BILL ANALYSIS
Appropriations Committee Fiscal Summary
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| |AB 55 (Migden) |
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|Hearing Date: 8/25/99 |Amended: 8/24/99 |
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|Consultant: Kathleen Chavira |Policy Vote: Insurance |
| |7-0,1-2 |
| | |
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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.