defined as rescinding, canceling,  
          or limiting a plan contract due to a plan or insurer's  
          failure to complete medical underwriting and to resolve all  
          reasonable questions arising from written information  
          submitted on or with an application before issuing the plan  
          contract or insurance policy.

          Existing law authorizes the Department of Insurance to  
          impose civil penalties of up to $118 for each violation of  
          the standard provisions of insurance policies, including  
          incidences of post-claims underwriting. 

          Existing law establishes civil penalties of up to $2,500  
          per violation for any person who violates any provision of  
          the Knox-Keene Health Care Service Plan Act of 1975, the  
          law that regulates health care service plans, as well as  
          criminal penalties, including a fine of up to $10,000, upon  
          conviction for willful violations.

          This bill increases the civil penalty on a health insurer  
          for each act of post-claims underwriting from $118 to a  
          maximum of $5,000, and up to $10,000 for each act or  
          violation where the health insurer knew, or had reason to  
          know, that the act was unlawful.

          This bill provides that the first $118 of any penalties  
          collected pursuant to these provisions would be deposited  
          in the state's General Fund, as under current law, and that  
          the balance of the penalties would be deposited in the  
          Major Risk Medical Insurance Fund to support the Major Risk  
          Medical Insurance Program (MRMIP), which provides health  
          care coverage for otherwise uninsurable Californians, as  
          defined.

          This bill requires that the civil penalties and  
          disciplinary actions provided for by these provisions be  
          determined at a hearing conducted in accordance with the  
          Administrative Procedure Act.








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           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions                2009-10     2010-11     
           2011-12   Fund  
          Penalties revenue                                 unknown,  
          but potentially hundreds                          Special/*
                              of thousands of dollars       General

          *The first $118 of each penalty would go to the General  
          Fund; the balance would go to the Major Risk Medical  
          Insurance Fund

          Costs to the Department of Insurance to continue to assess  
          penalties for post-claims underwriting in accordance with  
          these provisions would be minor and absorbable.  To the  
          extent that insurers practice post-claims underwriting and  
          the Department collects penalties, there would be unknown,  
          increased revenue for the Major Risk Medical Insurance  
          Fund. 

           SUPPORT  :   (Verified  8/25/09)

          Department of Insurance (source) 
          AIDS Healthcare Foundation
          California Association of Marriage and Family Therapists
          California Medical Association
          California Psychological Association
          Latino Coalition for a Healthy California
          Professional Fiduciary Association


           ARGUMENTS IN SUPPORT  :    According to the Department of  
          Insurance, $5,000 for each violation of post-claims  
          underriting and $10,000 for willful violations, established  
          in this bill, are at the standard level for the  
          Department's major fines and will make it clear that  
          illegal rescission of health insurance is an especially  
          noteworthy violation of law.  The California Medical  
          Association supports parity between the two oversight  







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          agencies regulating health care with regard to these  
          penalties.  The California Association of Marriage and  
          Family Therapists (CAMFT) states that rescission of an  
          insurer contract generally occurs after expensive claims  
          have been submitted by the patient, prompting insurers to  
          comb through a patient's original application file to  
          discover any discrepancy within the application, no matter  
          how minute.  CAMFT states that when insurers rescind  
          coverage, patients are left with exorbitant medical costs.   
          CAMFT believes that the measure will protect consumers from  
          these post-claims underwriting practices by increasing the  
          penalty for such unlawful practices.



           ASSEMBLY FLOOR  : 
          AYES:  Ammiano, Arambula, Beall, Block, Blumenfield,  
            Brownley, Buchanan, Caballero, Charles Calderon, Carter,  
            Chesbro, Coto, Davis, De La Torre, De Leon, Eng, Evans,  
            Feuer, Fong, Fuentes, Furutani, Galgiani, Hall, Hayashi,  
            Hernandez, Hill, Huber, Huffman, Jones, Krekorian, Lieu,  
            Logue, Bonnie Lowenthal, Ma, Mendoza, Monning, Nava, John  
            A. Perez, V. Manuel Perez, Portantino, Price, Ruskin,  
            Salas, Saldana, Skinner, Solorio, Swanson, Torlakson,  
            Torres, Torrico, Tran, Yamada, Bass
          NOES:  Adams, Anderson, Bill Berryhill, Tom Berryhill,  
            Blakeslee, Conway, Cook, DeVore, Fletcher, Fuller,  
            Gaines, Garrick, Gilmore, Hagman, Harkey, Jeffries,  
            Knight, Miller, Niello, Nielsen, Silva, Smyth, Villines
          NO VOTE RECORDED:  Duvall, Emmerson, Nestande, Audra  
            Strickland


          RJG:nl  8/26/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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