BILL ANALYSIS                                                                                                                                                                                                    �



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          ASSEMBLY THIRD READING
          AB 778 (Atkins)
          As Amended April 27, 2011
          Majority vote 

           HEALTH              14-1        BUSINESS & PROFESSIONS           
          6-1                             
           
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          |Ayes:|Monning, Ammiano, Atkins, |Ayes:|Hayashi, Allen, Hagman,   |
          |     |Bonilla, Garrick,         |     |Hill, Ma, Smyth           |
          |     |Hayashi, Roger Hern�ndez, |     |                          |
          |     |Bonnie Lowenthal,         |     |                          |
          |     |Mansoor, Mitchell, Pan,   |     |                          |
          |     |V. Manuel P�rez, Silva,   |     |                          |
          |     |Williams                  |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Nestande                  |Nays:|Bill Berryhill            |
          |     |                          |     |                          |
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           APPROPRIATIONS      15-0                                        
           
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          |Ayes:|Fuentes, Harkey,          |     |                          |
          |     |Blumenfield, Bradford,    |     |                          |
          |     |Charles Calderon, Campos, |     |                          |
          |     |Gatto, Hall, Hill, Lara,  |     |                          |
          |     |Mitchell, Nielsen, Norby, |     |                          |
          |     |Solorio, Wagner           |     |                          |
          |     |                          |     |                          |
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           SUMMARY  :  Permits a dispensing optician, an optical company, a 
          manufacturer or distributor of optical goods, or a nonoptometric 
          corporation to own a health care service plan (health plan) that 
          provides vision care services and share its profits, contract 
          for business services with, lease office space or equipment to 
          or from, or share office space with, a health plan that provides 
          vision care services, and jointly advertise vision care services 
          with a health plan that provides vision care services.  
          Specifically,  this bill  :  

          1)Permits a dispensing optician, an optical company, a 
            manufacturer or distributor of optical goods, or a 
            nonoptometric corporation to:







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             a)   Own a health plan that provides vision care services and 
               share its profits;

             b)   Contract for business services with, lease office space 
               or equipment to or from, or share office space with, a 
               health plan that provides vision care services; and,

             c)   Jointly advertise vision care services with a health 
               plan that provides vision care services.
          
          2)Prohibits a registered dispensing optician, an optical 
            company, a manufacturer or distributor of optical goods, or a 
            nonoptometric corporation from engaging in conduct designed to 
            influence or interfere with the clinical decisions of an 
            optometrist employed by, or who has contracted with, a 
            specialized vision care service plan for fiscal or 
            administrative reasons.

          3)Requires the clinical decisions of an optometrist who is 
            employed by, or who has contracted with, a specialized vision 
            care service plan to be unhindered by fiscal and 
            administrative management, as specified.



           EXISTING LAW  :

          1)Prohibits health plans from being deemed to be engaged in the 
            practice of a profession, and may employ, or contract with, 
            any licensed health care professional to deliver professional 
            services, and may directly own, and may directly operate 
            through its professional employees or contracted licensed 
            professionals, offices, and subsidiary corporations.  
            Prohibits licensed health care professionals from owning or 
            controlling offices or branch offices unless otherwise 
            expressly authorized.  

          2)Provides for the licensure and regulation of dispensing 
            opticians by the Medical Board of California (MBC).  Provides 
            for the licensure and regulation of optometrists by the 
            California Board of Optometry (CBO).

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee, minor and absorbable costs to the Department of 
          Managed Health Care (DMHC) to continue oversight of licensed 
          health plans, as well as to the CBO and the MBC to regulate 
          optometrists and opticians, respectively.






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           COMMENTS  :  According to the author, EYEXAM of California was 
          licensed in 1986 as a specialized health plan, regulated by 
          DMHC, to provide vision services to its members throughout the 
          state.  Most EYEXAM locations are within a LensCrafters store 
          and have a partnership with the store.  Patients can purchase 
          frames at this location, or at any other eyewear location, 
          should they need prescription eyewear.  The author states that 
          there are over 100 EYEXAM locations throughout the state where 
          close to 400 optometrists are employed, serving their community. 
           The author states that current California law does not prohibit 
          a Knox-Keene plan from having a business relationship with an 
          optical dispenser, but there is no statutory language that 
          specifically authorizes this relationship either.  However, 
          current California law prohibits an optometrist from being 
          directly employed by an optical company.  The author states that 
          this bill is intended to specifically allow a specialty health 
          care plan (like EYEXAM) to conduct business with an optical 
          dispenser (like Lens Crafters).  The author states that due to 
          an ambiguity in the law, there is a question about whether the 
          co-location model can continue to remain in California and that 
          this bill seeks to provide clarity on the issue by defining the 
          business model.  According to information provided by the 
          sponsor of this bill, Californians for Healthy Vision (a 
          coalition of co-located eye care businesses and optometrists), 
          in California there are four companies that own both a plan and 
          an optical company 

          The co-location model that this bill codifies has been the 
          subject of past litigation as well as ongoing litigation.  Cases 
          brought by the Attorney General (AG) of California and private 
          defendants challenging the influence of control such 
          arrangements have over optometrists and ophthalmologists have 
          been settled over the last decade, leaving the underlying legal 
          issues unresolved.  Most recently, a federal judge struck down 
          the law upon which the AG's case was based as unconstitutional. 
          This case has been appealed.  According to the sponsor of this 
          bill, this litigation could take years to resolve.

          In general, opponents (VSP, the California Optometric 
          Association, and the United Nurses Association of 
          California/Union of Health Care Professionals) argue that the 
          model allows for inappropriate lay control over health care 
          providers and that the legal process should be allowed to run 
          its course.

           Analysis Prepared by :    Teri Boughton / HEALTH / (916) 






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          319-2097FN: 0000616