BILL NUMBER: AB 714 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MARCH 29, 2011
INTRODUCED BY Assembly Member Atkins
FEBRUARY 17, 2011
An act to amend Section 127420 of, and to add Section
104164 Sections 104164, 120971.5, and 120971.6
to, the Health and Safety Code, to add Sections 12693.77,
12693.78, 12693.79, 12698.45, 12734, and
12739.615 to the Insurance Code, and to add Sections 14029.9 and
14105.182 to the Welfare and Institutions Code, relating to health
care coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 714, as amended, Atkins. Health care coverage: California
Health Benefit Exchange.
Existing law, the federal Patient Protection and Affordable Care
Act, requires each state to, by January 1, 2014, establish an
American Health Benefit Exchange that makes available qualified
health plans to qualified individuals and employers. Existing state
law establishes the California Health Benefit Exchange within state
government, specifies the powers and duties of the board governing
the Exchange relative to determining eligibility for enrollment in
the Exchange and arranging for coverage under qualified health plans,
and requires the board to facilitate the purchase of qualified
health plans through the Exchange by qualified individuals and small
employers by January 1, 2014.
Existing law establishes a program for the treatment of breast and
cervical cancer, administered by the State Department of Health Care
Services. Existing law provides specified health care coverage to
eligible individuals under the Healthy Families Program, the Access
for Infants and Mothers Program, the California Major Risk Medical
Insurance Program, and the Federal Temporary High Risk Pool, which
are administered by the Managed Risk Medical Insurance Board.
Existing law provides specified health care coverage to eligible
individuals under the Medi-Cal program and the Family PACT program,
which are administered by the State Department of Health Care
Services. Existing law provides specified health care coverage
to specified individuals under the AIDS Drug Assistance
Program (ADAP) and the federal Ryan White HIV/AIDS Treatment
Extension Act of 2009. Existing law provides for the regulation
and licensure of hospital facilities by the State Department of
Public Health.
This bill would, until June 30, 2013, require the State Department
of Health Care Services and the Managed Risk Medical Insurance Board
to disclose information on health care coverage through the
California Health Benefit Exchange to every individual who has ceased
to be enrolled under the programs described above except that, with
respect to the breast and cervical cancer treatment program
and , the Family PACT program, and the
programs for treatment of HIV/AIDS, the disclosure would be
made to each enrollee. On and after January 1, 2013, the bill would
require the department and the board to provide to the Medi-Cal
program and to the California Health Benefit Exchange information on
every individual who has ceased to be enrolled under those programs,
program, and the programs for treatment of HIV/AIDS,
except the cancer treatment and Family PACT
programs, and the programs for treatment of
HIV/AIDS for purposes of enrolling those individuals in the
Exchange and to disclose that enrollment to those individuals. The
bill would require an entity providing services or treatment under
the programs relating to cancer treatment
and program, the Family PACT program , and
the programs for treatment of HIV/AIDS, to provide certain
information regarding each enrollee to the department, as specified,
and would require the department to provide that information to the
Exchange and to the Medi-Cal program. The bill would require certain
hospitals, when billing, to include additional disclosures regarding
health care coverage through the Exchange. The bill would allow an
individual to opt out of that coverage in writing to the Exchange.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 104164 is added to the Health and Safety Code,
to read:
104164. (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual receiving services or treatment for
cancer under this chapter shall be provided the following notice:
"Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(b) Effective July 1, 2013, every individual receiving services or
treatment under this chapter shall be provided the following notice:
"Because you are enrolled in a cancer screening or treatment
program, an application for health care coverage through the
California Health Benefit Exchange will be made for you. Coverage
will not be effective until January 1, 2014. You are not required to
accept coverage from the Exchange. Your payment for coverage will be
based on your income last year. If you make significantly less or
more this year than you made last year, please tell the California
Health Benefit Exchange and your charges will be based on your
current income. If your income is low, you may qualify for no-cost
coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(c) (1) Effective January 1, 2013, every entity providing services
or treatment under this chapter shall provide to the department the
name, address, and other information of each enrollee as required by
the department. The department shall provide the information to the
Exchange and to the Medi-Cal program so that eligibility may be
determined and enrollment completed.
(2) The information to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
(d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
SEC. 2. Section 120971.5 is added to the
Health and Safety Code , to read:
120971.5. (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual receiving care or services under the AIDS
Drug Assistance Program (ADAP), as provided in Section 120950 shall
be provided the following notice:
"Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(b) Effective July 1, 2013, every individual receiving care or
services under (ADAP) as provided in Section 120950 shall be provided
the following notice:
"Because you are enrolled in the California ADAP program, an
application for health care coverage through the California Health
Benefit Exchange will be made for you. Coverage will not be effective
until January 1, 2014. You are not required to accept coverage from
the Exchange. Your payment for coverage will be based on your income
last year. If you make significantly less or more this year than you
made last year, please tell the California Health Benefit Exchange
and your charges will be based on your current income. If your income
is low, you may qualify for no-cost coverage through Medi-Cal. For
more information, check www.healthcare.ca.gov or call
1-888-Healthhelp (insert telephone number)."
(c) (1) Effective January 1, 2013, every entity providing services
or treatment under (ADAP) as provided in Section 120950 shall
provide to the department the name, address, and other information of
each enrollee as required by the department. The department shall
provide the information to the Exchange and to the Medi-Cal program
so that eligibility may be determined and enrollment completed.
(2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
(d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
SEC. 3. Section 120971.6 is added to the
Health and Safety Code , to read:
120971.6. (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual receiving care or services under the
federal Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public
Law 111-187) shall be provided the following notice:
"Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(b) Effective July 1, 2013, every individual receiving care or
services under the federal Ryan White HIV/AIDS Treatment Extension
Act of 2009 (Public Law 111-187) shall be provided the following
notice:
"Because you are enrolled in the Ryan White program, an
application for health care coverage through the California Health
Benefit Exchange will be made for you. Coverage will not be effective
until January 1, 2014. You are not required to accept coverage from
the Exchange. Your payment for coverage will be based on your income
last year. If you make significantly less or more this year than you
made last year, please tell the California Health Benefit Exchange
and your charges will be based on your current income. If your income
is low, you may qualify for no-cost coverage through Medi-Cal. For
more information, check www.healthcare.ca.gov or call
1-888-Healthhelp (insert telephone number)."
(c) (1) Effective January 1, 2013, every entity providing services
or treatment under the federal Ryan White HIV/AIDS Treatment
Extension Act of 2009 (Public Law 111-187) shall provide to the
department the name, address, and other information of each enrollee
as required by the department. The department shall provide the
information to the Exchange and to the Medi-Cal program so that
eligibility may be determined and enrollment completed.
(2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
(d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
SEC. 2. SEC. 4. Section 127420 of
the Health and Safety Code is amended to read:
127420. (a) Each hospital shall make all reasonable efforts to
obtain from the patient or his or her representative information
about whether private or public health insurance or sponsorship may
fully or partially cover the charges for care rendered by the
hospital to a patient, including, but not limited to, any of the
following:
(1) Private health insurance.
(2) Medicare.
(3) The Medi-Cal program, the Healthy Families Program, the
California Childrens' Services Program, or other state-funded
programs designed to provide health coverage.
(b) If a hospital bills a patient who has not provided proof of
coverage by a third party at the time the care is provided or upon
discharge, as a part of that billing, the hospital shall provide the
patient with a clear and conspicuous notice that includes all of the
following:
(1) A statement of charges for services rendered by the hospital.
(2) A request that the patient inform the hospital if the patient
has health insurance coverage, Medicare, Healthy Families, Medi-Cal,
or other coverage.
(3) A statement that if the consumer does not have health
insurance coverage, the consumer may be eligible for Medicare,
Healthy Families, Medi-Cal, California Childrens' Services Program,
or charity care. Effective January 1, 2013, the statement shall
include information about the availability of coverage through the
California Health Benefit Exchange and that such coverage shall be
available effective January 1, 2014.
(4) (A) A statement indicating how patients may obtain
applications for the Medi-Cal program and the Healthy Families
Program and that the hospital will provide these applications.
Effective January 1, 2013, the statement shall include information
about the availability of coverage through the California Health
Benefit Exchange and that such coverage shall be available effective
January 1, 2014. If the patient does not indicate coverage by a
third-party payer specified in subdivision (a), or requests a
discounted price or charity care then the hospital shall provide an
application for the Medi-Cal program, the Healthy Families Program or
other governmental program to the patient. This application shall be
provided prior to discharge if the patient has been admitted or to
patients receiving emergency or outpatient care.
(B) Effective January 1, 2014, the California Health Benefit
Exchange shall be included as a government program under this
section, including for purposes of the notice and application
requirements under this subdivision.
(5) Information regarding the financially qualified patient and
charity care application, including the following:
(A) A statement that indicates that if the patient lacks, or has
inadequate, insurance, and meets certain low- and moderate-income
requirements, the patient may qualify for discounted payment or
charity care.
(B) The name and telephone number of a hospital employee or office
from whom or which the patient may obtain information about the
hospital's discount payment and charity care policies, and how to
apply for that assistance.
SEC. 3. SEC. 5. Section
12693.77 12693.78 is added to the Insurance
Code, to read:
12693.77. 12693.78. (a) Effective
January 1, 2012, to June 30, 2013, inclusive, every individual who
ceases to be enrolled in the program shall be provided the following
notice:
"Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(b) Effective July 1, 2013, every individual who ceases to be
enrolled in the program shall be provided the following notice:
"Because you are no longer enrolled in the Healthy Families
Program, an application for health care coverage through the
California Health Benefit Exchange will be made for you. Coverage
will not be effective until January 1, 2014. You are not required to
accept coverage from the Exchange. Your payment for coverage will be
based on your income last year. If you make significantly less or
more this year than you made last year, please tell the California
Health Benefit Exchange and your charges will be based on your
current income. If your income is low, you may qualify for no-cost
coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(c) (1) Effective January 1, 2013, the board shall provide the
name, address, and other information regarding those individuals who
have ceased to be enrolled in the program to the Exchange and to the
Medi-Cal program so that eligibility may be determined and enrollment
completed.
(d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
SEC. 6. Section 12693.79 is added to the
Insurance Code , to read:
12693.79. Effective January 1, 2012, every individual enrolled in
the Healthy Families program shall be provided the following notice:
"Effective January 1, 2014, if your parents or other family
members do not have health care coverage that costs less than 10% of
your income, your parents or other family members may be eligible for
reduced cost, comprehensive health care coverage through the
California Health Benefit Exchange. If your income is low, you may be
eligible for no-cost coverage through Medi-Cal. For more
information, please visit www.healthcare.ca.gov or call
1-888-Healthhelp (insert telephone number)."
SEC. 4. SEC. 7. Section 12698.45 is
added to the Insurance Code, to read:
12698.45. (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual who ceases to be enrolled in the program
shall be provided the following notice:
"Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(b) Effective July 1, 2013, every individual who ceases to be
enrolled in the program shall be provided the following notice:
"Because you are no longer enrolled in AIM (Access for Infants and
Mothers Program), an application for health care coverage through
the California Health Benefit Exchange will be made for you. Coverage
will not be effective until January 1, 2014. You are not required to
accept coverage from the Exchange. Your payment for coverage will be
based on your income last year. If you make significantly less or
more this year than you made last year, please tell the California
Health Benefit Exchange and your charges will be based on your
current income. If your income is low, you may qualify for no-cost
coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(c) (1) Effective January 1, 2013, the board shall provide the
name, address, and other information regarding those individuals who
have ceased to be enrolled in the program to the Exchange and to the
Medi-Cal program so that eligibility may be determined and enrollment
completed.
(2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
(d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
SEC. 5. SEC. 8. Section 12734 is
added to the Insurance Code, to read:
12734. (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual who ceases to be enrolled in the program
shall be provided the following notice:
"Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(b) Effective July 1, 2013, every individual who ceases to be
enrolled in the program shall be provided the following notice:
"Because you are no longer enrolled in the California Major Risk
Medical Insurance Program, an application for health care coverage
through the California Health Benefit Exchange will be made for you.
Coverage will not be effective until January 1, 2014. You are not
required to accept coverage from the Exchange. Your payment for
coverage will be based on your income last year. If you make
significantly less or more this year than you made last year, please
tell the California Health Benefit Exchange and your charges will be
based on your current income. If your income is low, you may qualify
for no-cost coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(c) (1) Effective January 1, 2013, the board shall provide the
name, address, and other information regarding those individuals who
have ceased to be enrolled in the program to the Exchange and to the
Medi-Cal program so that eligibility may be determined and enrollment
completed.
(2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
(d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
SEC. 6. SEC. 9. Section 12739.615 is
added to the Insurance Code, to read:
12739.615. (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual who ceases to be enrolled in the program
shall be provided the following notice:
"Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(b) Effective July 1, 2013, every individual who ceases to be
enrolled in the program shall be provided the following notice:
"Because you are no longer enrolled in the Federal Temporary High
Risk Pool, an application for health care coverage through the
California Health Benefit Exchange will be made for you. Coverage
will not be effective until January 1, 2014. You are not required to
accept coverage from the Exchange. Your payment for coverage will be
based on your income last year. If you make significantly less or
more this year than you made last year, please tell the California
Health Benefit Exchange and your charges will be based on your
current income. If your income is low, you may qualify for no-cost
coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(c) (1) Effective January 1, 2013, the board shall provide the
name, address, and other information regarding those individuals who
have ceased to be enrolled in the program to the Exchange and to the
Medi-Cal program so that eligibility may be determined and enrollment
completed.
(2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
(d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
SEC. 7. SEC. 10. Section 14029.9 is
added to the Welfare and Institutions Code, to read:
14029.9. (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual who ceases to be enrolled in the Medi-Cal
program shall be provided the following notice:
"Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(b) Effective July 1, 2013, every individual who ceases to be
enrolled in the Medi-Cal program shall be provided the following
notice:
"Because you are no longer enrolled in Medi-Cal, an application
for health care coverage through the California Health Benefit
Exchange will be made for you. Coverage will not be effective until
January 1, 2014. You are not required to accept coverage from the
Exchange. Your payment for coverage will be based on your income last
year. If you make significantly less or more this year than you made
last year, please tell the California Health Benefit Exchange and
your charges will be based on your current income. If your income is
low, you may qualify for no-cost coverage through Medi-Cal. For more
information, check www.healthcare.ca.gov or call 1-888-Healthhelp
(insert telephone number)."
(c) (1) Effective January 1, 2013, the department shall provide
the name, address, and other information regarding those individuals
who have ceased to be enrolled in the Medi-Cal program to the
Exchange so that eligibility may be determined and enrollment
completed.
(2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
(d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
SEC. 8. SEC. 11. Section 14105.182
is added to the Welfare and Institutions Code, to read:
14105.182. (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual receiving care or services under the
Family PACT program as provided in subdivision (aa) of Section 14132
shall be provided the following notice:
"Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."
(b) Effective July 1, 2013, every individual receiving care or
services under the Family PACT program as provided in subdivision
(aa) of Section 14132 shall be provided the following notice:
"Because you are enrolled in the Family PACT program, an
application for health care coverage through the California Health
Benefit Exchange will be made for you. Coverage will not be effective
until January 1, 2014. You are not required to accept coverage from
the Exchange. Your payment for coverage will be based on your income
last year. If you make significantly less or more this year than you
made last year, please tell the California Health Benefit Exchange
and your charges will be based on your current income. If your income
is low, you may qualify for no-cost coverage through Medi-Cal. For
more information, check www.healthcare.ca.gov or call
1-888-Healthhelp (insert telephone number)."
(c) (1) Effective January 1, 2013, every entity providing services
or treatment under the program as provided in subdivision (aa) of
Section 14132 shall provide to the department the name, address, and
other information of each enrollee as required by the department. The
department shall provide the information to the Exchange and to the
Medi-Cal program so that eligibility may be determined and enrollment
completed.
(2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
(d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.