BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 952|
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THIRD READING
Bill No: AB 952
Author: Krekorian (D)
Amended: 7/23/09 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 11-0, 7/8/09
AYES: Alquist, Strickland, Aanestad, Cedillo, Cox,
DeSaulnier, Leno, Maldonado, Negrete McLeod, Pavley, Wolk
SENATE JUDICIARY COMMITTEE : 5-0, 7/14/09
AYES: Corbett, Harman, Florez, Leno, Walters
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 76-0, 6/2/09 - See last page for vote
SUBJECT : Health information: disclosure: Taft-Hartley
plans
SOURCE : Pacific Federal Benefit Administrators
DIGEST : This bill permits a health care provider, health
care service plan, or contractor to disclose medical
information to an employee welfare benefit plan formed
under the federal Taft-Hartley Act if the disclosure meets
specified conditions, including that it is for the purpose
of determining eligibility, coordinating benefits, or to
allow the employee welfare benefit plan to advocate on
behalf of the patient or enrollee, as specified. The
request for information must be accompanied by a written
CONTINUED
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authorization for release of the information from the
patient or other authorized person, and the disclosure must
be permitted by and made in a manner consistent with the
Health Insurance Portability and Accountability Act of 1996
(HIPAA). This bill also permits the disclosure of medical
information to an entity contracting with the employee
welfare benefit plan for services, as specified.
ANALYSIS : Existing law, the Confidentiality of Medical
Information Act (CMIA), prohibits a health care provider,
health care service plan, or contractor from disclosing
medical information regarding a patient, enrollee, or
subscriber without first obtaining an authorization, except
as specified. (Civ. Code Sec. 56.10(a).)
Existing law requires a provider of health care, health
care service plan, or contractor to disclose medical
information if the disclosure is compelled as specified
(Civ. Code Sec. 56.10(b)) and permits a provider of health
care or service plan to disclose medical information in
specified circumstances. (Civ. Code Sec. 56.10(c).)
Existing law prohibits a health insurer or health care
service plan from releasing any information that would
indicate to an employer that an employee is receiving or
has received services from a health care provider covered
by the plan, unless the employee authorizes the disclosure.
(Ins. Code Sec. 791.27, Health & Saf. Code Sec. 1374.8.)
Existing federal law prohibits, under HIPAA, covered
entities from using or disclosing protected health
information, except as specified. Existing federal law
defines "covered entities" to include health plans, health
care clearinghouses, and health care providers that
transmit any health information in electronic form.
Federal law also defines "health plan" to include a group
health plan, an employee welfare benefit plan, or any other
arrangement that is established or maintained for the
purpose of offering or providing health benefits, as
specified. (42 U.S.C. 1320d et seq., 45 C.F.R. 164.500 et
seq.)
This bill amends CMIA to permit a health care provider or a
health plan to disclose medical information to: (1) an
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employee welfare benefit plan, as defined under the federal
Employee Retirement Income Security Act of 1974 (ERISA),
which is formed under the federal Taft-Hartley Act, to the
extent the benefit plan provides medical care; and (2) an
entity contracting with the plan for billing, claims
management, medical data processing, or other
administrative services related to the provision of medical
care to persons enrolled in the plan for health care
coverage. In both cases, all of the following conditions
must be met:
1.The disclosure is for the purpose of determining
eligibility, coordinating of benefits, or allowing the
employee welfare benefit plan, or the contracting entity,
to advocate on behalf of a patient or enrollee with a
health care provider, a health care service plan, or a
state or federal regulatory agency.
2.The request for the information is accompanied by a
written authorization for the release of the information
as provided under CMIA which requires that the
authorization be submitted by the patient, the legal
representative of the patient (if the patient is a minor
or an incompetent), the spouse of the patient or the
person financially responsible for the patient under
specified circumstances, or the beneficiary or personal
representative of a deceased patient.
3.The disclosure is authorized by and made in a manner
consistent with HIPAA; and
4.Any information disclosed is not further used or
disclosed by the recipient in any way that would directly
or indirectly violate CMIA or the restrictions imposed by
federal HIPAA regulations, including the manipulation of
the information in any way that might reveal individually
identifiable medical information.
This bill specifies that Health and Safety Code Section
1374.8 would not apply to the bill's provisions. That
section prohibits a health care service plan from releasing
any information to an employer that would indicate to the
employer that an employee is receiving or has received
services from a health care provider covered by the plan
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unless the employee authorizes the disclosure.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 8/19/09)
Pacific Federal Benefit Administrators (source)
Building Material, Construction, Industrial, Professional
and Technical
California Association of Joint Powers Authorities
California Conference of Machinists
California Teamsters Public Affairs Council
International Alliance of Theatrical Stage Employees Local
80
International Longshore and Warehouse Union
International Union of Security, Police and Fire
Professionals of America and Participating Employers
Health & Welfare Fund
Legal Aid Foundation of Los Angeles County's
Liberty Dental Plan
Neighborhood Legal Services
Professional Musicians Local 47 Employers' Health and
Welfare Fund
Teamsters Local 36
Teamsters Local 572
Trustees of the Public Employees Benefit Trust
Trustees of the South Bay Teamsters and Employers Health
and Welfare and Related Benefits Trust
Trustees to the Union Heritage Trust
United Food & Commercial Workers Western States Council
UNITE-HERE!
Valley Industry and Commerce Association
Western Alliance Trust Fund
ARGUMENTS IN SUPPORT : According to the author's office:
In recently adopted federal regulations around HIPAA,
a problem has emerged with provisions that give
deference in the implementation of HIPAA to more
strict state law. As a result, a uniquely structured
class of health plans present in California (ERISA
Taft-Hartley Trusts regulated by the federal
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Department of Labor), is unduly burdened by a quirk in
state law.
Both HIPAA and CMIA allow appropriate Protected
Information to be shared with appropriate health plan
administrators in order to facilitate efficient and
proper administration of health benefits for
patients/consumers. If Protected Information is not
allowed to be shared with the Taft-Hartley Plan,
consistent with HIPAA and CMIA, the plan will not know
whether it is paying health care providers for the
appropriate benefits, for the right patients/consumers
and at the appropriate level of compensation.
The unfortunate quirk in California Law is that CMIA
does not recognize an ERISA DOL Taft-Hartley Health
Plan as a "Health" plan, and therefore health care
providers, in the absence of state law regarding
Taft-Hartley Plans, are imposing requirements for
sharing Protected Information that are even more
stringent than state law.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Tom
Berryhill, Blakeslee, Blumenfield, Brownley, Buchanan,
Caballero, Charles Calderon, Carter, Chesbro, Conway,
Cook, Coto, Davis, De La Torre, De Leon, DeVore, Duvall,
Emmerson, Eng, Evans, Feuer, Fletcher, Fong, Fuentes,
Fuller, Furutani, Gaines, Galgiani, Garrick, Gilmore,
Hagman, Harkey, Hayashi, Hernandez, Hill, Huber, Huffman,
Jeffries, Jones, Knight, Krekorian, Lieu, Logue, Bonnie
Lowenthal, Ma, Mendoza, Miller, Monning, Nava, Nestande,
Niello, Nielsen, John A. Perez, V. Manuel Perez,
Portantino, Price, Ruskin, Salas, Saldana, Silva,
Skinner, Smyth, Solorio, Audra Strickland, Swanson,
Torlakson, Torres, Torrico, Tran, Villines, Yamada
NO VOTE RECORDED: Bill Berryhill, Block, Hall, Bass
RJG:nl 8/19/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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