California Senate Bill SB56 Amended / Bill

 BILL NUMBER: SB 56AMENDED BILL TEXT AMENDED IN ASSEMBLY JUNE 3, 2010 AMENDED IN SENATE JANUARY 11, 2010 AMENDED IN SENATE MAY 5, 2009 AMENDED IN SENATE APRIL 2, 2009 INTRODUCED BY Senator Alquist JANUARY 20, 2009 An act to add Article 2.82 (commencing with Section 14087.98) to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, relating to health plans. LEGISLATIVE COUNSEL'S DIGEST SB 56, as amended, Alquist. Health plans: joint ventures. Existing law creates various health benefits programs administered by the State Department of Health Care Services. Existing law, the Knox-Keene Health Care Services Plan Act of 1975, administered by the  Managed Risk Medical Insurance Board   Department of Managed Health Care  , provides for the licensure and regulation of health care service plans. This bill would authorize certain county-organized health plans and various other health benefits programs to form joint ventures  to create integrated networks of public health plans that   that consist of contractual   relationships to  pool risk  and   or  share networks  ,  or  both, or  to provide for the joint or coordinated offering of health plans to individuals and groups. The bill would require all joint ventures  and health care networks  established pursuant to the aforementioned provisions to meet all of the requirements of the Knox-Keene Health Care Service Plan Act of 1975. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. (a) The Legislature finds and declares as follows: (1) Due to the economic downturn, hundreds of thousands of Californians are joining the ranks of the uninsured or are looking to publicly financed programs for their health care coverage. (2) Compared to persons with health care coverage, the uninsured are less likely to have a regular source of care, are likely to delay seeing a doctor, and are less likely to receive preventive health care services. (3) Based on recent data collected by the Kaiser Family Foundation, health care costs continue to rise at a faster rate than general inflation and average wage growth. (4) President Obama and the Congress of the United States have pledged to seek the adoption of major health care reforms at the national level, which are likely to include, at a minimum, additional funding for states as well as increased flexibility for states in how they administer their health care systems. (5) There is a continuing need for affordable health coverage options for California's uninsured population, particularly those with limited incomes and those who do not receive health coverage through their employment or the employment of a family member. (6) Due to their structure and design, county local initiative health plans and county-organized health systems have the potential to offer affordable health coverage in the individual and group markets. (7) Joint ventures involving local initiative health plans and county-organized health systems may be a particularly promising means of providing affordable coverage in many regions of the state. (b) In light of these findings, it is the intent of the Legislature that representatives of local initiative health plans, county-organized health systems, and consumer, labor, and provider groups hold stakeholder discussions for the purposes of facilitating establishment of affordable health coverage options in the individual and group markets. SEC. 2. Article 2.82 (commencing with Section 14087.98) is added to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, to read: Article 2.82. Health Plan Joint Ventures 14087.98. (a)  Health plans   A health plan  that  are   is  governed, owned, or operated by a county board of supervisors, a county special commission, a county-organized health system, or a county health authority that  are   is  authorized by Section 14018.7, 14087.31, 14087.35, 14087.36, 14087.38, Article 2.8 (commencing with Section 14087.5), Article 2.81 (commencing with Section 14087.96), or Chapter 3 (commencing with Section 101675) of Part 4 of Division 101 of the Health and Safety Code, or the County Medical Services Program, may form joint ventures  to create integrated networks of public health plans that pool risk and share networks or to provide  for the joint or coordinated offering of health plans to individuals and groups. (b)  For purposes of this section, the joint ventures may consist of either of the following:   (1) Contractual relationships entered into in order to pool risk or share networks, or both.   (2) Contractual relationships entered into in order to provide for the joint offering or marketing of health plans to individuals and groups.   (c)    In forming joint ventures, participating health plans shall seek to contract with designated public hospitals, county health clinics, community health centers, and other traditional safety net providers.  (c) All joint ventures and health care networks established   (d)     All joint ventures established  pursuant to this section shall meet all the requirements of the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code).