BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1142
                                                                  Page  1

          Date of Hearing:   May 13, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                    AB 1142 (Price) - As Amended:  April 28, 2009 

          Policy Committee:                              Health Vote:13-4

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill increases Medi-Cal beneficiary protections against  
          inappropriate and illegal billing in hospital settings.  
          Specifically, this bill:

          1)Requires hospitals to provide proof of a person's Medi-Cal  
            eligibility to hospital-based providers, emergency medical  
            transportation providers, and other providers of professional  
            services including anesthesiologists, radiologists, and  
            pathologists.

          2)Requires Medi-Cal providers to ensure that if patient accounts  
            are sold to a third-party collection agency, these accounts  
            are recalled under specified circumstances.

          3)In addition to current law and regulatory penalties, this bill  
            establishes a provider fine that may be levied by the  
            Department of Health Care Services (DHCS) for up to three  
            times the amount a patient was billed if the provider bills a  
            patient or fails to pull an account back from a third-party  
            collection agency. 

          4)Prohibits a Medi-Cal provider or third-party collection agency  
            who receives proof of Medi-Cal coverage from reporting a  
            beneficiary to a consumer credit reporting agency or failing  
            to correct a negative credit report regarding the Medi-Cal  
            covered services rendered.  

           FISCAL EFFECT  

          1)No direct fiscal impact to DHCS to continue oversight of  
            Medi-Cal billing and the requirements and prohibitions  








                                                                  AB 1142
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            established by this bill. Current law and regulations prohibit  
            providers with proof of Medi-Cal eligibility from seeking  
            reimbursement from a patient or sending patient billing issues  
            to a third-party collections agency. In addition, current  
            regulations provide DHCS with broad authority to impose  
            administrative sanctions, provider reprimands, or placement of  
            a provider on probationary status. The requirements and  
            prohibitions on providers and DHCS are generally current law  
            and practice. 

          2)Unknown, likely absorbable workload to the California  
            Department of Consumer Affairs to continue oversight of  
            California's third-party collection agency business practices.  


           COMMENTS  

           1)Rationale  . This bill is a consumer protection measure  
            sponsored by the Western Center Law on & Poverty (WCLP) and is  
            supported by a variety of legal services and consumer advocacy  
            groups. This bill clarifies current law and practice to reduce  
            the frequency of providers billing Medi-Cal beneficiaries and  
            sending unpaid bills to third-party collection agencies. 
           
             The WCLP and the author indicate significant and long-term  
            consequences occur when Medi-Cal patients are billed for  
            thousands of dollars of medical services. Usually, the medical  
            care was eligible for reimbursement at the time of service or  
            the treatments are later eligible for Medi-Cal reimbursement  
            when a beneficiary becomes retroactively eligible for the  
            program. Hospitals indicate they generally comply with the  
            provider notification provisions in this bill. 

            This bill increases this compliance and provides patients and  
            advocates with recourse when accounts are sent to collections.  


           2)Impacts of Inappropriate Medi-Cal Billing  . The author, WCLP,  
            and other advocates in support of this bill indicate the  
            consequences of wrongly billing Medi-Cal patients can be  
            catastrophic, destroying low-income beneficiaries' credit  
            ratings, generating relentless contacts from credit agencies,  
            increasing stress, and exacerbating access problems when the  
            fear of being billed prevents beneficiaries from seeking  
            treatment. 








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          3)       Related Legislation  . AB 2285 (Chu) in 2004 contained  
            similar features as AB 1142. AB 2285 was vetoed due to  
            concerns about other provisions of AB 2285.   
           

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