SB 1046, as introduced, Beall. Insurance: mental illness: developmental disabilities: coverage: penalties.
Existing law requires that health insurance policies provide coverage for the diagnosis and medically necessary treatment of severe mental illnesses of a person of any age and of serious emotional disturbances of a child, under the same terms and conditions applied to other medical conditions, as specified. Existing law requires health insurance policies to provide benefits for specified conditions, including coverage for behavioral health treatment, as defined, for pervasive developmental disorder or autism, as specified.
This bill would give the Insurance Commissioner the authority to assess administrative penalties for any violations of the above provisions, including any rules or orders adopted or issued based on violations of those provisions. The penalties would not exceed $2,500 for each violation, or for an ongoing and continuous violation, the penalty would not exceed $2,500 per day for as long as the violation continues.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 10144.53 is added to the Insurance Code,
2to read:
(a) In addition to any other remedy permitted by
2law, the commissioner shall have the authority to assess
3administrative penalties as specified in this section against insurers
4for violations of Sections 10144.5 and 10144.51.
5(b) Any person who violates Section 10144.5 or 10144.51, or
6who violates any rules or orders adopted or issued pursuant to this
7chapter based on a violation of Section 10144.5 or 10144.51, shall
8be liable for a penalty not to exceed two thousand five hundred
9dollars ($2,500) for each violation or, for a violation that is ongoing
10 and continuous, not to exceed two thousand five hundred dollars
11($2,500) for each day that the violation continues.
12(c) Each
patient harmed by a violation of this chapter constitutes
13a separate and distinct violation subject to the penalties set forth
14in this section.
15(d) The remedies provided by this section and by other sections
16of this code are not exclusive, and may be sought and employed
17in any combination to enforce this chapter.
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