California Assembly Bill AB2299 Amended / Bill

 BILL NUMBER: AB 2299AMENDED BILL TEXT AMENDED IN ASSEMBLY MAY 6, 2014 AMENDED IN ASSEMBLY MARCH 28, 2014 INTRODUCED BY Assembly Member Nazarian FEBRUARY 21, 2014 An act to amend Section 4659.1 of the Welfare and Institutions Code, relating to developmental services. LEGISLATIVE COUNSEL'S DIGEST AB 2299, as amended, Nazarian. Developmental services: health insurance copayments. The Lanterman Developmental Disabilities Services Act authorizes the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities. Under existing law, the regional centers purchase needed services for individuals with developmental disabilities through approved service providers or arrange for their provision through other publicly funded agencies. The services and supports to be provided to a regional center consumer are contained in an individual program plan or individualized family service plan, developed in accordance with prescribed requirements. Existing law authorizes a regional center to pay any applicable copayment or coinsurance for a service or support required by a consumer's individual program plan if the service is paid for by the health care service plan or health insurance policy of the consumer or his or her parent, guardian, or caregiver and, among other conditions, the family or the consumer, as applicable, has an annual gross income that does not exceed 400% of the federal poverty level. Existing law prohibits a regional center from paying health care service plan or health insurance policy deductibles. This bill would delete  that   the  prohibition against payment of deductibles and would require a regional center, without regard to the family's or consumer's annual gross income, to pay any applicable copayment, coinsurance, or deductible for a service or support required by a consumer's individual program plan if the support or service is paid for by the health care service plan or health insurance policy of the consumer or his or her parent, guardian, or caregiver. 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. Section 4659.1 of the Welfare and Institutions Code is amended to read: 4659.1. (a) If a service or support provided pursuant to a consumer's individual program plan under this division or individualized family service plan pursuant to the California Early Intervention Services Act (Title 14 (commencing with Section 95000) of the Government Code) is paid for, in whole or in part, by the health care service plan or health insurance policy of the consumer or the consumer's parent, guardian, or caregiver, the regional center shall pay any applicable copayment, coinsurance, or deductible associated with the service or support for which the consumer or the parent, guardian, or caregiver is responsible if both of the following conditions are met: (1) The consumer is covered by his or her own health care service plan or health insurance policy, or that of his or her parent, guardian, or caregiver. (2) There is no other third party having liability for the cost of the service or support, as provided in subdivision (a) of Section 4659 and Article 2.6 (commencing with Section 4659.10). (b) Notwithstanding subdivision (a), if the cost of a copayment, coinsurance, or deductible payment associated with a service or support is more than the cost of directly  providing   purchasing  the service or support, a regional center may directly  provide   purchase  the service or support in lieu of paying the copayment, coinsurance, or deductible payment. (c) This section shall not be implemented in a manner that is inconsistent with the requirements of Part C of the federal Individuals with Disabilities Education Act (20 U.S.C. Sec. 1431 et seq.).