BILL NUMBER: AB 714	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Atkins

                        FEBRUARY 17, 2011

   An act to amend Section 127420 of, and to add Section 104164 to,
the Health and Safety Code, to add Sections 12693.77, 12698.45,
12734, and 12739.615 to the Insurance Code, and to add Sections
14029.9 and 14105.182 to the Welfare and Institutions Code, relating
to health care coverage.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 714, as introduced, Atkins. Health care coverage: California
Health Benefit Exchange.
   Existing law, the federal Patient Protection and Affordable Care
Act, requires each state to, by January 1, 2014, establish an
American Health Benefit Exchange that makes available qualified
health plans to qualified individuals and employers. Existing state
law establishes the California Health Benefit Exchange within state
government, specifies the powers and duties of the board governing
the Exchange relative to determining eligibility for enrollment in
the Exchange and arranging for coverage under qualified health plans,
and requires the board to facilitate the purchase of qualified
health plans through the Exchange by qualified individuals and small
employers by January 1, 2014.
   Existing law establishes a program for the treatment of breast and
cervical cancer, administered by the State Department of Health Care
Services. Existing law provides specified health care coverage to
eligible individuals under the Healthy Families Program, the Access
for Infants and Mothers Program, the California Major Risk Medical
Insurance Program, and the Federal Temporary High Risk Pool, which
are administered by the Managed Risk Medical Insurance Board.
Existing law provides specified health care coverage to eligible
individuals under the Medi-Cal program and the Family PACT program,
which are administered by the State Department of Health Care
Services. Existing law provides for the regulation and licensure of
hospital facilities by the State Department of Public Health.
   This bill would, until June 30, 2013, require the State Department
of Health Care Services and the Managed Risk Medical Insurance Board
to disclose information on health care coverage through the
California Health Benefit Exchange to every individual who has ceased
to be enrolled under the programs described above except that, with
respect to the breast and cervical cancer treatment program and the
Family PACT program, the disclosure would be made to each enrollee.
On and after January 1, 2013, the bill would require the department
and the board to provide to the Medi-Cal program and to the
California Health Benefit Exchange information on every individual
who has ceased to be enrolled under those programs, except the cancer
treatment and Family PACT programs, for purposes of enrolling those
individuals in the Exchange and to disclose that enrollment to those
individuals. The bill would require an entity providing services or
treatment under the programs relating to cancer treatment and the
Family PACT program to provide certain information regarding each
enrollee to the department, as specified, and would require the
department to provide that information to the Exchange and to the
Medi-Cal program. The bill would require certain hospitals, when
billing, to include additional disclosures regarding health care
coverage through the Exchange. The bill would allow an individual to
opt out of that coverage in writing to the Exchange.
   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 104164 is added to the Health and Safety Code,
to read:
   104164.  (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual receiving services or treatment for
cancer under this chapter shall be provided the following notice:

   "Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (b) Effective July 1, 2013, every individual receiving services or
treatment under this chapter shall be provided the following notice:


   "Because you are enrolled in a cancer screening or treatment
program, an application for health care coverage through the
California Health Benefit Exchange will be made for you. Coverage
will not be effective until January 1, 2014. You are not required to
accept coverage from the Exchange. Your payment for coverage will be
based on your income last year. If you make significantly less or
more this year than you made last year, please tell the California
Health Benefit Exchange and your charges will be based on your
current income. If your income is low, you may qualify for no-cost
coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (c) (1) Effective January 1, 2013, every entity providing services
or treatment under this chapter shall provide to the department the
name, address, and other information of each enrollee as required by
the department. The department shall provide the information to the
Exchange and to the Medi-Cal program so that eligibility may be
determined and enrollment completed.
   (2) The information to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
   (d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
  SEC. 2.  Section 127420 of the Health and Safety Code is amended to
read:
   127420.  (a) Each hospital shall make all reasonable efforts to
obtain from the patient or his or her representative information
about whether private or public health insurance or sponsorship may
fully or partially cover the charges for care rendered by the
hospital to a patient, including, but not limited to, any of the
following:
   (1) Private health insurance.
   (2) Medicare.
   (3) The Medi-Cal program, the Healthy Families Program, the
California Childrens' Services Program, or other state-funded
programs designed to provide health coverage.
   (b) If a hospital bills a patient who has not provided proof of
coverage by a third party at the time the care is provided or upon
discharge, as a part of that billing, the hospital shall provide the
patient with a clear and conspicuous notice that includes all of the
following:
   (1) A statement of charges for services rendered by the hospital.
   (2) A request that the patient inform the hospital if the patient
has health insurance coverage, Medicare, Healthy Families, Medi-Cal,
or other coverage.
   (3) A statement that if the consumer does not have health
insurance coverage, the consumer may be eligible for Medicare,
Healthy Families, Medi-Cal, California Childrens' Services Program,
or charity care.  Effective January 1, 2013,   the
statement shall include information about the availability of
coverage through the California Health Benefit Exchange and that such
coverage shall be available effective January 1, 2014. 
   (4)  (A)    A statement indicating how patients
may obtain applications for the Medi-Cal program and the Healthy
Families Program and that the hospital will provide these
applications.  Effective January 1, 2013, the statement shall
include information about the availability of coverage through the
California Health Benefit Exchange and that such coverage shall be
available effective January 1, 2014.  If the patient does not
indicate coverage by a third-party payer specified in subdivision
(a), or requests a discounted price or charity care then the hospital
shall provide an application for the Medi-Cal program, the Healthy
Families Program or other governmental program to the patient. This
application shall be provided prior to discharge if the patient has
been admitted or to patients receiving emergency or outpatient care.

   (B) Effective January 1, 2014, the California Health Benefit
Exchange shall be included as a government program under this
section, including for purposes of the notice and application
requirements under this subdivision. 
   (5) Information regarding the financially qualified patient and
charity care application, including the following:
   (A) A statement that indicates that if the patient lacks, or has
inadequate, insurance, and meets certain low- and moderate-income
requirements, the patient may qualify for discounted payment or
charity care.
   (B) The name and telephone number of a hospital employee or office
from whom or which the patient may obtain information about the
hospital's discount payment and charity care policies, and how to
apply for that assistance.
  SEC. 3.  Section 12693.77 is added to the Insurance Code, to read:
   12693.77.  (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual who ceases to be enrolled in the program
shall be provided the following notice:

   "Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (b) Effective July 1, 2013, every individual who ceases to be
enrolled in the program shall be provided the following notice:

   "Because you are no longer enrolled in the Healthy Families
Program, an application for health care coverage through the
California Health Benefit Exchange will be made for you. Coverage
will not be effective until January 1, 2014. You are not required to
accept coverage from the Exchange. Your payment for coverage will be
based on your income last year. If you make significantly less or
more this year than you made last year, please tell the California
Health Benefit Exchange and your charges will be based on your
current income. If your income is low, you may qualify for no-cost
coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (c) (1) Effective January 1, 2013, the board shall provide the
name, address, and other information regarding those individuals who
have ceased to be enrolled in the program to the Exchange and to the
Medi-Cal program so that eligibility may be determined and enrollment
completed.
   (d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
  SEC. 4.  Section 12698.45 is added to the Insurance Code, to read:
   12698.45.  (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual who ceases to be enrolled in the program
shall be provided the following notice:

   "Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (b) Effective July 1, 2013, every individual who ceases to be
enrolled in the program shall be provided the following notice:

   "Because you are no longer enrolled in AIM (Access for Infants and
Mothers Program), an application for health care coverage through
the California Health Benefit Exchange will be made for you. Coverage
will not be effective until January 1, 2014. You are not required to
accept coverage from the Exchange. Your payment for coverage will be
based on your income last year. If you make significantly less or
more this year than you made last year, please tell the California
Health Benefit Exchange and your charges will be based on your
current income. If your income is low, you may qualify for no-cost
coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (c) (1) Effective January 1, 2013, the board shall provide the
name, address, and other information regarding those individuals who
have ceased to be enrolled in the program to the Exchange and to the
Medi-Cal program so that eligibility may be determined and enrollment
completed.
   (2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
   (d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
  SEC. 5.  Section 12734 is added to the Insurance Code, to read:
   12734.  (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual who ceases to be enrolled in the program
shall be provided the following notice:

   "Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (b) Effective July 1, 2013, every individual who ceases to be
enrolled in the program shall be provided the following notice:

   "Because you are no longer enrolled in the California Major Risk
Medical Insurance Program, an application for health care coverage
through the California Health Benefit Exchange will be made for you.
Coverage will not be effective until January 1, 2014. You are not
required to accept coverage from the Exchange. Your payment for
coverage will be based on your income last year. If you make
significantly less or more this year than you made last year, please
tell the California Health Benefit Exchange and your charges will be
based on your current income. If your income is low, you may qualify
for no-cost coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (c) (1) Effective January 1, 2013, the board shall provide the
name, address, and other information regarding those individuals who
have ceased to be enrolled in the program to the Exchange and to the
Medi-Cal program so that eligibility may be determined and enrollment
completed.
   (2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
   (d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
  SEC. 6.  Section 12739.615 is added to the Insurance Code, to read:

   12739.615.  (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual who ceases to be enrolled in the program
shall be provided the following notice:

   "Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (b) Effective July 1, 2013, every individual who ceases to be
enrolled in the program shall be provided the following notice:

   "Because you are no longer enrolled in the Federal Temporary High
Risk Pool, an application for health care coverage through the
California Health Benefit Exchange will be made for you. Coverage
will not be effective until January 1, 2014. You are not required to
accept coverage from the Exchange. Your payment for coverage will be
based on your income last year. If you make significantly less or
more this year than you made last year, please tell the California
Health Benefit Exchange and your charges will be based on your
current income. If your income is low, you may qualify for no-cost
coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (c) (1) Effective January 1, 2013, the board shall provide the
name, address, and other information regarding those individuals who
have ceased to be enrolled in the program to the Exchange and to the
Medi-Cal program so that eligibility may be determined and enrollment
completed.
   (2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
   (d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
  SEC. 7.  Section 14029.9 is added to the Welfare and Institutions
Code, to read:
   14029.9.  (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual who ceases to be enrolled in the Medi-Cal
program shall be provided the following notice:

   "Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (b) Effective July 1, 2013, every individual who ceases to be
enrolled in the Medi-Cal program shall be provided the following
notice:

   "Because you are no longer enrolled in Medi-Cal, an application
for health care coverage through the California Health Benefit
Exchange will be made for you. Coverage will not be effective until
January 1, 2014. You are not required to accept coverage from the
Exchange. Your payment for coverage will be based on your income last
year. If you make significantly less or more this year than you made
last year, please tell the California Health Benefit Exchange and
your charges will be based on your current income. If your income is
low, you may qualify for no-cost coverage through Medi-Cal. For more
information, check www.healthcare.ca.gov or call 1-888-Healthhelp
(insert telephone number)."

   (c) (1) Effective January 1, 2013, the department shall provide
the name, address, and other information regarding those individuals
who have ceased to be enrolled in the Medi-Cal program to the
Exchange so that eligibility may be determined and enrollment
completed.
   (2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
   (d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.
  SEC. 8.  Section 14105.182 is added to the Welfare and Institutions
Code, to read:
   14105.182.  (a) Effective January 1, 2012, to June 30, 2013,
inclusive, every individual receiving care or services under the
Family PACT program as provided in subdivision (aa) of Section 14132
shall be provided the following notice:

   "Effective January 1, 2014, you may be eligible for reduced-cost,
comprehensive health care coverage through the California Health
Benefit Exchange. If your income is low, you may be eligible for
no-cost coverage through Medi-Cal. For more information, please visit
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number)."

   (b) Effective July 1, 2013, every individual receiving care or
services under the Family PACT program as provided in subdivision
(aa) of Section 14132 shall be provided the following notice:

   "Because you are enrolled in the Family PACT program, an
application for health care coverage through the California Health
Benefit Exchange will be made for you. Coverage will not be effective
until January 1, 2014. You are not required to accept coverage from
the Exchange. Your payment for coverage will be based on your income
last year. If you make significantly less or more this year than you
made last year, please tell the California Health Benefit Exchange
and your charges will be based on your current income. If your income
is low, you may qualify for no-cost coverage through Medi-Cal. For
more information, check www.healthcare.ca.gov or call
1-888-Healthhelp (insert telephone number)."

   (c) (1) Effective January 1, 2013, every entity providing services
or treatment under the program as provided in subdivision (aa) of
Section 14132 shall provide to the department the name, address, and
other information of each enrollee as required by the department. The
department shall provide the information to the Exchange and to the
Medi-Cal program so that eligibility may be determined and enrollment
completed.
   (2) The information provided to the Exchange shall constitute an
application for enrollment in coverage within the meaning of Section
100503 of the Government Code.
   (d) The individual shall have the opportunity to decline health
care coverage pursuant to this section by notifying the Exchange in
writing.