BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1455
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 1455 (Scott)
          As Amended August 30, 2000
          Majority vote
           
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          |ASSEMBLY:  |     |(May 27, 1999)  |SENATE: |34-0 |(August 31,    |
          |           |     |                |        |     |2000)          |
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                    (vote not relevant)

          Original Committee Reference:    INS.  

           SUMMARY :  Revises the dispute resolution process for payment  
          claims for medical services between providers and health care  
          service plans (health plans).

           The Senate amendments  delete the Assembly version of this bill,  
          and instead:

          1)Require health plan contracts with providers to have a fast,  
            fair, and cost-effective dispute resolution mechanism, that it  
            be accessible to noncontracting providers for billing  
            disputes, and that health plans annually submit a report to  
            the Department of Managed Care (DMC) on this dispute  
            mechanism, as specified.

          2)Increase the interest penalty for unpaid uncontested claims  
            from 10% to 15%, and requires that interest be automatically  
            included in the claim payment.  Require the same penalty on  
            contested claims which are determined to be payable, and  
            provides for a $10 fee for non-compliance.

          3)Prohibit health plans from denying a claim based on a lack of  
            authorization for health care services if the services were  
            related to previously authorized services, it was medically  
            necessary, and the services were provided after business hours  
            and the health plan does not have an after-hours authorization  
            process.

          4)Prohibit health plans from engaging in an unfair payment  
            pattern, defined as a demonstrable and unjust pattern of  
            reviewing or processing complete and accurate claims that  
            results in payment delays, reduced payments, denials of  
            complete and accurate claims, or failure to pay interest due.








                                                                  AB 1455
                                                                  Page  2


          5)Permit DMC, when it has determined that a health plan has  
            engaged in an unfair payment pattern, to impose monetary  
            penalties, require health plans to pay claims in an  
            accelerated manner for three years, and collect costs incurred  
            by DMC for investigative and enforcement expenses.

          6)Require DMC to define in regulations a "complete and accurate  
            claim," and to report to the Legislature its definitions of   
            "unjust patterns."  Require DMC to make available to the  
            public upon request, and on its website, information regarding  
            actions taken on payment practices.

          7)Require DMC to adopt regulations ensuring that health plans  
            have adopted the dispute resolution process provided for in  
            this bill, and report to the Legislature its recommendations  
            for additional statutory requirements.

          8)Permit providers and health plans to report possible unfair  
            patterns to DMC by toll-free telephone or email, and require  
            DMC to report to the Legislature the process of responding to  
            these patterns.

           EXISTING LAW  requires: 

          1)Emergency services and care to be rendered without first  
            questioning the patient or any other person as to his or her  
            ability to pay therefor.  

          2)For emergency care claims, a health plan to notify a claimant  
            in writing if a complete claim, or portion thereof, is  
            contested or denied.

          3)If an uncontested claim is not paid by a health plan within 30  
            working days, or by a health maintenance organization (HMO)  
            within 45 working days, interest on the claim to accrue at 10%  
            per year.

           AS PASSED BY THE ASSEMBLY  , this bill required the Department of  
          Insurance to complete a closed claims study on or before July 1,  
          2000 on auto insurance claims closed in 1988, a copy of which  
          was to be submitted to the Legislature.

           FISCAL EFFECT  :   Unknown









                                                                  AB 1455
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           COMMENTS  :   According to the author, it is increasingly  
          difficult for providers to obtain full and timely reimbursement  
          from plan payors for services rendered to enrollees, and  
          although existing law provides remedies such as civil action or  
          arbitration, these are not viable alternatives due to the time,  
          cost and likelihood of retaliation against a provider by a plan.  
           This bill is sponsored by the California Healthcare  
          Association, which states that this bill is an innovative and  
          proactive treatment for California's ailing health care system.

          This bill was substantially amended in the Senate and the  
          Assembly-approved provisions of this bill were deleted in the  
          Senate.  This bill, as amended in the Senate, is identical to  
          the current version of SB 1177 (Perata), the subject matter of  
          which was heard in Assembly Health Committee.
           
           
           Analysis Prepared by  :  Vincent D. Marchand / HEALTH / (916)  
          319-2097


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