127660. (a) The Legislature hereby requests the University of
California to establish the California Health Benefit Review Program
to assess legislation proposing to mandate a benefit or service, as
defined in subdivision (c), and legislation proposing to repeal a
mandated benefit or service, as defined in subdivision (d), and to
prepare a written analysis with relevant data on the following:
(1) Public health impacts, including, but not limited to, all of
the following:
(A) The impact on the health of the community, including the
reduction of communicable disease and the benefits of prevention such
as those provided by childhood immunizations and prenatal care.
(B) The impact on the health of the community, including diseases
and conditions where gender and racial disparities in outcomes are
established in peer-reviewed scientific and medical literature.
(C) The extent to which the benefit or service reduces premature
death and the economic loss associated with disease.
(2) Medical impacts, including, but not limited to, all of the
following:
(A) The extent to which the benefit or service is generally
recognized by the medical community as being effective in the
screening, diagnosis, or treatment of a condition or disease, as
demonstrated by a review of scientific and peer reviewed medical
literature.
(B) The extent to which the benefit or service is generally
available and utilized by treating physicians.
(C) The contribution of the benefit or service to the health
status of the population, including the results of any research
demonstrating the efficacy of the benefit or service compared to
alternatives, including not providing the benefit or service.
(D) The extent to which mandating or repealing the benefits or
services would not diminish or eliminate access to currently
available health care benefits or services.
(3) Financial impacts, including, but not limited to, all of the
following:
(A) The extent to which the coverage or repeal of coverage will
increase or decrease the benefit or cost of the benefit or service.
(B) The extent to which the coverage or repeal of coverage will
increase the utilization of the benefit or service, or will be a
substitute for, or affect the cost of, alternative benefits or
services.
(C) The extent to which the coverage or repeal of coverage will
increase or decrease the administrative expenses of health care
service plans and health insurers and the premium and expenses of
subscribers, enrollees, and policyholders.
(D) The impact of this coverage or repeal of coverage on the total
cost of health care.
(E) The potential cost or savings to the private sector, including
the impact on small employers as defined in paragraph (1) of
subdivision (l) of Section 1357, the Public Employees' Retirement
System, other retirement systems funded by the state or by a local
government, individuals purchasing individual health insurance, and
publicly funded state health insurance programs, including the
Medi-Cal program and the Healthy Families Program.
(F) The extent to which costs resulting from lack of coverage or
repeal of coverage are or would be shifted to other payers, including
both public and private entities.
(G) The extent to which mandating or repealing the proposed
benefit or service would not diminish or eliminate access to
currently available health care benefits or services.
(H) The extent to which the benefit or service is generally
utilized by a significant portion of the population.
(I) The extent to which health care coverage for the benefit or
service is already generally available.
(J) The level of public demand for health care coverage for the
benefit or service, including the level of interest of collective
bargaining agents in negotiating privately for inclusion of this
coverage in group contracts, and the extent to which the mandated
benefit or service is covered by self-funded employer groups.
(K) In assessing and preparing a written analysis of the financial
impact of legislation proposing to mandate a benefit or service and
legislation proposing to repeal a mandated benefit or service
pursuant to this paragraph, the Legislature requests the University
of California to use a certified actuary or other person with
relevant knowledge and expertise to determine the financial impact.
(b) The Legislature requests that the University of California
provide every analysis to the appropriate policy and fiscal
committees of the Legislature not later than 60 days after receiving
a request made pursuant to Section 127661. In addition, the
Legislature requests that the university post every analysis on the
Internet and make every analysis available to the public upon
request.
(c) As used in this section, "legislation proposing to mandate a
benefit or service" means a proposed statute that requires a health
care service plan or a health insurer, or both, to do any of the
following:
(1) Permit a person insured or covered under the policy or
contract to obtain health care treatment or services from a
particular type of health care provider.
(2) Offer or provide coverage for the screening, diagnosis, or
treatment of a particular disease or condition.
(3) Offer or provide coverage of a particular type of health care
treatment or service, or of medical equipment, medical supplies, or
drugs used in connection with a health care treatment or service.
(d) As used in this section, "legislation proposing to repeal a
mandated benefit or service" means a proposed statute that, if
enacted, would become operative on or after January 1, 2008, and
would repeal an existing requirement that a health care service plan
or a health insurer, or both, do any of the following:
(1) Permit a person insured or covered under the policy or
contract to obtain health care treatment or services from a
particular type of health care provider.
(2) Offer or provide coverage for the screening, diagnosis, or
treatment of a particular disease or condition.
(3) Offer or provide coverage of a particular type of health care
treatment or service, or of medical equipment, medical supplies, or
drugs used in connection with a health care treatment or service.
127661. A request pursuant to this chapter may be made by an
appropriate policy or fiscal committee chairperson, the Speaker of
the Assembly, or the President pro Tempore of the Senate, who shall
forward the introduced bill to the University of California for
assessment.
127662. (a) In order to effectively support the University of
California and its work in implementing this chapter, there is hereby
established in the State Treasury, the Health Care Benefits Fund.
The university's work in providing the bill analyses shall be
supported from the fund.
(b) For fiscal years 2010-11 to 2014-15, inclusive, each health
care service plan, except a specialized health care service plan, and
each health insurer, as defined in Section 106 of the Insurance
Code, shall be assessed an annual fee in an amount determined through
regulation. The amount of the fee shall be determined by the
Department of Managed Health Care and the Department of Insurance in
consultation with the university and shall be limited to the amount
necessary to fund the actual and necessary expenses of the university
and its work in implementing this chapter. The total annual
assessment on health care service plans and health insurers shall not
exceed two million dollars ($2,000,000).
(c) The Department of Managed Health Care and the Department of
Insurance, in coordination with the university, shall assess the
health care service plans and health insurers, respectively, for the
costs required to fund the university's activities pursuant to
subdivision (b).
(1) Health care service plans shall be notified of the assessment
on or before June 15 of each year with the annual assessment notice
issued pursuant to Section 1356. The assessment pursuant to this
section is separate and independent of the assessments in Section
1356.
(2) Health insurers shall be noticed of the assessment in
accordance with the notice for the annual assessment or quarterly
premium tax revenues.
(3) The assessed fees required pursuant to subdivision (b) shall
be paid on an annual basis no later than August 1 of each year. The
Department of Managed Health Care and the Department of Insurance
shall forward the assessed fees to the Controller for deposit in the
Health Care Benefits Fund immediately following their receipt.
(4) "Health insurance," as used in this subdivision, does not
include Medicare supplement, vision-only, dental-only, or CHAMPUS
supplement insurance, or hospital indemnity, accident-only, or
specified disease insurance that does not pay benefits on a fixed
benefit, cash payment only basis.
127663. In order to avoid conflicts of interest, the Legislature
requests the University of California to develop and implement
conflict-of-interest provisions to prohibit a person from
participating in any analysis in which the person knows or has reason
to know he or she has a material financial interest, including, but
not limited to, a person who has a consulting or other agreement with
a person or organization that would be affected by the legislation.
127664. The Legislature requests the University of California to
submit a report to the Governor and the Legislature by January 1,
2014, regarding the implementation of this chapter.
127665. This chapter shall remain in effect until June 30, 2015,
and shall be repealed as of that date, unless a later enacted statute
that becomes operative on or before June 30, 2015, deletes or
extends that date.
127660. (a) The Legislature hereby requests the University of
California to establish the California Health Benefit Review Program
to assess legislation proposing to mandate a benefit or service, as
defined in subdivision (c), and legislation proposing to repeal a
mandated benefit or service, as defined in subdivision (d), and to
prepare a written analysis with relevant data on the following:
(1) Public health impacts, including, but not limited to, all of
the following:
(A) The impact on the health of the community, including the
reduction of communicable disease and the benefits of prevention such
as those provided by childhood immunizations and prenatal care.
(B) The impact on the health of the community, including diseases
and conditions where gender and racial disparities in outcomes are
established in peer-reviewed scientific and medical literature.
(C) The extent to which the benefit or service reduces premature
death and the economic loss associated with disease.
(2) Medical impacts, including, but not limited to, all of the
following:
(A) The extent to which the benefit or service is generally
recognized by the medical community as being effective in the
screening, diagnosis, or treatment of a condition or disease, as
demonstrated by a review of scientific and peer reviewed medical
literature.
(B) The extent to which the benefit or service is generally
available and utilized by treating physicians.
(C) The contribution of the benefit or service to the health
status of the population, including the results of any research
demonstrating the efficacy of the benefit or service compared to
alternatives, including not providing the benefit or service.
(D) The extent to which mandating or repealing the benefits or
services would not diminish or eliminate access to currently
available health care benefits or services.
(3) Financial impacts, including, but not limited to, all of the
following:
(A) The extent to which the coverage or repeal of coverage will
increase or decrease the benefit or cost of the benefit or service.
(B) The extent to which the coverage or repeal of coverage will
increase the utilization of the benefit or service, or will be a
substitute for, or affect the cost of, alternative benefits or
services.
(C) The extent to which the coverage or repeal of coverage will
increase or decrease the administrative expenses of health care
service plans and health insurers and the premium and expenses of
subscribers, enrollees, and policyholders.
(D) The impact of this coverage or repeal of coverage on the total
cost of health care.
(E) The potential cost or savings to the private sector, including
the impact on small employers as defined in paragraph (1) of
subdivision (l) of Section 1357, the Public Employees' Retirement
System, other retirement systems funded by the state or by a local
government, individuals purchasing individual health insurance, and
publicly funded state health insurance programs, including the
Medi-Cal program and the Healthy Families Program.
(F) The extent to which costs resulting from lack of coverage or
repeal of coverage are or would be shifted to other payers, including
both public and private entities.
(G) The extent to which mandating or repealing the proposed
benefit or service would not diminish or eliminate access to
currently available health care benefits or services.
(H) The extent to which the benefit or service is generally
utilized by a significant portion of the population.
(I) The extent to which health care coverage for the benefit or
service is already generally available.
(J) The level of public demand for health care coverage for the
benefit or service, including the level of interest of collective
bargaining agents in negotiating privately for inclusion of this
coverage in group contracts, and the extent to which the mandated
benefit or service is covered by self-funded employer groups.
(K) In assessing and preparing a written analysis of the financial
impact of legislation proposing to mandate a benefit or service and
legislation proposing to repeal a mandated benefit or service
pursuant to this paragraph, the Legislature requests the University
of California to use a certified actuary or other person with
relevant knowledge and expertise to determine the financial impact.
(b) The Legislature requests that the University of California
provide every analysis to the appropriate policy and fiscal
committees of the Legislature not later than 60 days after receiving
a request made pursuant to Section 127661. In addition, the
Legislature requests that the university post every analysis on the
Internet and make every analysis available to the public upon
request.
(c) As used in this section, "legislation proposing to mandate a
benefit or service" means a proposed statute that requires a health
care service plan or a health insurer, or both, to do any of the
following:
(1) Permit a person insured or covered under the policy or
contract to obtain health care treatment or services from a
particular type of health care provider.
(2) Offer or provide coverage for the screening, diagnosis, or
treatment of a particular disease or condition.
(3) Offer or provide coverage of a particular type of health care
treatment or service, or of medical equipment, medical supplies, or
drugs used in connection with a health care treatment or service.
(d) As used in this section, "legislation proposing to repeal a
mandated benefit or service" means a proposed statute that, if
enacted, would become operative on or after January 1, 2008, and
would repeal an existing requirement that a health care service plan
or a health insurer, or both, do any of the following:
(1) Permit a person insured or covered under the policy or
contract to obtain health care treatment or services from a
particular type of health care provider.
(2) Offer or provide coverage for the screening, diagnosis, or
treatment of a particular disease or condition.
(3) Offer or provide coverage of a particular type of health care
treatment or service, or of medical equipment, medical supplies, or
drugs used in connection with a health care treatment or service.
127661. A request pursuant to this chapter may be made by an
appropriate policy or fiscal committee chairperson, the Speaker of
the Assembly, or the President pro Tempore of the Senate, who shall
forward the introduced bill to the University of California for
assessment.
127662. (a) In order to effectively support the University of
California and its work in implementing this chapter, there is hereby
established in the State Treasury, the Health Care Benefits Fund.
The university's work in providing the bill analyses shall be
supported from the fund.
(b) For fiscal years 2010-11 to 2014-15, inclusive, each health
care service plan, except a specialized health care service plan, and
each health insurer, as defined in Section 106 of the Insurance
Code, shall be assessed an annual fee in an amount determined through
regulation. The amount of the fee shall be determined by the
Department of Managed Health Care and the Department of Insurance in
consultation with the university and shall be limited to the amount
necessary to fund the actual and necessary expenses of the university
and its work in implementing this chapter. The total annual
assessment on health care service plans and health insurers shall not
exceed two million dollars ($2,000,000).
(c) The Department of Managed Health Care and the Department of
Insurance, in coordination with the university, shall assess the
health care service plans and health insurers, respectively, for the
costs required to fund the university's activities pursuant to
subdivision (b).
(1) Health care service plans shall be notified of the assessment
on or before June 15 of each year with the annual assessment notice
issued pursuant to Section 1356. The assessment pursuant to this
section is separate and independent of the assessments in Section
1356.
(2) Health insurers shall be noticed of the assessment in
accordance with the notice for the annual assessment or quarterly
premium tax revenues.
(3) The assessed fees required pursuant to subdivision (b) shall
be paid on an annual basis no later than August 1 of each year. The
Department of Managed Health Care and the Department of Insurance
shall forward the assessed fees to the Controller for deposit in the
Health Care Benefits Fund immediately following their receipt.
(4) "Health insurance," as used in this subdivision, does not
include Medicare supplement, vision-only, dental-only, or CHAMPUS
supplement insurance, or hospital indemnity, accident-only, or
specified disease insurance that does not pay benefits on a fixed
benefit, cash payment only basis.
127663. In order to avoid conflicts of interest, the Legislature
requests the University of California to develop and implement
conflict-of-interest provisions to prohibit a person from
participating in any analysis in which the person knows or has reason
to know he or she has a material financial interest, including, but
not limited to, a person who has a consulting or other agreement with
a person or organization that would be affected by the legislation.
127664. The Legislature requests the University of California to
submit a report to the Governor and the Legislature by January 1,
2014, regarding the implementation of this chapter.
127665. This chapter shall remain in effect until June 30, 2015,
and shall be repealed as of that date, unless a later enacted statute
that becomes operative on or before June 30, 2015, deletes or
extends that date.
127660. (a) The Legislature hereby requests the University of
California to establish the California Health Benefit Review Program
to assess legislation proposing to mandate a benefit or service, as
defined in subdivision (c), and legislation proposing to repeal a
mandated benefit or service, as defined in subdivision (d), and to
prepare a written analysis with relevant data on the following:
(1) Public health impacts, including, but not limited to, all of
the following:
(A) The impact on the health of the community, including the
reduction of communicable disease and the benefits of prevention such
as those provided by childhood immunizations and prenatal care.
(B) The impact on the health of the community, including diseases
and conditions where gender and racial disparities in outcomes are
established in peer-reviewed scientific and medical literature.
(C) The extent to which the benefit or service reduces premature
death and the economic loss associated with disease.
(2) Medical impacts, including, but not limited to, all of the
following:
(A) The extent to which the benefit or service is generally
recognized by the medical community as being effective in the
screening, diagnosis, or treatment of a condition or disease, as
demonstrated by a review of scientific and peer reviewed medical
literature.
(B) The extent to which the benefit or service is generally
available and utilized by treating physicians.
(C) The contribution of the benefit or service to the health
status of the population, including the results of any research
demonstrating the efficacy of the benefit or service compared to
alternatives, including not providing the benefit or service.
(D) The extent to which mandating or repealing the benefits or
services would not diminish or eliminate access to currently
available health care benefits or services.
(3) Financial impacts, including, but not limited to, all of the
following:
(A) The extent to which the coverage or repeal of coverage will
increase or decrease the benefit or cost of the benefit or service.
(B) The extent to which the coverage or repeal of coverage will
increase the utilization of the benefit or service, or will be a
substitute for, or affect the cost of, alternative benefits or
services.
(C) The extent to which the coverage or repeal of coverage will
increase or decrease the administrative expenses of health care
service plans and health insurers and the premium and expenses of
subscribers, enrollees, and policyholders.
(D) The impact of this coverage or repeal of coverage on the total
cost of health care.
(E) The potential cost or savings to the private sector, including
the impact on small employers as defined in paragraph (1) of
subdivision (l) of Section 1357, the Public Employees' Retirement
System, other retirement systems funded by the state or by a local
government, individuals purchasing individual health insurance, and
publicly funded state health insurance programs, including the
Medi-Cal program and the Healthy Families Program.
(F) The extent to which costs resulting from lack of coverage or
repeal of coverage are or would be shifted to other payers, including
both public and private entities.
(G) The extent to which mandating or repealing the proposed
benefit or service would not diminish or eliminate access to
currently available health care benefits or services.
(H) The extent to which the benefit or service is generally
utilized by a significant portion of the population.
(I) The extent to which health care coverage for the benefit or
service is already generally available.
(J) The level of public demand for health care coverage for the
benefit or service, including the level of interest of collective
bargaining agents in negotiating privately for inclusion of this
coverage in group contracts, and the extent to which the mandated
benefit or service is covered by self-funded employer groups.
(K) In assessing and preparing a written analysis of the financial
impact of legislation proposing to mandate a benefit or service and
legislation proposing to repeal a mandated benefit or service
pursuant to this paragraph, the Legislature requests the University
of California to use a certified actuary or other person with
relevant knowledge and expertise to determine the financial impact.
(b) The Legislature requests that the University of California
provide every analysis to the appropriate policy and fiscal
committees of the Legislature not later than 60 days after receiving
a request made pursuant to Section 127661. In addition, the
Legislature requests that the university post every analysis on the
Internet and make every analysis available to the public upon
request.
(c) As used in this section, "legislation proposing to mandate a
benefit or service" means a proposed statute that requires a health
care service plan or a health insurer, or both, to do any of the
following:
(1) Permit a person insured or covered under the policy or
contract to obtain health care treatment or services from a
particular type of health care provider.
(2) Offer or provide coverage for the screening, diagnosis, or
treatment of a particular disease or condition.
(3) Offer or provide coverage of a particular type of health care
treatment or service, or of medical equipment, medical supplies, or
drugs used in connection with a health care treatment or service.
(d) As used in this section, "legislation proposing to repeal a
mandated benefit or service" means a proposed statute that, if
enacted, would become operative on or after January 1, 2008, and
would repeal an existing requirement that a health care service plan
or a health insurer, or both, do any of the following:
(1) Permit a person insured or covered under the policy or
contract to obtain health care treatment or services from a
particular type of health care provider.
(2) Offer or provide coverage for the screening, diagnosis, or
treatment of a particular disease or condition.
(3) Offer or provide coverage of a particular type of health care
treatment or service, or of medical equipment, medical supplies, or
drugs used in connection with a health care treatment or service.
127661. A request pursuant to this chapter may be made by an
appropriate policy or fiscal committee chairperson, the Speaker of
the Assembly, or the President pro Tempore of the Senate, who shall
forward the introduced bill to the University of California for
assessment.
127662. (a) In order to effectively support the University of
California and its work in implementing this chapter, there is hereby
established in the State Treasury, the Health Care Benefits Fund.
The university's work in providing the bill analyses shall be
supported from the fund.
(b) For fiscal years 2010-11 to 2014-15, inclusive, each health
care service plan, except a specialized health care service plan, and
each health insurer, as defined in Section 106 of the Insurance
Code, shall be assessed an annual fee in an amount determined through
regulation. The amount of the fee shall be determined by the
Department of Managed Health Care and the Department of Insurance in
consultation with the university and shall be limited to the amount
necessary to fund the actual and necessary expenses of the university
and its work in implementing this chapter. The total annual
assessment on health care service plans and health insurers shall not
exceed two million dollars ($2,000,000).
(c) The Department of Managed Health Care and the Department of
Insurance, in coordination with the university, shall assess the
health care service plans and health insurers, respectively, for the
costs required to fund the university's activities pursuant to
subdivision (b).
(1) Health care service plans shall be notified of the assessment
on or before June 15 of each year with the annual assessment notice
issued pursuant to Section 1356. The assessment pursuant to this
section is separate and independent of the assessments in Section
1356.
(2) Health insurers shall be noticed of the assessment in
accordance with the notice for the annual assessment or quarterly
premium tax revenues.
(3) The assessed fees required pursuant to subdivision (b) shall
be paid on an annual basis no later than August 1 of each year. The
Department of Managed Health Care and the Department of Insurance
shall forward the assessed fees to the Controller for deposit in the
Health Care Benefits Fund immediately following their receipt.
(4) "Health insurance," as used in this subdivision, does not
include Medicare supplement, vision-only, dental-only, or CHAMPUS
supplement insurance, or hospital indemnity, accident-only, or
specified disease insurance that does not pay benefits on a fixed
benefit, cash payment only basis.
127663. In order to avoid conflicts of interest, the Legislature
requests the University of California to develop and implement
conflict-of-interest provisions to prohibit a person from
participating in any analysis in which the person knows or has reason
to know he or she has a material financial interest, including, but
not limited to, a person who has a consulting or other agreement with
a person or organization that would be affected by the legislation.
127664. The Legislature requests the University of California to
submit a report to the Governor and the Legislature by January 1,
2014, regarding the implementation of this chapter.
127665. This chapter shall remain in effect until June 30, 2015,
and shall be repealed as of that date, unless a later enacted statute
that becomes operative on or before June 30, 2015, deletes or
extends that date.
