BILL ANALYSIS                                                                                                                                                                                                    �



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          ASSEMBLY THIRD READING
          AB 2138 (Blumenfield)
          As Introduced  February 23, 2012
          Majority vote 

           INSURANCE           13-0        APPROPRIATIONS      12-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Solorio, Hagman,          |Ayes:|Fuentes, Blumenfield,     |
          |     |Bradford, Charles         |     |Bradford, Charles         |
          |     |Calderon, Carter, Feuer,  |     |Calderon, Campos, Davis,  |
          |     |Beth Gaines, Hayashi,     |     |Gatto, Ammiano, Hill,     |
          |     |Miller, Olsen, Skinner,   |     |Lara, Mitchell, Solorio   |
          |     |Torres, Wieckowski        |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Increases the fee charged to health insurers to pay 
          for health and disability insurance fraud investigations and 
          prosecutions (fraud fee) from $0.10 to $0.20 per insured and 
          increases the share of this fee revenue provided to district 
          attorney's from 50% to 70%.  Specifically,  this bill :  

          1)Increases the maximum fraud fee that may be charged by the 
            Insurance Commissioner (commissioner) from $0.10 to $0.20 per 
            insured.

          2)Increases the share of fraud fee revenue allocated to district 
            attorney's from 50% to 70%.

          3)Reduces the share of fraud fee revenue allocated to the 
            Department of Insurance (DOI) from 50% to 30%.

          4)Requires the commissioner to adopt regulations to implement 
            these changes.

           EXISTING LAW  : 

          1)Establishes insurance fraud as a felony.

          2)Requires health and disability insurers to pay a $0.10 annual 
            fraud fee for every insured.

          3)Specifies that the DOI and local district attorneys share the 
            revenue generated by the fraud fee evenly.








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          4)Requires the commissioner to distribute one-half of the fraud 
            fee revenues to district attorneys to enhance the prosecution 
            of disability and health insurance fraud.

          5)Permits district attorneys to apply for fraud fee funds.

          6)Requires the commissioner to conduct audits of how district 
            attorneys use the fraud fee revenues they are awarded.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee, assuming regulations are promulgated to implement 
          this bill's provisions effective July 1, 2013, DOI would collect 
          an estimated $4 million in additional revenue in fiscal year 
          (FY) 2013-14 and ongoing.  Local district attorneys will receive 
          approximately $2.9 million of this additional revenue, with the 
          remainder going to the DOI.  

           COMMENTS  :  

          Purpose of the bill.  According to the author, health and 
          disability insurance fraud in California is on the rise.  While 
          fraudulent claims are increasing, there are insufficient funds 
          to investigate and prosecute these claims. Although there are no 
          precise figures, it is believed that fraudulent activities 
          account for billions of dollars annually in added health care 
          costs nationally.  An incremental assessment may prove to be 
          cost effective given how much fraud costs the insured, the 
          insurer, the state of California, and society as a whole.


          Department Fraud Program.  The fraud fee supports criminal 
          investigations by the DOI's Fraud Division and prosecution by 
          district attorneys of suspected fraud involving disability and 
          healthcare fraud.  This program area includes fraudulent claims 
          involving:

          1)Dental Care



          2)Billing Fraud Scheme










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          3)Immunization Fraud



          4)Unlawful Solicitation 



          5)Durable Medical Equipment


          Currently, there are ten investigators statewide assigned to 
          investigate suspected disability and healthcare fraud.  This 
          team also provides assistance and training to investigators and 
          adjusters of private health insurance companies and other state 
          and federal government agencies.  During Fiscal Year 2009-10, 
          the Fraud Division identified and reported 288 suspected 
          fraudulent claims, assigned 33 new cases and made eight arrests 
          with 13 submissions to prosecuting authorities.  Potential 
          losses in these cases exceed $32 million.


          In Fiscal Year 2009-10, five counties received $1.7 million 
          through the department's Disability and Healthcare Insurance 
          Fraud Grant Program.  District attorneys in these counties 
          reported 133 investigations, 59 arrests, and 58 convictions.  
          Chargeable fraud amounted to $320,384,787, with $1,758,527 
          restitution ordered by the courts.


          Revenue.  The fraud fee was established in 1991 with the current 
          cap of $0.10 per insured and the fee cap has not been increased 
          since then.  Much of the increase called for in this bill 
          offsets the impact of inflation (the fee would need to be 
          increased to $0.17 to adjust for the impact of inflation since 
          1991).  The bill proposes a modest increase in real revenue to 
          increase the resources available for fraud investigations and 
          prosecutions.  The department estimates that the proposed 
          increase would produce approximately $4 million per year in 
          added revenue.  

          Allocation of Revenues.  When first established in 1991 by 
          Senate Bill 894 (Insurance, Banking and Corporations Committee), 








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          Chapter 1008, Statutes of 1991, the program required that 50% of 
          fraud fee revenues be distributed to district attorneys based on 
          the population of their county.   In 2004, AB 1728 (Insurance 
          Committee), Chapter 599, Statutes of 2004, was enacted requiring 
          district attorneys to apply for funding and increased 
          accountability from funding recipients by:

          1)Requiring district attorneys receiving funding to annually 
            provide an accounting for how the funding was used.
          2)Requiring district attorneys to report on the success of each 
            case or project funded.

          3)Permitting the Commissioner to audit the use of this funding 
            by district attorneys.

          Prevalence of Health Insurance Fraud.  According to the Federal 
          Bureau of Investigation, fraudulent billings to health care 
          programs, both public and private, are estimated between 3 and 
          10% of total health care expenditures.  Over time, fraud schemes 
          have become more sophisticated and complex and are now being 
          perpetrated by organized crime groups, corporate-driven schemes, 
          and systematic abuse by healthcare providers.  Health care fraud 
          is expected to continue to rise as people live longer and 
          healthcare expenditures continue to grow as a fraction of gross 
          domestic product. 


           Analysis Prepared by  :    Paul Riches / INS. / (916) 319-2086 


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