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
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|Ayes:|Monning, Ammiano, Carter, |
| | |
| |De La Torre, De Leon, |
| |Eng, Hayashi, Hernandez, |
| |Bonnie Lowenthal, Nava, |
| |V. Manuel Perez, Salas |
| | |
|-----+--------------------------|
|Nays:|Conway, Gaines |
| | |
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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.
SB 220
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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
SB 220
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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
FN: 0006775