2015-2016 Legislative Package
SB X2 2 - Health Care Funding: Raises much needed funds for Medi-Cal, by imposing a three-year tax on managed care organizations (MCOs) in the state. The way the MCO tax swap proposal is structured is very complex, but the net effect of the proposal is actually quite simple. The tax will provide stable and ongoing funding for Medi-Cal and allow California to maximize its share of existing federal dollars without negatively impacting premiums. It will deliver a $106 million net benefit to plans and provides appropriate funding to our developmental services community, who have suffered much too long. SB X2 2 was signed by the Governor on March 1, 2016.
SB X2 7– Tobacco 21: Changes the minimum legal purchase age for all tobacco products in California from 18 to 21, in order to decrease tobacco addiction in California by restricting youth access to tobacco products. It is estimated that 90% of tobacco users start before the age of 21, roughly 80% first try tobacco before age 18, and 75% of teen smokers continue into their adult years. Limiting access during this important time will reduce the number of Californians who become lifetime smokers and suffer from the long terms impacts of tobacco usage. SB X2 7 is moving forward to the Governor for signature.
SB 33 – Medi-Cal Estate Recovery: Limits estate recovery in the Medi-Cal program by requiring collection for only those health care services required to be collected under federal law. Makes it easier for individuals to pass on their assets by using a narrower definition of “estate” in federal Medicaid law, and allows a hardship exemption from estate recovery for a home of modest value. In addition, SB 33 makes it easier for Medi-Cal beneficiaries to obtain information on amounts spent by Medi-Cal on the beneficiary’s behalf that are subject to estate recovery. SB 33 is on the Assembly Floor awaiting action.
SB 323 – Nurse Practitioner Full Practice Authority: Allows nurse practitioners to provide care, without physician supervision, to the fullest extent of their education and training, after meeting specific requirements, in certain health care settings. SB 323 would be a big step forward for access to health care, especially in rural and underserved areas. SB 323 is pending in Assembly Business and Professions Committee.
SB 815 – Medi-Cal Waiver: SB 815 would implement the recently approved “Medi-Cal 2020” federal Medicaid waiver. Medi-Cal 2020 includes federal funding over the five years of $6.2 billion, and will implement innovative changes in the way Medi-Cal provides services to its members, with the goal of improving efficiency, access and quality of care. SB 815 is pending in Senate Health Committee.
SB 908 – Unreasonable Rate Increase: Requires health plans and health insurers whose rates have been determined by the Department of Managed Health Care (DMHC) or California Department of Insurance (CDI) to be unreasonable or unjustified, to notify the purchaser of this determination and give the purchaser an opportunity to shop for different coverage. Most plans and insurers reduce their rate increases after an unreasonable rate filing by a department, but some do not. In those cases, no one tells the individual consumer or the small business owner, who purchasers the coverage, if the rate has been found unreasonable or unjustified. This means consumers and small business owners can be unwittingly locked into an unreasonable rate because they don’t know it is unreasonable.
SB 923 – No Cost Sharing Changes Mid-Year: The ACA provides many new consumer protections to make health insurance more affordable and available. One of the many individual market reforms California enacted while implementing the ACA, was a provision that prohibited plans and insurers from altering premiums during the plan year. This essential patient protection, while meaningful on its own, does not currently apply to cost sharing requirements across all markets. This bill will ensure health care consumers are actually provided what they were promised when signing up for coverage by prohibiting a health care service plan contract or health insurance policy from changing any cost sharing requirements during the plan year.
SB 1010 – Prescription Drug Cost Notification: Requires prior notice to purchasers by drug manufacturers of price increases and requires health plans and insurers to report the proportion of premium dollar spent on prescription drugs. This bill is one of several bills authored by Senator Hernandez aimed at promoting transparency in health care costs, toward ensuring that affordable coverage and services are available to consumers.
SB 1094 – Initiative Reform: In recent years, the initiative process has become increasingly dominated by corporations and wealthy individuals pushing narrower agendas. SB 1094 will take steps to preserve the original intent of the initiative process by ensuring that proposed ballot initiatives are rooted in true, broad-based support. To achieve that goal, SB 1094 requires at least 15 percent of the signatures gathered to qualify a state ballot initiative to be collected by volunteers or grassroots signature gatherers.
SB 1236 – City of Industry Corruption Cleanup: A recent audit by the State Controller found extensive waste, fraud, and abuse by City of Industry officials, findings similar to what was uncovered in the cities of Bell and Vernon. All 3 cities are “charter cities,” meaning the state cannot step into their municipal affairs. SB 1236 makes the case that the State has an obligation to ensure a transparent, open, and honest government no matter where you live, and therefore good governance laws – and not charter city laws – should apply to Industry.
SB 1365 – Facility Charges: Prohibits a hospital from charging a hospital facility fee for care provided in an outpatient setting that is not part of the hospital. Hospitals will often add a “facility fee” as a separate component of charges resulting from care provided in a hospital setting. Increasingly, hospitals are acquiring outpatient settings, and charging these same facility fees, even though the fees were originally intended to offset the high costs of running a hospital -- such as maintaining an emergency room. There have been numerous examples of patients going to what they believe is simply a medical doctors office, and facing a much higher fee than expected because of this additional "facility fee." SB 1365 will ensure these facility fees stay where they belong -- at the hospital.
SB 36 – Medi-Cal Waiver Bill: Authorizes the Department of Health Care Services (DHCS) to request one or more temporary waiver extensions to continue the operation of the current "California Bridge to Reform Demonstration," the state’s Section 1115 Medicaid waiver which expires on October 31, 2015. In addition, SB 36 also requires DHCS to extend and apply the existing Medi-Cal hospital payment methodologies and allocations to the extent permitted by the federal government or by federal Medicaid law. SB 36 was signed by the Governor on October 10, 2015.
SB 43 – Update of Essential Health Benefits: Updates health insurance Essential Health Benefits (EHBs) available under the Affordable Care Act to consumers, reflecting a change in the federal regulations on EHBs. SB 43 was signed by the Governor on October 8, 2015.
SB 137 – Provider Directories: Establishes standards for health plans and health insurers (carriers) with regard to their provider directories, which includes a requirement to indicate those providers who are accepting new patients. The bill requires electronic directories to be updated weekly and available on carrier websites without requiring searchers to create or access an account or commit to signing up for the plan. Directory information would include whether the provider or staff speaks any non-English language. The bill also requires the Department of Managed Health Care and the Department of Insurance to develop provider directory standards by December 31, 2016. SB 137 was signed by the Governor on October 8, 2015.
SB 282 – Prescription Drugs and Prior Authorization: SB 282 is a follow-up bill to SB 866, which established a standardized form and process for health insurance prescription prior authorization requests. SB 866 directed the Departments of Managed Health Care and Insurance to develop a standardized prior authorization form for prescription drug benefits, and required prescribing providers to use, and health care service plans and health insurers to accept the standardized form. This bill would permit the use of alternative electronic methods beside the standardized form, as long as the method adheres to a specified industry standard, and clarifies that certain groups are exempt from having to use the standardized form, consistent with the intent of SB 866.
This bill also aligns prior authorization timelines with those of the federal government. SB 282 was signed by the Governor on October 8, 2015.
SB 327 - Meal Period Wage Orders: Allows health care employers to continue offering a meal period waiver that enables employees working 12-hour shifts to voluntarily waive one of their two meal periods after a recent California Court of Appeal decision invalidated a meal period regulation adopted over 20 years ago by the Industrial Welfare Commission. This bill benefits hospitals and health care workers alike and allows precious health care dollars to continue flowing toward patient care and employee salaries rather than unnecessary legal liability. SB 327 was signed by the Governor on October 5, 2015.
SB 461 - State Highway Route 164, Rosemead Boulevard: Relinquishes an approximately 3.5 mile state-owned portion of State Highway Route 164, also known as Rosemead Boulevard, to the County of Los Angeles and the City of South El Monte. These segments will be utilized for the purpose of realizing a community-driven vision for a Complete Streets corridor. The Complete Streets project fully accommodates safe and convenient travel for ALL users of the road, especially vulnerable roadway users such as people with disabilities, seniors, youth, pedestrians and cyclists. This project also aims to complement the surrounding Whittier Narrows Recreational Area – the largest park in the region – by enhancing recreation opportunities and access to the park. SB 461 was signed by the Governor on October 7, 2015.
SB 464 – Self reporting tools for hormonal contraception: Permits blood pressure, weight, height, and patient health history to be self-reported by patients to prescribers for the purpose of receiving hormonal contraception. Using these tools in mobile and web-based technologies will increase access to hormonal contraception in all underserved communities. SB 464 was signed by the Governor on September 30, 2015.
SB 485 – Sanitation District: Provides cost-effective flexibility to achieve compliance with municipal stormwater (MS4) permit requirements through collaboration among existing local agencies in Los Angeles County. Current law does not specifically grant the Los Angeles County Sanitation District authority to manage stormwater; SB 485 removes this uncertainty. SB 485 was signed by the Governor on October 9, 2015.