Amended in Senate January 6, 2014

Amended in Senate April 24, 2013

Amended in Senate April 3, 2013

Amended in Senate March 18, 2013

Senate Bill No. 266

Introduced by Senator Lieu

February 13, 2013

An act to begin delete add Section 687 to the Business and Professions Code, and to add Section 1250.04 to the Health and Safety Code end delete begin insert amend Section 1741.1 of the Labor Code end insert , relating to begin delete health care coverage end delete begin insert public works end insert .

LEGISLATIVE COUNSEL’S DIGEST

SB 266, as amended, Lieu. begin delete Health care coverage: out-of-network coverage. end delete begin insert Prevailing wages. end insert

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Existing law requires the Labor Commissioner to issue a civil wage and penalty assessment to a contractor or subcontractor, or both, if, after an investigation, the commissioner determines there has been a violation of the law regulating public works projects, including the payment of prevailing wages. Existing law tolls the period for service of assessments for the period of time required by the Director of Industrial Relations to determine whether a project is a public work, as specified. Existing law, with respect to the determination of whether a project is a public work, requires a person filing a notice of completion of the project to also provide notice to the Labor Commissioner, as specified, and requires the awarding body or political subdivision accepting a public work to provide to the Labor Commissioner notice of that acceptance, as specified.

end insert begin insert

This bill instead would require the body awarding the contract for public work to furnish, within 10 days after receipt of a written request from the Labor Commissioner, a copy of the valid notice of completion for the public work or a document evidencing the awarding body’s acceptance of the public work on a particular date, whichever occurs later, in accordance with specified provisions. The bill would require the awarding body to notify the appropriate office of the Labor Commissioner if, at the time of receipt of the Labor Commissioner’s written request, there has been no valid notice of completion filed by the awarding body in the office of the county recorder, and no document evidencing the awarding body’s acceptance of the public work on a particular date. If the awarding body fails to timely furnish the Labor Commissioner with the applicable document, the bill would require that the period for service of assessments be tolled until the Labor Commissioner’s receipt of the applicable document. The bill would also include legislative findings and declarations.

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Existing law provides for the licensure and regulation of health care practitioners by various healing arts boards within the Department of Consumer Affairs. Existing law also provides for the licensure and regulation of health facilities by the State Department of Public Health. A violation of these provisions is a crime.

end delete begin delete

This bill would prohibit a medical group or clinic, as defined, from stating, verbally or in writing, that it is within a plan network or a provider network unless all of the individual providers providing services with the medical group or clinic are within the plan network or provider network. The bill would require a provider group or clinic to recommend that the patient contact his or her health care service plan or health insurer for information about providers who are within the patient’s plan network or medical network if any of the providers in that medical group or clinic are not within the plan network or provider network. Those provisions would not apply to emergency services and care.

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This bill would also require a hospital, before providing nonemergency services and care, to provide a specified written notice to the patient stating that individual providers providing services within the hospital may not be in the patient’s plan network or provider network, except as specified. By expanding the scope of a crime, this bill would impose a state-mandated local program.

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The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

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This bill would provide that no reimbursement is required by this act for a specified reason.

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Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program:  begin delete yes end delete begin insert no end insert .

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

The Legislature finds and declares at all of the
following:

(1)  The process for the Director of Industrial Relations to
determine the existence of a public work and to decide
administrative appeals from those determinations has created
unacceptable delays and prejudice to the enforcement of the public
works law, often resulting in the expiration of the statute of
limitation for the identification and collection of wage and penalty
assessments. As a result, wage theft has occurred because workers
are not paid prevailing wage rates and the time for assessment
has expired.

(2) There has been an incentive to some developers, contractors,
and public bodies to engage in expensive and time-consuming
litigation in efforts to extend the time for determining the existence
of a public work. This litigation is often a needless expense to the
state.

(3) Public bodies, developers, contractors, and others are
entitled to a determination of whether a project is a public work
as early as possible so that the costs of the project and the duties
of the parties under the law may be known as early as possible.

(4) Therefore, this act is necessary to ensure the actual receipt
of proper wages, to reduce administrative and litigation costs to
the state and others, and to provide early guidance to all interested
parties.

end insert

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 1741.1 of the end insert begin insert Labor Code end insert begin insert is amended to read: end insert

1741.1.  

(a) The period for service of assessments shall be
tolled for the period of time required by the Director of Industrial
Relations to determine whether a project is a public work, including
a determination on administrative appeal, if applicable, pursuant
to subdivisions (b) and (c) of Section 1773.5. The period for service
of assessments shall also be tolled for the period of time that a
contractor or subcontractor fails to provide in a timely manner
certified payroll records pursuant to a request from the Labor
Commissioner or a joint labor-management committee under
Section 1776, or an approved labor compliance program under
Section 1771.5 or 1771.7.

begin delete

(b) The person filing a notice of completion in the office of a
county recorder pursuant to subdivision (a) of Section 1741 shall
at the same time also provide notice to the Labor Commissioner,
in a manner determined by the Labor Commissioner. The awarding
body or political subdivision accepting a public work under
subdivision (a) of Section 1741 shall provide notice of that
acceptance to the Labor Commissioner within five days of the
acceptance, in a manner determined by the Labor Commissioner.
The 180-day period for service of assessments shall be tolled for
the length of time notice is not given in a timely manner to the
Labor Commissioner pursuant to this subdivision.

end delete begin insert

(b) (1) The body awarding the contract for public work shall
furnish, within 10 days after receipt of a written request from the
Labor Commissioner, a copy of the valid notice of completion for
the public work filed in the office of the county recorder, or a
document evidencing the awarding body’s acceptance of the public
work on a particular date, whichever occurs later, by first-class
mail addressed to the office of the Labor Commissioner that is
listed on the written request. If, at the time of receipt of the Labor
Commissioner’s written request, a valid notice of completion has
not been filed by the awarding body in the office of the county
recorder and there is no document evidencing the awarding body’s
acceptance of the public work on a particular date, the awarding
body shall so notify the office of the Labor Commissioner that is
listed on the written request. Thereafter, the awarding body shall
furnish copies of the applicable document within 10 days after
filing a valid notice of completion with the county recorder’s office,
or within 10 days of the awarding body’s acceptance of the public
work on a particular date.

end insert begin insert

(2) If the awarding body fails to timely furnish the Labor
Commissioner with the documents identified in paragraph (1), the
period for service of assessments under Section 1741 shall be
tolled until the Labor Commissioner’s actual receipt of the valid
notice of completion for the public work or a document evidencing
the awarding body’s acceptance of the public work on a particular
date.

end insert

(c) The tolling provisions in this section shall also apply to the
period of time for commencing an action brought by a joint
labor-management committee pursuant to Section 1771.2.

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SECTION 1.  

Section 687 is added to the Business and
Professions Code, to read:

687.  

(a) (1) A medical group or clinic shall not state, verbally
or in writing, that it is within a patient’s plan network or provider
network unless all of the individual providers providing services
with the medical group or clinic are within that plan network or
provider network.

(2) If any of the providers are not within the plan network or
provider network, then the medical group or clinic shall recommend
that the patient contact his or her health care service plan or health
insurer for information about providers who are within the patient’s
plan network or medical network.

(b) For purposes of this section, the following definitions shall
apply:

(1) “Clinic” means a surgical center as defined in paragraph (1)
of subdivision (b) of Section 1204 of the Health and Safety Code,
an outpatient setting as defined in paragraph (1) of subdivision (b)
of Section 1248 of the Health and Safety Code, or an ambulatory
surgical center certified to participate in the Medicare Program
under Title XVIII of the federal Social Security Act (42 U.S.C.
Sec. 1395 et seq.).

(2) “Plan network” means any entity, group of providers, or
individual providers contracted with a preferred provider
organization plan contract or point-of-service plan contract.

(3) “Provider network” means any entity, group of providers,
or provider contracted with a preferred provider organization health
insurance policy.

(4) “Medical group” means any entity, group of providers, or
any other similar organization that contracts with a preferred
provider organization.

(c) This section shall not apply to emergency services and care.

SEC. 2.  

Section 1250.04 is added to the Health and Safety
Code, to read:

1250.04.  

(a) (1) Prior to providing nonemergency services
and care to a patient, a hospital shall provide a written notice to
the patient stating that individual providers providing services
within the hospital may not be in the patient’s plan network or
provider network.

(2) The hospital notice shall recommend that the patient contact
his or her health care service plan or health insurer for information
about providers who are within the patient’s plan network or
provider network.

(b) For purposes of this section, the following definitions shall
apply:

(1) “Hospital” means a general acute care hospital as defined
in subdivision (a) of Section 1250.

(2) “Plan network” means any entity, group of providers, or
individual providers contracted with a preferred provider
organization plan contract or point-of-service plan contract.

(3) “Provider network” means any entity, group of providers,
or provider contracted with a preferred provider organization health
insurance policy.

(c) This section shall not apply to emergency services and care.

(d) This section shall not apply if all of the providers providing
services within the hospital are within the same plan network or
provider network as the hospital.

SEC. 3.  

No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of
the Government Code, or changes the definition of a crime within
the meaning of Section 6 of Article XIII B of the California
Constitution.

end delete