BILL ANALYSIS                                                                                                                                                                                                    




          Appropriations Committee Fiscal Summary

 ------------------------------------------------------------ 
|                               |AB 55  (Migden)             |
|-------------------------------+----------------------------|
|                               |                            |
|-------------------------------+----------------------------|
|Hearing Date: 8/25/99          |Amended: 8/24/99            |
|-------------------------------+----------------------------|
|Consultant: Kathleen Chavira   |Policy Vote: Insurance      |
|                               |7-0,1-2                     |
|                               |                            |
 ------------------------------------------------------------ 

BILL SUMMARY: 

AB55 establishes, by January 1, 2001 an independent medical  
review system (IMRS) to review decisions by a health care  
service plan or disability insurer to deny or delay  
treatment based on medical necessity or appropriateness.   
The IMRS would be administered by the Department of  
Corporations (DOC) or, in the case of disability insurers,  
by the Department of Insurance. Medi-Cal enrollees would be  
eligible for the IMRS.  The cost of the IMRS would be borne  
by the health plan or insurer.  The bill also modifies  
guidelines for health plan and DOC grievance procedures.

                         Fiscal Impact (in thousands)
  
Major Provisions   1999-2000     2000-01      2001-02      Fund  

Independent Review System       -unknown cost offset by fees-Corp
State employee health benefits         unknown cost                      
General/
                                                   Special
Medi-Cal managed care plans   unknown cost         General/
                                                   federal

STAFF COMMENTS: 

This bill may be a candidate for Suspense.


To the extent that the state is a purchaser of health  
benefits for state employees, the state could experience  
increased premium costs associated with the cost of  










providing IMRS.  In addition the bill provisions which  
reduce the response times for accepting and responding to  
complaints may result in a greater number of complaints  
being referred to the state and could result in increased  
staff costs to comply with the shorter timeframes.