BILL NUMBER: SB 296	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Lowenthal

                        FEBRUARY 25, 2009

   An act to add Sections 1367.27, 1367.28, and 1367.29 to the Health
and Safety Code, relating to health care coverage.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 296, as introduced, Lowenthal. Mental health services.
   Existing law provides for licensing and regulation of health care
service plans by the Department of Managed Health Care. A willful
violation of provisions governing health care service plans is a
crime. Existing law imposes certain requirements on health care
service plans and specialized health care service plans that provide
coverage for professional mental health services.
   This bill would require every health care service plan, including
a specialized health care service plan, that offers professional
mental health services to direct those services to be provided in a
manner that ensures coordination of benefits between all mental
health care providers and general physical health care providers. The
bill would require these plans to establish an Internet Web site
conforming to minimum standards and guidelines established by the
department by an unspecified date, and to issue a benefits card to
enrollees with specified information.
   By imposing new requirements on certain health care service plans,
the willful violation of which would be a crime, the bill would
impose a state-mandated local program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


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

  SECTION 1.  Section 1367.27 is added to the Health and Safety Code,
to read:
   1367.27.  (a) The Legislature finds and declares that coordination
of care between mental health care providers and general physical
health care providers is necessary to optimize the overall health of
a patient.
   (b) Every health care service plan that offers professional mental
health services, including a specialized health care service plan
that offers those services, shall direct those services to be
provided in a manner that ensures coordination of benefits between
mental health care providers and general physical health care
providers.
  SEC. 2.  Section 1367.28 is added to the Health and Safety Code, to
read:
   1367.28.  (a) On or before January 1, ____, every health care
service plan that offers professional mental health services,
including a specialized health care service plan that offers those
services, shall establish a plan Internet Web site. The purpose of
the plan Internet Web site shall be to provide consumer, patient, and
provider access to plan procedures, policies, and network provider
information.
   (b) Each Internet Web site shall, at a minimum, include the plan's
policies and procedures identified in Sections 1363, 1363.5,
1367.01, 1367.23, 1367.26, 1368.015, 1371, 1371.8, 1373.95, 1374.30,
and 1380.
   (c) The material described in subdivision (b) shall be updated at
least every month.
   (d) On or before January 1, ____, the department shall establish
minimum standards and guidelines for plan Internet Web sites, after
consultation with stakeholder groups, including, but not limited to,
individual, group, and institutional providers and consumer
protection groups. The minimum standards shall be implemented by
plans on or before January 1, ____.
   (e) The department shall include on the department's Internet Web
site a link to each plan Internet Web site.
  SEC. 3.  Section 1367.29 is added to the Health and Safety Code, to
read:
   1367.29.  (a) Every health care service plan that offers
professional mental health services, including a specialized health
care service plan that offers those services, shall issue a benefits
card to each enrollee for assistance with mental health benefits
coverage information, in-network provider access information, and
claims processing purposes. The benefits card, at a minimum, shall
include all of the following information:
   (1) The name of the benefit administrator or health care service
plan issuing the card, which shall be displayed on the front side of
the card.
   (2) The enrollee's identification number, or the subscriber's
identification number when the enrollee is a dependent who accesses
services using the subscriber's identification number. The number
shall be displayed on the front side of the card.
   (3) A telephone number that enrollees may call 24 hours a day,
seven days a week, for assistance regarding health benefits coverage
information, in-network provider access information, and claims
processing.
   (4) A brief statement indicating that enrollees may call the
telephone number for assistance regarding mental health services and
coverage.
   (5) Preauthorization restrictions or requirements.
   (6) Information required by the benefits administrator or health
care service plan that is necessary to commence processing a claim,
except as otherwise provided in subdivision (b).
   (b) A health care service plan shall not print any of the
following information on the benefits card:
   (1) Any information that may result in fraudulent use of the card.

   (2) Any information that is otherwise prohibited from being
included on the card.
   (c) On and after July 1, ___, the benefits card required by this
section shall be issued by a health care service plan or a
specialized health care service plan to an enrollee upon enrollment
or upon any change in the enrollee's coverage that impacts the data
content or format of the card.
   (d) Nothing in this section requires a health care service plan to
issue a separate benefits card for mental health coverage if the
plan issues a card for health care coverage in general and the card
provides the information required by this section.
   (e) If a specialized health care service plan delegates
responsibility for issuing the benefits card to a contractor or
agent, then the contract between the plan and its contractor or agent
shall require compliance with this section.
  SEC. 4.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.