BILL NUMBER: AB 2389	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MAY 20, 2010
	AMENDED IN ASSEMBLY  APRIL 8, 2010

INTRODUCED BY   Assembly Member Gaines

                        FEBRUARY 19, 2010

   An act to add Section 1367.49 to the Health and Safety Code, and
to add Section 10133.64 to the Insurance Code, relating to health
care coverage.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 2389, as amended, Gaines. Health care coverage: provider
contracts.
   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. Existing law also
provides for the regulation of health insurers by the Department of
Insurance. Existing law prohibits a contract between a plan or
insurer and a health care provider from containing certain terms.
   This bill would prohibit a contract  between 
 by or on behalf of  a plan or insurer and a  health
care facility   licensed hospital, as defined, or any
other licensed health care   facility, as defined, owned by
a licensed hospital  to provide inpatient hospital services or
ambulatory care services to subscribers and enrollees of the plan or
policyholders and insureds of the insurer from containing a provision
that restricts the ability of the plan or insurer to furnish
information to subscribers or enrollees of the plan or policyholders
or insureds of the insurer concerning the cost of procedures at the
 hospital or licensed health care  facility or the quality
of services  provided   performed  by the
 hospital or  facility. The bill would make a contractural
provision inconsistent with this requirement void and unenforceable.

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


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

  SECTION 1.  Section 1367.49 is added to the Health and Safety Code,
to read:
   1367.49.  (a) A contract issued, amended, renewed, or delivered on
or after January 1, 2011,  between   by or on
behalf of  a health care service plan and a  health care
facility   licensed hospital or any other licensed
health care facility owned by a licensed hospital  to provide
inpatient hospital services or ambulatory care services to
subscribers and enrollees of the plan shall not contain any provision
that restricts the ability of the health care service plan to
furnish information to subscribers or enrollees of the plan
concerning the cost of procedures at the  hospital or the
licensed health care  facility or the quality of services
 provided   performed  by the  hospital
or  facility.
   (b) Any contractural provision inconsistent with this section
shall be void and unenforceable. 
   (c) For purposes of this section, the following definitions apply:
 
   (1) "Licensed hospital" has the same meaning as set forth in
Section 4028 of the Business and Professions Code.  
   (2) "Licensed health care facility" means any institution or
health facility, other than a long-term health care facility as
defined pursuant to Section 1418, licensed by the State Department of
Public Health to deliver or furnish health care services. 

   (c) 
    (d)  Section 1390 shall not apply for purposes of this
section.
  SEC. 2.  Section 10133.64 is added to the Insurance Code, to read:
   10133.64.  (a) A contract issued, amended, renewed, or delivered
on or after January 1, 2011,  between   by or on
behalf of  a health insurer and a  health care facility
  licensed hospital or any other licensed health care
facility owned by a licensed hospital  to provide inpatient
hospital services or ambulatory care services to policyholders and
insureds of the insurer shall not contain any provision that
restricts the ability of the health insurer to furnish information to
policyholders or insureds concerning the cost of procedures at the
 hospital or the licensed health care  facility or the
quality of services provided by the  hospital or  facility.
   (b) Any contractural provision inconsistent with this section
shall be void and unenforceable. 
   (c) For purposes of this section, the following definitions apply:
 
   (1) "Licensed hospital" has the same meaning as set forth in
Section 4028 of the Business and Professions Code.  
   (2) "Licensed health care facility" means any institution or
health facility, other than a long-term health care facility as
defined pursuant to Section 1418 of the Health and Safety Code,
licensed by the State Department of Public Health to deliver or
furnish health care services.