BILL ANALYSIS �
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|SENATE RULES COMMITTEE | AB 137|
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THIRD READING
Bill No: AB 137
Author: Portantino (D)
Amended: 8/22/12 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 6/27/12
AYES: Hernandez, Harman, Alquist, Anderson, Blakeslee, De
Le�n, DeSaulnier, Rubio, Wolk
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 71-0, 1/26/12 - See last page for vote
SUBJECT : Health care coverage: mammographies
SOURCE : Author
DIGEST : This bill provides that individual or group
policies of health insurance shall be deemed to provide
coverage for mammographies for screening or diagnostic
purposes upon referral of a participating nurse
practitioner, participating certified nurse-midwife,
participating physician assistant, or participating
physician, as specified.
Senate Floor Amendments of 8/22/12 add participating
physician assistants to the list of providers allowed to
refer a patient for mammography for screening or diagnostic
purposes, and to clarify that specified insurance products
are exempt from the requirements of this bill.
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ANALYSIS : Under existing law, an individual or group
policy of disability insurance that is issued, amended,
delivered, or renewed on or after January 1, 2000, is
deemed to provide specified coverage based upon age for
mammography for screening or diagnostic purposes upon
referral by a participating nurse practitioner,
participating certified nurse-midwife, or participating
physician, providing care to the patient and operating
within the scope of practice provided under existing law.
This bill provides that individual or group policies of
health insurance shall be deemed to provide coverage for
mammographies for screening or diagnostic purposes upon
referral of a participating nurse practitioner,
participating certified nurse-midwife, participating
physician assistant, or participating physician, as
specified.
This bill allows participating physician assistants to the
list of providers allowed to refer a patient for
mammography for screening or diagnostic purposes, and
states that specified insurance products are exempt from
the requirements of this bill.
Background
Prevalence of breast cancer . According to the American
Cancer Society's "Breast Cancer Facts & Figures 2009-2010,"
excluding cancers of the skin, breast cancer is the most
common cancer among women; accounting for more than one in
four cancers diagnosed in U.S. women. It is the second
leading cause of death of women in California. According
to the California Breast Cancer Research Program, the
breast cancer death rate in California has dropped 20%
since 1973, but California women are more likely to get
breast cancer today than in 1973. While the death rate for
breast cancer has dropped, the gains have not been shared
equally among all women. Minority and low-income women are
less likely than other women to be diagnosed at an early
stage, receive effective treatment, and survive the
disease. California Health Benefits Review Program reports
that white women are most likely to get the disease,
followed closely by African American women, Asian Pacific
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Islander women, and Hispanic women. African American women
have the highest death rate despite being less likely than
white women to get the disease.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
SUPPORT : (Verified 8/22/12)
AFSCME, AFL-CIO
American Congress of Obstetricians and Gynecologists
District IX California
Association of Northern California Oncologists
California Commission on the Status of Women
California Communities United Institute
California Medical Association
California Nurse Midwives Association
Disability Rights Legal Center
Medical Oncology Association of Southern California
Planned Parenthood Affiliates of California
Planned Parenthood Mar Monte
Susan G. Komen for the Cure - Central Valley Affiliate
Susan G. Komen for the Cure - Inland Empire Affiliate
Susan G. Komen for the Cure - Los Angeles County Affiliate
Susan G. Komen for the Cure - Orange County Affiliate
Susan G. Komen for the Cure - Sacramento Valley Affiliate
Susan G. Komen for the Cure - San Diego Affiliate
Susan G. Komen for the Cure - San Francisco Bay Area
Affiliate
OPPOSITION : (Verified 8/22/12)
America's Health Insurance Plans (prior version)
ARGUMENTS IN SUPPORT : American Federation of State,
County and Municipal Employees writes in support that this
bill will require insurance companies to cover mammograms
for screening purposes for breast cancer. California Nurse
Midwives Association (CNMA) writes in support that
certified nurse midwives are often the initial contact for
women in providing ongoing health care and provide quality
health care to women in a variety of settings. CNMA
contends that this bill will help enhance the quality of
health care for many women in our state. The American
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Congress of Obstetricians and Gynecologists (ACOG) write in
support that this bill corrects an inconsistency in the
Insurance Code relative to mammography coverage. ACOG
maintains that it rectifies this discrepancy by mirroring
the language for mammography coverage in Knox-Keene. Knox
Keene regulations on HMOs provide for mammography, upon
referral by a physician subject to medical necessity
standards and practice guidelines.
ARGUMENTS IN OPPOSITION : America's Health Insurance
Plans (AHIP) opposes insurance mandate bills, including
this bill. AHIP argues adding additional mandates to
California's existing mandates will have a harmful effect
on program costs to California's budget.
ASSEMBLY FLOOR : 71-0, 1/26/12
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Beall,
Bill Berryhill, Block, Blumenfield, Bonilla, Bradford,
Brownley, Buchanan, Butler, Campos, Carter, Cedillo,
Chesbro, Conway, Cook, Dickinson, Donnelly, Eng, Feuer,
Fletcher, Fong, Fuentes, Furutani, Beth Gaines, Garrick,
Gatto, Gordon, Grove, Hagman, Hall, Hayashi, Roger
Hern�ndez, Hill, Huber, Hueso, Huffman, Jeffries, Jones,
Knight, Lara, Logue, Bonnie Lowenthal, Ma, Mansoor,
Mendoza, Miller, Mitchell, Morrell, Nestande, Nielsen,
Olsen, Pan, Perea, V. Manuel P�rez, Portantino, Silva,
Skinner, Solorio, Swanson, Torres, Valadao, Wagner,
Wieckowski, Williams, Yamada, John A. P�rez
NO VOTE RECORDED: Charles Calderon, Davis, Galgiani,
Gorell, Halderman, Harkey, Monning, Norby, Smyth
CTW:dk 8/23/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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