BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                  SB 1283|
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                                 THIRD READING


          Bill No:  SB 1283
          Author:   Steinberg (D)
          Amended:  5/28/10
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  5-0, 4/21/10
          AYES:  Alquist, Leno, Negrete McLeod, Pavley, Romero
          NO VOTE RECORDED:  Strickland, Aanestad, Cedillo, Cox

           SENATE APPROPRIATIONS COMMITTEE  :  7-3, 5/27/10
          AYES:  Kehoe, Alquist, Corbett, Leno, Price, Wolk, Yee
          NOES:  Denham, Walters, Wyland
          NO VOTE RECORDED:  Cox


           SUBJECT  :    Health care coverage:  grievance system

          SOURCE  :     Author


           DIGEST  :    This bill deletes the authority of the Director  
          of the Department of Managed Health Care (DMHC) to  
          determine that additional time is necessary to review a  
          grievance.  This bill requires DMHC to send written notice  
          to the enrollee or subscriber of the final disposition of  
          the grievance within 30 days of receipt of all relevant  
          information.

           ANALYSIS  :    The Knox-Keene Health Care Service Plan Act of  
          1975 (Knox-Keene Act) regulates the licensure of health  
          care service plans (health plan), and DMHC oversees  
          compliance by health plans with state law.  Existing law  
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          also requires all health plans to establish and maintain a  
          grievance process, approved by DMHC, under which enrollees  
          and subscribers may submit their grievances to the plan.   
          An enrollee or subscriber, who has either (1) completed  
          his/her plan's grievance process, or (2) participated in  
          the plan's grievance process for a minimum of 30 days, is  
          authorized under existing law to submit his/her grievance  
          to DMHC for review.  Existing law also allows providers to  
          assist their patients in the filing of grievances with  
          DMHC.  Upon receiving a request to review a grievance,  
          existing law requires DMHC to send a written notice of the  
          final disposition of the grievance to the enrollee or  
          subscriber within 30 days, unless the Director of DMHC,  
          using his/her discretion, determines that additional time  
          is reasonably needed to complete the review.

          This bill deletes the authority of the Director of DMHC to  
          determine that additional time is necessary to review a  
          grievance.  This bill requires DMHC to send written notice  
          to the enrollee or subscriber of the final disposition of  
          the grievance within 30 days of receipt of the request for  
          review unless the Director, in his/her discretion,  
          determines that additional time is reasonably necessary to  
          fully and fairly evaluate the relevant grievance.  If the  
          Director determines that additional time is necessary to  
          evaluate a grievance and make a determination, DMHC shall  
          do all of the following:

          1. Make a determination, within 30 calendar days of receipt  
             of the request for review, as to what additional  
             information is necessary for DMHC to complete its review  
             of the grievance and make a determination.

          2. Notify the subscriber or the enrollee in writing, within  
             30 calendar days of receipt of the request for review,  
             of the additional information that DMHC has identified  
             for it to complete the grievance review and to make a  
             determination.

          3. Upon receipt of all information that constitutes a  
             completed application, notify the subscriber or the  
             enrollee, in writing within five business days, of the  
             date the application was completed.








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          4. Make a determination of the final disposition of the  
             grievance, and the reasons therefor, within 30 calendar  
             days of having established a completed application.

          5. Notify the subscriber or enrollee of the decision in  
             writing within five business days of the final  
             disposition of the grievance.

          This bill requires DMHC to specify the necessary  
          information on its Internet Web site and on each  
          application used for filing a grievance with DMHC.

          Existing law requires the Director to make and file  
          annually with DMHC as a public record an aggregate summary  
          of grievances against plans filed with DMHC, as specified.

          This bill outlines a timeline for DMHC to complete the  
          grievance process for complaints that exceed 30 days  
          instead of the bill's current provisions that would provide  
          that DMHC would need to complete the complaint process in  
          30 days once all relevant information was submitted to  
          DMHC.

          This bill states that the Director shall also include in  
          the report a review of the grievances not resolved within  
          30 days and shall report on the number, proportion by type  
          and medical condition, and causes of the grievances, as  
          well as the reasons for the failure to resolve any  
          grievance pending for more than 30 days.

          This bill states that the grievance resolution plan shall  
          include in a quarterly report data regarding the timeframes  
          for grievance resolution.  This data shall include, but is  
          not limited to, the average number of days before a  
          grievance is closed, a breakdown of the number of cases  
          resolved in less than 30 days and in more than 30 days, and  
          for grievances not resolved within 30 days, the number,  
          proportion by type and medical condition, and causes of the  
          grievances, as well as the reasons for the failure to  
          resolve any grievance pending for more than 30 days.

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








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          According to the Senate Appropriations Committee:

                           Fiscal Impact (in thousands)

             Major Provisions                2010-11     2011-12        
             2012-13               Fund  

            DMHC regulations              $38-$76   $75-$152      
            ongoing minor       Special*

            * Managed Care Fund

           SUPPORT  :   (Verified  5/27/10)

          Alliance of California Autism Organization
          Association of Regional Center Agencies
          PTA
          Special Education Local Plan Area Administrators


          CTW:mw  5/28/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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