BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 220
                                                                  Page  1


          SENATE THIRD READING
          SB 220 (Yee)
          As Amended August 24, 2010
          Majority vote 

           SENATE VOTE  :21-15  
           
           HEALTH              12-2                                        
           
           -------------------------------- 
          |Ayes:|Monning, Ammiano, Carter, |
          |     |                          |
          |     |De La Torre, De Leon,     |
          |     |Eng, Hayashi, Hernandez,  |
          |     |Bonnie Lowenthal, Nava,   |
          |     |V. Manuel Perez, Salas    |
          |     |                          |
          |-----+--------------------------|
          |Nays:|Conway, Gaines            |
          |     |                          |
           -------------------------------- 
           SUMMARY  :   Requires a health care service plan (health plan)  
          contract or health insurance policy issued, amended, renewed or  
          delivered after January 1, 2011, to cover specified tobacco  
          cessation treatments, requests the California Health Benefits  
          Review Program (CHBRP) to prepare an analysis of the cost  
          savings as a result of the provisions of this bill and states  
          that this bill shall become inoperative on the date the American  
          Health Benefit Exchange (Exchange), as defined, determines that  
          the requirements of this bill will result in additional costs to  
          the state.  Specifically,  this bill  :   

          1)Makes specified findings and declarations regarding the costs  
            of tobacco use in California and the benefits of tobacco  
            cessation services.  

          2)Requires group or individual health plan contracts and health  
            insurance policies that are issued, amended, renewed, or  
            delivered on or after September 23, 2010, to comply with  
            specified requirements related to preventative health of the  
            federal Patient Protection and Affordable Care Act of 2010  
            (PPACA) (Public Law 111-148) and any subsequent rules or  
            regulations issued pursuant to those requirements. 









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          3)Requires a health plan contract or health insurance policy  
            issued, amended, renewed, or delivered on or after January 1,  
            2011, to cover a minimum of two courses of treatment in a  
            12-month period for all smoking cessation treatments rated "A"  
            or "B" by the United States Preventive Services Task Force,  
            which shall include counseling and over-the-counter medication  
            and prescription pharmacotherapy approved by the federal Food  
            and Drug and Administration (FDA).  

          4)States that coverage provided pursuant to this bill shall only  
            be available upon the order of an authorized provider and that  
            nothing in this bill shall preclude a health plan from  
            allowing enrollees to access tobacco cessation services on a  
            self-referral basis. 

          5)For purposes of this bill, states that "course of treatment"  
            shall be defined to consist of the following:

             a)   As applied to "counseling," at least four sessions of  
               counseling, which may be telephone, group, or individual  
               counseling with each session lasting at least 10 minutes;  
               and, 

             b)   As applied to "prescription" or "over-the-counter"  
               medication, the duration of treatment approved by the FDA  
               for that medication.

          6)States that enrollees shall not be required to enter  
            counseling in order to receive tobacco cessation medications  
            after the patient's first course of treatment.

          7)Prohibits a health plan contract or health insurance policy  
            from imposing prior authorization or stepped-care requirements  
            on tobacco cessation treatments after the patient's first  
            course of treatment. 

          8)States that this bill shall not apply to Medicare supplement  
            plan contracts or to specialized health plan contracts.  

          9)Requests that the University of California, as part of CHBRP  
            prepare a report by December 31, 2013, evaluating the  
            requirements of this bill to determine any state savings as a  
            result of the requirements and requests that the report be  
            made available to the Legislature and to the Department of  








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            Insurance and the Department of Managed Health Care.

          10)States that this bill shall become inoperative on the date  
            that the state determines that, taking into account any state  
            savings identified in 9) above, the requirements of this bill  
            will result in the state assuming additional costs pursuant to  
            specified requirements of the PPACA.

           FISCAL EFFECT  :  This bill as amended has not been analyzed by an  
          Assembly fiscal committee.

           COMMENTS  :  According to the author, smoking remains one of the  
          most difficult public health issues facing California, with  
          nearly four million smokers in our state and 32,000 youth  
          becoming smokers each year.  Smoking costs California's economy  
          an estimated $18 billion in a year in the form of medical care,  
          lost productivity, and worker absenteeism.  Studies show that  
          people who use tobacco cessation treatment such as counseling,  
          over-the-counter and prescription medications are more likely to  
          quit and stay tobacco free for a longer period of time.   
          Additionally, people with full coverage for medications and  
          counseling services for tobacco cessation are more likely to use  
          tobacco cessation medication than those who do not have  
          coverage.  The author states this bill will address these  
          negative impacts by requiring health plans and health insurance  
          policies that provide outpatient prescription drug benefits to  
          include coverage for comprehensive tobacco cessation services.


           Analysis Prepared by  :    Martin Radosevich / HEALTH / (916)  
          319-2097 


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