BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2389
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 2389 (Gaines)
          As Amended August 20, 2010
          Majority vote
           
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          |ASSEMBLY:  |61-0 |(May 28, 2010)  |SENATE: |29-6 |(August 30,    |
          |           |     |                |        |     |2010)          |
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           Original Committee Reference:    HEALTH  

           SUMMARY  :  Prohibits a contract between a health facility and a  
          health care service plan or health insurer (collectively  
          carriers) from containing a provision that restricts the ability  
          of the carrier to furnish information on the cost of procedures  
          or health care quality information to carrier enrollees.  

           The Senate amendments  :

          1)Clarify that the cost information provided to carrier  
            enrollees by a carrier is limited to the range of elective,  
            uncomplicated procedures performed on patients without  
            malignancy or comorbidity, with a length of stay consistent  
            with the diagnosis-related group assignment.

          2)Clarify that the quality information provided to carrier  
            enrollees by a carrier be based on consensus-based, or  
            nationally recognized evidence-based, clinical recommendations  
            or guidelines.

          3)Require that the information and data used as the basis for  
            the quality information provided to carrier enrollees be  
            updated regularly and no less than annually.

          4)Require a carrier, prior to furnishing cost and quality  
            information to its enrollees, to provide to a health facility  
            being evaluated a summary of the criteria and methodology used  
            in the development and evaluation of cost range and quality  
            measurements.  Require the summary to be sufficiently detailed  
            and reasonably understandable to allow the facility to verify  
            the data against its own records. 

          5)Clarify that a health facility has the right to provide  
            supplemental information to the carrier if the facility finds  








                                                                  AB 2389
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            discrepancies in the data or cost range criteria used by the  
            carrier.

          6)Require a carrier to provide notice of, and an annual update  
            of, information furnished to carrier enrollees on the cost  
            range of procedures at a health facility.  Permit a carrier to  
            satisfy this requirement by providing an electronic copy to  
            the facility or by providing the facility with access to the  
            carrier's cost information through Internet Web site or  
            electronic portal made available by the carrier.

          7)Make technical clarifying changes.

           EXISTING LAW  :  

          1)Establishes the Office of the Patient Advocate (OPA) within  
            DMHC, and requires the OPA to prepare and make available a  
            quality of care report card that includes a rating of health  
            care service plans.

          2)Requires hospitals to make a written or electronic copy of its  
            charge description master (a list of prices for services)  
            available, either by posting an electronic copy on the  
            hospital's Web site, or by making a written or electronic copy  
            available at the hospital.   

          3)Requires hospitals to submit their average charges for 25  
            common outpatient procedures, as specified, annually to Office  
            of Statewide Health Planning and Development (OSHPD) who is  
            required to publish this information on its Web site.   
            Requires OSHPD to publish and update on its Web site, a list  
            of the 25 inpatient procedures most commonly performed in  
            California hospitals, along with each hospital's average  
            charges for those procedures.  

          4)Requires OSHPD to publish risk-adjusted outcome reports for  
            medical, surgical, and obstetric conditions or procedures, as  
            specified.

          5)Requires hospitals, upon request, to provide to a person who  
            has no health coverage, a written estimate of the amount the  
            hospital will charge for the health care services, procedures,  
            and supplies that are reasonably expected to be provided to  
            the person by the hospital, as well as information about its  
            financial assistance and charity care policies, as specified.   








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           AS PASSED BY THE ASSEMBLY  , this bill was substantially similar  
          to the version passed by the Senate.

           FISCAL EFFECT :  None

           COMMENTS  :  According to the author, this bill will ensure  
          consumers have the quality and cost information that they need  
          to make purchasing decisions about health products and services.  
           While the majority of hospitals in this state already allow  
          this information to be shared, the author argues that some  
          hospitals are turning to "gag clauses" in contracts with  
          carriers that preclude carriers from sharing cost and quality  
          information about hospitals with their enrollees.  The author  
          maintains that consumers are increasingly being required to pay  
          more attention to the cost of their care when they have a  
          greater responsibility for paying for it due to deductibles and  
          other cost sharing arrangements, particularly for a preferred  
          provider organization (PPO) product where the consumer pays 20%  
          or more of their total health care bill.  The author asserts  
          that this bill will ensure that carriers are not restricted in  
          their ability to provide cost and quality information to their  
          members.


           Analysis Prepared by  :    Tanya Robinson-Taylor / HEALTH / (916)  
          319-2097                                               


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