BILL ANALYSIS                                                                                                                                                                                                    �



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          SENATE THIRD READING
          SB 1196 (Ed Hernandez)
          As Amended June 28, 2012
          Majority vote

           SENATE VOTE  :35-0  
           
           HEALTH              19-0        APPROPRIATIONS      17-0        
           
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          |Ayes:|Monning, Logue, Ammiano,  |Ayes:|Fuentes, Harkey,          |
          |     |Atkins, Bonilla, Eng,     |     |Blumenfield, Bradford,    |
          |     |Garrick, Gordon, Hayashi, |     |Charles Calderon, Campos, |
          |     |Roger Hern�ndez,          |     |Davis, Donnelly, Gatto,   |
          |     |Bonnie Lowenthal,         |     |Hall, Hill, Lara,         |
          |     |Mansoor, Mitchell,        |     |Mitchell, Nielsen, Norby, |
          |     |Nestande, Pan,            |     |Solorio, Wagner           |
          |     |V. Manuel P�rez, Silva,   |     |                          |
          |     |Smyth, Williams           |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Prohibits a contract in existence or issued, amended, 
          or renewed on or after January 1, 2013, between a health care 
          service plan (health plan), or health insurer (collectively, 
          carriers), and a provider or supplier, from prohibiting, 
          conditioning, or in any way restricting the disclosure of claims 
          data related to health care services provided to an enrollee or 
          subscriber of the health plan or carrier, or beneficiaries of 
          any self-funded health coverage arrangement administered by the 
          carrier to a qualified entity, as defined.  Specifically,  this 
          bill  :

          1)Requires a qualified entity to comply with all requirements 
            established pursuant to federal law, as specified, and any 
            rules, regulations, and guidelines adopted pursuant to the 
            federal Patient Protection and Affordable Care Act (ACA), to 
            ensure the privacy and security of the data.

          2)Requires a qualified entity to also comply with rules, 
            regulations, and guidelines adopted pursuant to the ACA 
            governing provider and supplier requests for error correction 
            for data obtained under this bill.

          3)Defines provider as a hospital, a skilled nursing facility, a 








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            comprehensive outpatient rehabilitation facility, a home 
            health agency, a hospice, a clinic, or a rehabilitation 
            agency.

          4)Defines supplier as a physician and surgeon or other health 
            care practitioner, or an entity that furnishes health care 
            services other than a provider.

           EXISTING LAW  :  

          1)Makes Medicare data, under federal law, available for the 
            evaluation of the performance of providers of services and 
            suppliers, to qualified entities, defined as a public or 
            private entity that is qualified as determined by the 
            Secretary of the federal Department of Health and Human 
            Services (HHS), to use claims data to evaluate the performance 
            of providers of services and suppliers on measures of quality, 
            efficiency, effectiveness, and resource use, and agrees to 
            meet specified requirements and other requirements as the HHS 
            Secretary may specify, such as ensuring security of data.

          2)Requires, under federal regulation, a qualified entity to 
            share measures, measurement methodologies, and measure results 
            with providers and suppliers at least 60 calendar days before 
            making the reports public.  Requires a qualified entity to 
            inform providers and suppliers of the date after which the 
            reports will be made public, and if necessary will include 
            information related to the status of any data or error 
            correction requests, regardless of their status.  If a 
            provider or supplier has a data or error correction request 
            outstanding at the time the reports become public, the 
            qualified entity must, if feasible, post publicly the name of 
            the appealing provider or supplier and the category of the 
            appeal request.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee, negligible state costs.

           COMMENTS :  According to the author, under the ACA and final 
          implementing regulations issued in December 2011, the vast 
          Medicare claims database will be made available for use in 
          producing public reports on the performance of health care 
          providers.  Any report issued by a qualified entity using this 
          data must include an understandable description of the measures 








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          which shall include quality measures, risk adjustment methods, 
          physician attribution methods, data specifications and 
          limitations, and sponsors so that consumers, providers, 
          suppliers and others can assess the reports.

          The reports must be available confidentially to any provider of 
          services or supplier to be identified in such report, prior to 
          the public release of such report, and provide an opportunity to 
          appeal and correct errors.  The reports must only include 
          information on a provider of services or supplier in an 
          aggregate form as determined appropriate by the HHS Secretary.  
          According to the implementing regulations, the Centers for 
          Medicare and Medicaid Services (CMS) believes the sharing of 
          Medicare data with qualified entities and the resulting reports 
          will be an important driver of improving quality and reducing 
          costs in Medicare, as well as for the health care system in 
          general.  CMS believes this will increase the transparency of 
          provider and supplier performance while ensuring Medicare 
          beneficiary privacy.

          Supporters all agree that increasing transparency and giving 
          consumers access to data on health care costs will help in 
          making more informed decisions.  The Small Business Majority 
          (SBM) emphasizes that California's small businesses are being 
          hit hard with skyrocketing health care costs that impact their 
          ability to create jobs and grow the economy.  SBM continues that 
          the ACA's health care reforms will improve access for small 
          businesses to affordable health care and ensure their health 
          care dollars are being spent in the most efficient way.  The 
          Pacific Business Group on Health supports this bill because 
          claims data contain standardized information on sizeable patient 
          populations with little effort from providers.  These data can 
          provide information preventing unnecessary hospitalizations and 
          an average price an insured patient would pay for knee 
          replacement surgery.

          The California Hospital Association requests amendments to 
          ensure hospitals can review the data and methodology before it 
          is released for accuracy and risk adjustment of the data.


           Analysis Prepared by  :    Teri Boughton / HEALTH / (916) 319-2097 










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