California Assembly Bill AB2389 Amended / Bill

 BILL NUMBER: AB 2389AMENDED BILL TEXT AMENDED IN ASSEMBLY MAY 20, 2010 AMENDED IN ASSEMBLY APRIL 8, 2010 INTRODUCED BY Assembly Member Gaines FEBRUARY 19, 2010 An act to add Section 1367.49 to the Health and Safety Code, and to add Section 10133.64 to the Insurance Code, relating to health care coverage. LEGISLATIVE COUNSEL'S DIGEST AB 2389, as amended, Gaines. Health care coverage: provider contracts. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law prohibits a contract between a plan or insurer and a health care provider from containing certain terms. This bill would prohibit a contract  between   by or on behalf of  a plan or insurer and a  health care facility   licensed hospital, as defined, or any other licensed health care   facility, as defined, owned by a licensed hospital  to provide inpatient hospital services or ambulatory care services to subscribers and enrollees of the plan or policyholders and insureds of the insurer from containing a provision that restricts the ability of the plan or insurer to furnish information to subscribers or enrollees of the plan or policyholders or insureds of the insurer concerning the cost of procedures at the  hospital or licensed health care  facility or the quality of services  provided   performed  by the  hospital or  facility. The bill would make a contractural provision inconsistent with this requirement void and unenforceable. Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 1367.49 is added to the Health and Safety Code, to read: 1367.49. (a) A contract issued, amended, renewed, or delivered on or after January 1, 2011,  between   by or on behalf of  a health care service plan and a  health care facility   licensed hospital or any other licensed health care facility owned by a licensed hospital  to provide inpatient hospital services or ambulatory care services to subscribers and enrollees of the plan shall not contain any provision that restricts the ability of the health care service plan to furnish information to subscribers or enrollees of the plan concerning the cost of procedures at the  hospital or the licensed health care  facility or the quality of services  provided   performed  by the  hospital or  facility. (b) Any contractural provision inconsistent with this section shall be void and unenforceable.  (c) For purposes of this section, the following definitions apply:   (1) "Licensed hospital" has the same meaning as set forth in Section 4028 of the Business and Professions Code.   (2) "Licensed health care facility" means any institution or health facility, other than a long-term health care facility as defined pursuant to Section 1418, licensed by the State Department of Public Health to deliver or furnish health care services.   (c)   (d)  Section 1390 shall not apply for purposes of this section. SEC. 2. Section 10133.64 is added to the Insurance Code, to read: 10133.64. (a) A contract issued, amended, renewed, or delivered on or after January 1, 2011,  between   by or on behalf of  a health insurer and a  health care facility   licensed hospital or any other licensed health care facility owned by a licensed hospital  to provide inpatient hospital services or ambulatory care services to policyholders and insureds of the insurer shall not contain any provision that restricts the ability of the health insurer to furnish information to policyholders or insureds concerning the cost of procedures at the  hospital or the licensed health care  facility or the quality of services provided by the  hospital or  facility. (b) Any contractural provision inconsistent with this section shall be void and unenforceable.  (c) For purposes of this section, the following definitions apply:   (1) "Licensed hospital" has the same meaning as set forth in Section 4028 of the Business and Professions Code.   (2) "Licensed health care facility" means any institution or health facility, other than a long-term health care facility as defined pursuant to Section 1418 of the Health and Safety Code, licensed by the State Department of Public Health to deliver or furnish health care services.