Health Administration Responsibility Project


AB 55 (Migden)

Requires the Department of Corporations to establish an independent medical review system by January 1, 2001, for patients to dispute claims when treatment has been delayed, denied or modified by their plan.

SB 189 (Schiff)

Requires health care service plans to provide enrollees with written response to grievances while expanding the right to external review for experimental treatments. It also expedites the review process in order to respond quickly to a patient's appeal for treatment coverage.


AB 78 (Gallegos)

Establishes a state agency devoted exclusively to the licensing and regulation of health care service plans. The newly created Department of Managed Care will be within the Business, Transportation and Housing Agency. This bill will also establish a new Office of the Patient Advocate, which will assist health plan enrollees with complaints, provide educational guides, issue annual reports and make recommendations on consumer issues.


SB 21 (Figueroa)

States that a patient has the right to sue his health plan for harm caused by failure to provide ordinary care under the plan. It provides a remedy for consumers who are substantially harmed by a health care service plan or managed care entity's action to delay, deny or modify medically necessary treatment.
See Sharon Arkin's pseudo-brief to defend this bill against the expected ERISA attack.


AB 12 (Davis)

Requires health care service plans to provide a second medical opinion upon request by the patient.

AB 285 (Corbett)

Requires health plans that provide telephone medical advice services to have a medical license.

AB 416 (Machado)

Prohibits health care providers from releasing medical information regarding an individual's participation in outpatient psychotherapy without a written request to the provider and notice to the patient. Currently, there are protections related to inpatient care for mental health conditions, but not for records of outpatient psychotherapy. AB 416 resolves this issue.

SB 19 (Figueroa)

Prohibits the unauthorized selling, sharing or use of medical information for any purpose not necessary to provide health care services. Requires health care service plans to make their policies and procedures available upon request.

SB 59 (Perata)

Sets forth procedures and time frames for health care service plans to review a treatment request by a physician. Helps to ensure timely information and decisions regarding a patient's treatment needs and makes certain that patients are entitled to information regarding the process used by health care professionals to determine whether to deny, modify or approve health care services.

AB 215 (Soto)

Establishes deadlines for health plans to respond to physician requests when a patient is referred to a specialist. This is a technical clean up bill to SB 260 by Senator Speier.

SB 559 (Brulte)

Prohibits service plans from inappropriately marketing and selling their provider lists to gain additional revenue. Similar requirements on contracting agents who sell, lease, assign or otherwise transfer a list of contracted providers are also applied to those who pay for these contracts.


SB 260 (Speier)

Establishes the Financial Solvency Standards Board within the newly created Department of Managed Care. Addresses the fiscal solvency crisis facing medical groups in California by adopting regulations and placing adequate safeguards in contracts between health care service plans and risk bearing organizations.



AB 39 (Hertzberg)

Requires health care service plans that provide outpatient prescription drug benefits to provide FDA approved prescription contraception methods.

SB 41 (Speier)

Requires specified individual and group disability insurance policies to provide contraception coverage for spouses and other dependents. Provides exemptions for religious employers.


SB 5 (Rainey)

Requires coverage for the screening, diagnosis and treatment of breast cancer. Also enrollment cannot be denied because of a personal or family history of breast disease or breast cancer.

SB 205 (Perata)

Requires health care service plans and disability insurers to cover medically accepted cancer screening tests or any contract or policy issued, amended or renewed on or after January 1, 2000.


AB 88 (Thomson)

Requires health care service plan contracts to cover the diagnosis and medically necessary treatment of severe mental illnesses at any age and serious emotional disturbances of a child.

SB 349 (Figueroa)

Requires coverage for psychiatric emergency medical conditions. This bill provides additional screening, examination and evaluation of a patient to determine whether a psychiatric emergency medical condition exists.


AB 892 (Alquist)

Adds hospice care to the basic health care services required to be provided by health care service plans.

SB 148 (Alpert)

Provides coverage for the testing and treatment of phenylketonuria (PKU) for Newborns before or soon after discharge from the hospital.

SB 64 (Solis)

Requires coverage for diabetic services and supplies including specified equipment, supplies, training, and prescription drugs that are determined to be medically necessary.


SB 1237 (Escutia)

AB 1309 (Scott)

Allow plaintiffs to sue defendants' insurers directly for insurance bad faith, subject to certain limitations
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