BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1196
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          SENATE THIRD READING
          SB 1196 (Ed Hernandez)
          As Amended August 22, 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 
            comprehensive outpatient rehabilitation facility, a home 








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            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.

          5)Establishes in the Civil Code a requirements on qualified 
            entities, as defined in federal law, that receive claims data 
            from a health care service plan or health insurer to comply 
            with the requirements governing provider and supplier requests 
            for error correction established under Medicare regulations, 
            as specified, for all claims data received, including data 
            from sources other than Medicare.

          6)Requires all disclosures of data made under this bill to 
            comply with all applicable state and federal laws for the 
            protection of the privacy and security of the data, including, 
            but not limited to, the federal Health Insurance Portability 
            and Accountability Act of 1996 and the Health Information 
            Technology for Economic and Clinical Health Act, of the 
            federal American Recovery and Reinvestment Act of 2009, and 
            implementing regulations.

           EXISTING LAW  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.

           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 
          which shall include quality measures, risk adjustment methods, 








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          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.


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



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