BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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                              UNFINISHED BUSINESS


          Bill No:  SB 296
          Author:   Lowenthal (D)
          Amended:  8/17/09
          Vote:     21

           
           SENATE HEALTH COMMITTEE  : 10-1, 04/22/09
          AYES:  Alquist, Aanestad, Cedillo, Cox, DeSaulnier, Leno,  
            Maldonado, Negrete McLeod, Pavley, Wolk
          NOES:  Strickland

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           SENATE FLOOR  :  25-12, 5/14/09
          AYES:  Aanestad, Alquist, Calderon, Corbett, Correa, Cox,  
            DeSaulnier, Florez, Hancock, Kehoe, Leno, Liu, Lowenthal,  
            Maldonado, Negrete McLeod, Oropeza, Padilla, Pavley,  
            Romero, Simitian, Steinberg, Wiggins, Wolk, Wright, Yee
          NOES:  Ashburn, Benoit, Cogdill, Denham, Dutton, Harman,  
            Hollingsworth, Huff, Runner, Strickland, Walters, Wyland
          NO VOTE RECORDED:  Cedillo, Ducheny, Vacancy

           ASSEMBLY FLOOR  :  74-0, 8/27/09 - See last page for vote


           SUBJECT  :    Mental health services

           SOURCE  :     California Psychiatric Association 
                      California Society for Clinical Social Work


           DIGEST  :    This bill requires health care service plans and  
          health insurers that provide professional mental health  
                                                           CONTINUED





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          services to issue identification cards to all enrollees and  
          insured containing specified information by July 1, 2011,  
          and provide specified information relating to their  
          policies and procedures on their Internet web sites by  
          January 1, 2012.

           Assembly Amendments revise and recast the bill with a  
          similar intent as it left the Senate.

           ANALYSIS  :    

           Existing Law

           1.Provides for the regulation of health care service plans  
            (health plans) by the Department of Managed Health Care  
            (DMHC) and regulation of disability insurers who sell  
            health insurance (health insurers) by the Department of  
            Insurance (DOI).

          2.Requires full service health plans licensed by DMHC to  
            provide basic health care services, as defined.

          3.Requires health care service plans and health insurers to  
            comply with certain administrative requirements, premium  
            requirements, patient protection requirements, fiduciary  
            and financial requirements, provider access requirements,  
            and to provide certain mandated benefits to enrollees.

          4.Requires health plans and health insurers to provide  
            coverage for the diagnosis and medically necessary  
            treatment of certain severe mental illnesses, as defined,  
            and of serious emotional disturbances of a child, as  
            defined, under the same terms and conditions applied to  
            other medical conditions.

          5.Requires web sites of health plans that provide coverage  
            for professional mental health services to include, but  
            not be limited to, providing information for subscribers,  
            enrollees, and providers on accessing mental health  
            services.

          This bill:

           1.Requires, on or before July 1, 2011, every health plan,  







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             including a specialized health plan, and health insurer  
             that provides coverage for professional mental health  
             services to issue an identification card to each  
             enrollee and insured to assist the enrollee or insured  
             with accessing health benefits coverage information,  
             including, but not limited to, in-network provider  
             access information, and claims processing information.

           2.Specifies that the identification card must at least  
             include the following:

             A.    The name of the health plan or health insurer  
                issuing the card.

             B.    The enrollee's or insured's identification number.

             C.    A telephone number that enrollees or insured may  
                call for assistance with health coverage information  
                described in #1 above, and when assessment services  
                are provided by the health care service plan, access  
                to assessment services for the purpose of referral to  
                an appropriate level of care or appropriate health  
                provider.

             D.    The health plan's or health insurers Internet web  
                site address.

           3.Requires the identification card required by this bill  
             to be issued by a health plan, a specialized health  
             plan, or health insurer to an enrollee upon enrollment  
             or insured upon commencement of coverage or upon any  
             change in the enrollee's or insured's coverage that  
             impacts the data content or format of the card.

           4.Specifies the term "identification card" includes other  
             technology that performs substantially the same function  
             as an identification card.

           5.Specifies that nothing in this bill requires a health  
             plan or health insurer to issue a separate  
             identification card for professional mental health  
             services coverage if a card for health care coverage in  
             general is already issued and the card complies with the  
             information required by this bill.







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           6.Directs the contractor or agent that is delegated by a  
             health plan, specialized health plan, or health insurer  
             to issue the identification card required by this bill  
             to comply with the requirements of this bill.

           7.Specifies that this bill does not apply to Medicare  
             supplement, Employee Assistance Programs, short-term  
             limited duration health insurance, Civilian health and  
             Medical Program of the Uniformed Services  
             (CHAMPUS)-supplement insurance, TRI-CARE supplement, or  
             to hospital indemnity, accident-only, and specified  
             disease insurance, as well as specialized health care  
             service plans, except behavioral health-only plans.

           8.Specifies that this bill does not apply to a behavioral  
             health-only plan that provides coverage for professional  
             mental health services pursuant to a contract with a  
             health care service plan or insurer if that plan or  
             insurer issues an identification card to its subscribers  
             or insureds.

           9.Clarifies that nothing in this bill be construed to  
             prohibit a health plan, specialized health plan, or  
             health insurer from meeting the standards of the  
             Workgroup for Electronic Data Interchange (WEDI) or  
             other national uniform standards with respect to  
             identification cards, as long as the minimum  
             requirements in this bill have been met.

          10.Requires, on or before January 1, 2012, every health  
             plan and health insurer, including a specialized health  
             plan, that covers professional mental health services,  
             to disclose on its Internet web site, or provide a link  
             to, the following information:

             A.    A telephone number that the enrollee or provider  
                can call, during normal business hours, for  
                assistance obtaining mental health benefits coverage  
                information, including the extent to which benefits  
                have been exhausted, in-network provider access  
                information, and claims processing information.

             B.    A link to prescription drug formularies, as  







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                specified.

             C.    A detailed summary describing the process by which  
                the plan reviews and authorizes or approves,  
                modifies, or denies requests for health care  
                services, as specified.

             D.    Lists of in-network providers.

             E.    A detailed summary of the enrollee grievance  
                process required under existing law.

             F.    A detailed summary of how an enrollee may request  
                continuity of care, as specified.

             G.    Information concerning the right, and applicable  
                procedure, of an enrollee to request an independent  
                medical review pursuant to existing law.

             H.    A link to the DMHC's final report on the plan's  
                periodic review, or to DOI's market conduct  
                examination, as specified.

             I.    Provider manual templates containing specified  
                information.

          11.Requires the material described in #10(I) above to be  
             updated within 30 days of any material change and an  
             electronic notification of materials changes to be  
             communicated to applicable contract providers  
             immediately.

          12.Requires the information prescribed in #10 above to be  
             updated at least quarterly, to be made available through  
             a secured Internet web site accessible only to  
             enrollees, and to be made available to enrollees in hard  
             copy upon request.

          13.Clarifies that nothing in this bill precludes a health  
             plan or health insurer from including additional  
             information on its Internet web site, as specified.

          14.Requires DMHC and DOI to include on their respective  
             Internet web sites a link to the Internet web site of  







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             each health plan, specialized health plan, or health  
             insurer.

          15.Requires, on or before January 1, 2012, every health  
             insurer that covers professional mental health services  
             to establish an Internet web site that must include  
             information similar to the Internet web site disclosures  
             required for every health plan that covers professional  
             mental health services in #10 above.

          16.Exempts from the provisions of this bill specialized  
             health insurance policies, except for behavioral  
             health-only policies, Medicare supplement, short-term  
             limited duration health insurance, vision-only,  
             CHAMPUS-supplement insurance, TRI-CARE supplement, or  
             hospital indemnity, accident-only, and specified disease  
             insurance. 

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes

           SUPPORT  :   (Verified  8/27/09)

          California Psychiatric Association (co-source)
          California Society for Clinical Social Work (co-source)
          Board of Behavioral Sciences
          California Association of Marriage and Family Therapists
          California Psychological Association
          NAMI California
          National Association of Social Workers, California Chapter


           ARGUMENTS IN SUPPORT  :    The California Psychiatric  
          Association (CPA), the sponsor of this bill, states that  
          the changes suggested by this bill can be valuable to the  
          patient and increase their access to information and  
          services.  CPA argues that requiring a specific number on a  
          benefits card related to mental health services can help  
          avoid situations in which the complexity of phone trees and  
          call transfers between different corporate entities cause  
          consumers to simply hang up and forego access to  
          information and/or services.









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           ASSEMBLY FLOOR  : 
          AYES:  Adams, Ammiano, Anderson, Arambula, Beall, Bill  
            Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,  
            Brownley, Buchanan, Caballero, Charles Calderon, Carter,  
            Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,  
            DeVore, Duvall, Emmerson, Eng, Feuer, Fletcher, Fong,  
            Fuller, Furutani, Gaines, Galgiani, Garrick, Gilmore,  
            Hagman, Harkey, Hayashi, Hernandez, Hill, Huber, Huffman,  
            Jeffries, Jones, Knight, Krekorian, Lieu, Logue, Bonnie  
            Lowenthal, Ma, Mendoza, Miller, Monning, Nava, Nestande,  
            Niello, Nielsen, John A. Perez, V. Manuel Perez,  
            Portantino, Ruskin, Salas, Silva, Skinner, Smyth,  
            Solorio, Audra Strickland, Swanson, Torlakson, Torres,  
            Torrico, Tran, Villines, Yamada
          NO VOTE RECORDED:  Evans, Fuentes, Hall, Saldana, Bass,  
            Vacancy


          JJA:cm  8/28/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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