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AB-714 Health care coverage: California Health Benefit Exchange.(2011-2012)

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AB714:v93#DOCUMENT

Amended  IN  Senate  June 30, 2011
Amended  IN  Senate  June 23, 2011
Amended  IN  Assembly  May 27, 2011
Amended  IN  Assembly  May 03, 2011
Amended  IN  Assembly  April 14, 2011
Amended  IN  Assembly  March 29, 2011

CALIFORNIA LEGISLATURE— 2011–2012 REGULAR SESSION

Assembly Bill
No. 714


Introduced  by  Assembly Member Atkins

February 17, 2011


An act to amend Section 127420 of, and to add Sections 104164, 120971.5, and 120971.6 to, the Health and Safety Code, to add Sections 12693.78, 12693.79, 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 amended, 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, and a program for cancer screening administered by the State Department of Public Health. 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 specified health care coverage to individuals under the AIDS Drug Assistance Program (ADAP) and the federal Ryan White HIV/AIDS Treatment Extension Act of 2009, which are administered by the State Department of Public Health. 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, the State Department of Public Health, and the Managed Risk Medical Insurance Board, respectively, 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 cancer treatment and screening programs, the Family PACT program, and the programs for treatment of HIV/AIDS, the disclosure would be made to each enrollee, and for the Family PACT Program, the disclosure would be made by Family PACT providers and on and after July 1, 2013, as specified. The bill would require certain hospitals, when billing, to include additional disclosures regarding health care coverage through the Exchange.
On and after January 1, 2013, this bill would require the State Department of Health Care Services and the Managed Risk Medical Insurance Board to provide to the California Health Benefit Exchange specified information for each individual who has ceased to be enrolled under those programs, except the cancer treatment and screening programs, the Family PACT program, and the programs for treatment of HIV/AIDS, in a manner to be prescribed by the Exchange, for purposes of determining eligibility and completing enrollment in the Exchange, and to disclose that enrollment to those individuals. On and after January 1, 2013, with respect to the cancer treatment and screening programs, the programs for the treatment of HIV/AIDS, and the Family PACT program, this bill would require the State Department of Health Care Services or the State Department of Public Health to provide to the Exchange specified information for each enrollee in a manner to be prescribed by the Exchange for purposes of determining eligibility and completing enrollment in the Exchange. The bill would make the automatic enrollment of those individuals in the Exchange subject to the State Department of Health Care Services, the State Department of Public Health, and the Managed Risk Medical Insurance Board receiving approval from the United States Department of Health and Human Services to transfer the minimum information necessary to initiate an application for enrollment, as specified. The bill would allow an individual who has been enrolled in the Exchange by the departments or the board to opt out of that coverage in a manner to be prescribed by the Exchange require each affected individual to be given the opportunity to provide informed consent to commence eligibility determination and complete enrollment, but would provide that failure to consent or to respond would be construed to mean the individual is declining coverage.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   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) (1) Effective January 1, 2012, to June 30, 2013, inclusive, the State Department of Health Care Services shall include the following notice in materials otherwise provided to every individual receiving services or treatment for cancer under this chapter or Section 14007.71 of the Welfare and Institutions Code:

“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).”

(2) Effective January 1, 2012, to June 30, 2013, inclusive, the State Department of Public Health shall include the notice set forth in paragraph (1) in materials otherwise provided to every individual receiving cancer screening under Section 30461.8 of the Revenue and Taxation Code.
(b) (1) Effective July 1, 2013, the State Department of Health Care Services shall include the following notice in materials otherwise provided to every individual receiving services or treatment under this chapter or Section 14007.71 of the Welfare and Institutions Code:

“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).”

(2) Effective July 1, 2013, the State Department of Public Health shall include the notice set forth in paragraph (1) in materials otherwise provided to every individual receiving cancer screening under Section 30461.8 of the Revenue and Taxation Code.
(c) (1) To maximize the number of individual Californians complying with the requirements of the federal Patient Protection and Affordable Care Act (Public Law 111-148) by obtaining coverage consistent with the provisions of federal law, the departments shall seek approval from the United States Department of Health and Human Services to transfer the minimum information necessary to initiate an application for enrollment under this section consistent with Section 100503 of the Government Code.
(2) Effective January 1, 2013, for each enrollee, the departments shall provide to the Exchange the name, most recent address, clinical information, recent providers providers within the last 12 months, and other information that is in the possession of the program that the Exchange may require, in a manner to be prescribed by the Exchange strictly necessary in order to determine eligibility, complete enrollment, and maximize continuity of care. The information shall be kept confidential in a manner consistent with subsection (g) of Section 1411 of the federal Patient Protection and Affordable Care Act (Public Law 111-148) and other federal and state medical privacy laws.
(3) The information to the Exchange shall initiate an application for enrollment in coverage within the meaning of Section 100503 of the Government Code. Nothing in this section shall be construed to alter the responsibility of the Exchange or other state and local government entities with respect to the criteria and process for eligibility and enrollment in the Exchange and other public health care coverage programs.

(d)The individual shall have the opportunity to decline health care coverage pursuant to this section in a manner to be prescribed by the Exchange.

(d) An individual for whom an application has been initiated by the transfer of information shall be given the opportunity to provide informed consent for the use of the transferred information to commence eligibility determination and complete enrollment as well as the opportunity to correct any transferred information or provide additional information before a final eligibility determination is made. If the individual fails to consent or fails to respond to the opportunity to provide informed consent within a reasonable period of time, that failure to consent or respond shall be construed to mean that the individual is declining coverage.

SEC. 2.

 Section 120971.5 is added to the Health and Safety Code, to read:

120971.5.
 (a) Effective January 1, 2012, to June 30, 2013, inclusive, the State Department of Public Health shall include the following notice in materials otherwise provided to every individual receiving care or services under the AIDS Drug Assistance Program (ADAP), as provided in Section 120950:

“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, the State Department of Public Health shall include the following notice in materials otherwise provided to every individual receiving care or services under ADAP as provided in Section 120950:

“Because you are enrolled in a public health 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) To maximize the number of individual Californians complying with the requirements of the federal Patient Protection and Affordable Care Act (Public Law 111-148) by obtaining coverage consistent with the provisions of federal law, the State Department of Public Health shall seek approval from the United States Department of Health and Human Services to transfer the minimum information necessary to initiate an application for enrollment under this section consistent with Section 100503 of the Government Code.
(2) Effective January 1, 2013, for each enrollee, the State Department of Public Health shall provide to the Exchange the name, most recent address, clinical information, recent providers providers within the last 12 months, and other information that is in the possession of the program that the Exchange may require, in a manner to be prescribed by the Exchange strictly necessary in order to determine eligibility, complete enrollment, and maximize continuity of care. The information shall be kept confidential in a manner consistent with subsection (g) of Section 1411 of the federal Patient Protection and Affordable Care Act (Public Law 111-148), the and other federal and state medical privacy laws. The information shall be provided consistent with Section 120980.
(3) The information provided to the Exchange shall initiate an application for enrollment in coverage within the meaning of Section 100503 of the Government Code. Nothing in this section shall be construed to alter the responsibility of the Exchange or other state and local government entities with respect to the criteria and process for eligibility and enrollment in the Exchange and other public health care coverage programs.

(d)The individual shall have the opportunity to decline health care coverage pursuant to this section in a manner to be prescribed by the Exchange.

(d) An individual for whom an application has been initiated by the transfer of information shall be given the opportunity to provide informed consent for the use of the transferred information to commence eligibility determination and complete enrollment as well as the opportunity to correct any transferred information or provide additional information before a final eligibility determination is made. If the individual fails to consent or fails to respond to the opportunity to provide informed consent within a reasonable period of time, that failure to consent or respond shall be construed to mean that the individual is declining coverage.

SEC. 3.

 Section 120971.6 is added to the Health and Safety Code, to read:

120971.6.
 (a) Effective January 1, 2012, to June 30, 2013, inclusive, the State Department of Public Health shall include the following notice in materials otherwise provided to every individual receiving care or services under the federal Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-187):

“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, the State Department of Public Health shall include the following notice in materials otherwise provided to every individual receiving care or services under the federal Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-187):

“Because you are enrolled in a public health 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) To maximize the number of individual Californians complying with the requirements of the federal Patient Protection and Affordable Care Act (Public Law 111-148) by obtaining coverage consistent with the provisions of federal law, the State Department of Public Health shall seek approval from the United States Department of Health and Human Services to transfer the minimum information necessary to initiate an application for enrollment under this section consistent with Section 100503 of the Government Code.
(2) Effective January 1, 2013, for each enrollee, the State Department of Public Health shall provide to the Exchange the name, most recent address, clinical information, recent providers providers within the last 12 months, and other information that is in the possession of the program that the Exchange may require, in a manner to be prescribed by the Exchange strictly necessary in order to determine eligibility, complete enrollment, and maximize continuity of care. The information shall be kept confidential in a manner consistent with subsection (g) of Section 1411 of the federal Patient Protection and Affordable Care Act (Public Law 111-148), the and other federal and state medical privacy laws. The information shall be provided consistent with Section 120980.
(3) The information provided to the Exchange shall initiate an application for enrollment in coverage within the meaning of Section 100503 of the Government Code. Nothing in this section shall be construed to alter the responsibility of the Exchange or other state and local government entities with respect to the criteria and process for eligibility and enrollment in the Exchange and other public health care coverage programs.

(d)The individual shall have the opportunity to decline health care coverage pursuant to this section in a manner to be prescribed by the Exchange.

(d) An individual for whom an application has been initiated by the transfer of information shall be given the opportunity to provide informed consent for the use of the transferred information to commence eligibility determination and complete enrollment as well as the opportunity to correct any transferred information or provide additional information before a final eligibility determination is made. If the individual fails to consent or fails to respond to the opportunity to provide informed consent within a reasonable period of time, that failure to consent or respond shall be construed to mean that the individual is declining coverage.

SEC. 4.

 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. 5.

 Section 12693.78 is added to the Insurance Code, to read:

12693.78.
 (a) Effective January 1, 2012, to June 30, 2013, inclusive, the board shall include the following notice in materials otherwise provided to every individual who ceases to be enrolled in the program:

“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, the board shall include the following notice in materials otherwise provided to every individual who ceases to be enrolled in the program after that date:

“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) To maximize the number of individual Californians complying with the requirements of the federal Patient Protection and Affordable Care Act (Public Law 111-148) by obtaining coverage consistent with the provisions of federal law, the board shall seek approval from the United States Department of Health and Human Services to transfer the minimum information necessary to initiate an application for enrollment under this section consistent with Section 100503 of the Government Code.
(2) Effective January 1, 2013, for each enrollee who has ceased to be enrolled, the board shall provide to the Exchange the name, most recent address, clinical information, recent providers providers within the last 12 months, and other information that is in the possession of the program that the Exchange may require, in a manner to be prescribed by the Exchange strictly necessary in order to determine eligibility, complete enrollment, and maximize continuity of care. The information shall be kept confidential in a manner consistent with subsection (g) of Section 1411 of the federal Patient Protection and Affordable Care Act (Public Law 111-148) and other federal and state medical privacy laws.
(3) The information provided to the Exchange shall initiate an application for enrollment in coverage within the meaning of Section 100503 of the Government Code. Nothing in this section shall be construed to alter the responsibility of the Exchange or other state and local government entities with respect to the criteria and process for eligibility and enrollment in the Exchange and other public health care coverage programs.

(d)The individual shall have the opportunity to decline health care coverage pursuant to this section in a manner to be prescribed by the Exchange.

(d) An individual for whom an application has been initiated by the transfer of information shall be given the opportunity to provide informed consent for the use of the transferred information to commence eligibility determination and complete enrollment as well as the opportunity to correct any transferred information or provide additional information before a final eligibility determination is made. If the individual fails to consent or fails to respond to the opportunity to provide informed consent within a reasonable period of time, that failure to consent or respond shall be construed to mean that the individual is declining coverage.

SEC. 6.

 Section 12693.79 is added to the Insurance Code, to read:

12693.79.
 Effective January 1, 2012, the board shall include the following notice in materials otherwise provided to every individual enrolled in the Healthy Families Program:

“Effective January 1, 2014, if your parents or other family members do not have health care coverage that costs less than 10% of your income, your parents or other family members 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).”

SEC. 7.

 Section 12698.45 is added to the Insurance Code, to read:

12698.45.
 (a) Effective January 1, 2012, to June 30, 2013, inclusive, the board shall include the following notice in materials otherwise provided to every individual who ceases to be enrolled in the program:

“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, the board shall include the following notice in materials otherwise provided to every individual who ceases to be enrolled in the program:

“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) To maximize the number of individual Californians complying with the requirements of the federal Patient Protection and Affordable Care Act (Public Law 111-148) by obtaining coverage consistent with the provisions of federal law, the board shall seek approval from the United States Department of Health and Human Services to transfer the minimum information necessary to initiate an application for enrollment under this section consistent with Section 100503 of the Government Code.
(2) Effective January 1, 2013, for each enrollee who has ceased to be enrolled, the board shall provide to the Exchange the name, most recent address, clinical information, recent providers providers within the last 12 months, and other information that is in the possession of the program that the Exchange may require, in a manner to be prescribed by the Exchange strictly necessary in order to determine eligibility, complete enrollment, and maximize continuity of care. The information shall be kept confidential in a manner consistent with subsection (g) of Section 1411 of the federal Patient Protection and Affordable Care Act (Public Law 111-148) and other federal and state medical privacy laws.
(3) The information provided to the Exchange shall initiate an application for enrollment in coverage within the meaning of Section 100503 of the Government Code. Nothing in this section shall be construed to alter the responsibility of the Exchange or other state and local government entities with respect to the criteria and process for eligibility and enrollment in the Exchange and other public health care coverage programs.

(d)The individual shall have the opportunity to decline health care coverage pursuant to this section in a manner to be prescribed by the Exchange.

(d) An individual for whom an application has been initiated by the transfer of information shall be given the opportunity to provide informed consent for the use of the transferred information to commence eligibility determination and complete enrollment as well as the opportunity to correct any transferred information or provide additional information before a final eligibility determination is made. If the individual fails to consent or fails to respond to the opportunity to provide informed consent within a reasonable period of time, that failure to consent or respond shall be construed to mean that the individual is declining coverage.

SEC. 8.

 Section 12734 is added to the Insurance Code, to read:

12734.
 (a) Effective January 1, 2012, to June 30, 2013, inclusive, the board shall include the following notice in materials otherwise provided to every individual who ceases to be enrolled in the program:

“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, the board shall include the following notice in materials otherwise provided to every individual who ceases to be enrolled in the program:

“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) To maximize the number of individual Californians complying with the requirements of the federal Patient Protection and Affordable Care Act (Public Law 111-148) by obtaining coverage consistent with the provisions of federal law, the board shall seek approval from the United States Department of Health and Human Services to transfer the minimum information necessary to initiate an application for enrollment under this section consistent with Section 100503 of the Government Code.
(2) Effective January 1, 2013, for each enrollee who has ceased to be enrolled, the board shall provide to the Exchange the name, most recent address, clinical information, recent providers providers within the last 12 months, and other information that is in the possession of the program that the Exchange may require, in a manner to be prescribed by the Exchange strictly necessary in order to determine eligibility, complete enrollment, and maximize continuity of care. The information shall be kept confidential in a manner consistent with subsection (g) of Section 1411 of the federal Patient Protection and Affordable Care Act (Public Law 111-148) and other federal and state medical privacy laws.
(3) The information provided to the Exchange shall initiate an application for enrollment in coverage within the meaning of Section 100503 of the Government Code. Nothing in this section shall be construed to alter the responsibility of the Exchange or other state and local government entities with respect to the criteria and process for eligibility and enrollment in the Exchange and other public health care coverage programs.

(d)The individual shall have the opportunity to decline health care coverage pursuant to this section in a manner to be prescribed by the Exchange.

(d) An individual for whom an application has been initiated by the transfer of information shall be given the opportunity to provide informed consent for the use of the transferred information to commence eligibility determination and complete enrollment as well as the opportunity to correct any transferred information or provide additional information before a final eligibility determination is made. If the individual fails to consent or fails to respond to the opportunity to provide informed consent within a reasonable period of time, that failure to consent or respond shall be construed to mean that the individual is declining coverage.

SEC. 9.

 Section 12739.615 is added to the Insurance Code, to read:

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

“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, the board shall include the following notice in materials otherwise provided to every individual who ceases to be enrolled in the program:

“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) To maximize the number of individual Californians complying with the requirements of the federal Patient Protection and Affordable Care Act (Public Law 111-148) by obtaining coverage consistent with the provisions of federal law, the board shall seek approval from the United States Department of Health and Human Services to transfer the minimum information necessary to initiate an application for enrollment under this section consistent with Section 100503 of the Government Code.
(2) Effective January 1, 2013, for each enrollee who has ceased to be enrolled, the board shall provide to the Exchange the name, most recent address, clinical information, recent providers providers within the last 12 months, and other information that is in the possession of the program that the Exchange may require, in a manner to be prescribed by the Exchange strictly necessary in order to determine eligibility, complete enrollment, and maximize continuity of care. The information shall be kept confidential in a manner consistent with subsection (g) of Section 1411 of the federal Patient Protection and Affordable Care Act (Public Law 111-148) and other federal and state medical privacy laws.
(3) The information provided to the Exchange shall initiate an application for enrollment in coverage within the meaning of Section 100503 of the Government Code. Nothing in this section shall be construed to alter the responsibility of the Exchange or other state and local government entities with respect to the criteria and process for eligibility and enrollment in the Exchange and other public health care coverage programs.

(d)The individual shall have the opportunity to decline health care coverage pursuant to this section in a manner to be prescribed by the Exchange.

(d) An individual for whom an application has been initiated by the transfer of information shall be given the opportunity to provide informed consent for the use of the transferred information to commence eligibility determination and complete enrollment as well as the opportunity to correct any transferred information or provide additional information before a final eligibility determination is made. If the individual fails to consent or fails to respond to the opportunity to provide informed consent within a reasonable period of time, that failure to consent or respond shall be construed to mean that the individual is declining coverage.

SEC. 10.

 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, the department shall include the following notice in materials otherwise provided to every individual who ceases to be enrolled in the Medi-Cal program and received full-scope Medi-Cal benefits for which there was federal financial participation:

“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, the department shall include the following notice in materials otherwise provided to every individual who ceases to be enrolled in the Medi-Cal program and received full-scope Medi-Cal benefits for which there was federal financial participation:

“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) To maximize the number of individual Californians complying with the requirements of the federal Patient Protection and Affordable Care Act (Public Law 111-148) by obtaining coverage consistent with the provisions of federal law, the department shall seek approval from the United States Department of Health and Human Services to transfer the minimum information necessary to initiate an application for enrollment under this section consistent with Section 100503 of the Government Code.
(2) Effective January 1, 2013, for each enrollee who has ceased to be enrolled, the department shall provide to the Exchange the name, most recent address, clinical information, recent providers providers within the last 12 months, and other information that is in the possession of the program that the Exchange may require, in a manner to be prescribed by the Exchange strictly necessary in order to determine eligibility, complete enrollment, and maximize continuity of care. The information shall be kept confidential in a manner consistent with subsection (g) of Section 1411 of the federal Patient Protection and Affordable Care Act (Public Law 111-148) and other federal and state medical privacy laws.
(3) The information provided to the Exchange shall initiate an application for enrollment in coverage within the meaning of Section 100503 of the Government Code. Nothing in this section shall be construed to alter the responsibility of the Exchange or other state and local government entities with respect to the criteria and process for eligibility and enrollment in the Exchange and other public health care coverage programs.

(d)The individual shall have the opportunity to decline health care coverage pursuant to this section in a manner to be prescribed by the Exchange.

(d) An individual for whom an application has been initiated by the transfer of information shall be given the opportunity to provide informed consent for the use of the transferred information to commence eligibility determination and complete enrollment as well as the opportunity to correct any transferred information or provide additional information before a final eligibility determination is made. If the individual fails to consent or fails to respond to the opportunity to provide informed consent within a reasonable period of time, that failure to consent or respond shall be construed to mean that the individual is declining coverage.

SEC. 11.

 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, the Family PACT provider shall include the following notice in materials otherwise provided to every individual receiving care or services under the Family PACT program as provided in subdivision (aa) of Section 14132:

“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) (1) Effective July 1, 2013, the Family PACT provider shall include the following notice in materials otherwise provided to every individual receiving care or services under the Family PACT program as provided in subdivision (aa) of Section 14132:

“Because you are enrolled in a public health program, an application for health care coverage through the California Health Benefit Exchange will be made for you. If you do not qualify for that coverage or if you decline that coverage, your enrollment in Family PACT will continue. 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).”

(2) The Family PACT provider shall seek written consent from every individual receiving care or services under the program to initiate an application for enrollment through the Exchange and shall provide to the department the name and patient identifier for those individuals who provide that consent.
(c) (1) To maximize the number of individual Californians complying with the requirements of the federal Patient Protection and Affordable Care Act (Public Law 111-148) by obtaining coverage consistent with the provisions of federal law, the department shall seek approval from the United States Department of Health and Human Services to transfer the minimum information necessary to initiate an application for enrollment under this section consistent with Section 100503 of the Government Code.
(2) Effective January 1, 2013, for each enrollee from whom the provider has obtained written consent, the department shall provide to the Exchange the name, most recent address, other information that is in the possession of the program, and providers within the last 12 months, in a manner to be prescribed by the Exchange strictly necessary in order to determine eligibility, complete enrollment, and maximize continuity of care. The information shall be kept confidential in a manner consistent with subsection (g) of Section 1411 of the federal Patient Protection and Affordable Care Act (Public Law 111-148) and other federal and state medical privacy laws. To maximize continuity of care in selecting a plan, enrollees shall be provided information about participating providers based on an enrollee’s existing or recent utilization of providers, to the extent possible and consistent with paragraph (9) of subdivision (a) of Section 100504 of the Government Code.
(3) The information provided to the Exchange shall initiate an application for enrollment in coverage within the meaning of Section 100503 of the Government Code. Nothing in this section shall be construed to alter the responsibility of the Exchange or other state and local government entities with respect to the criteria and process for eligibility and enrollment in the Exchange and other public health care coverage programs.

(d)The individual shall have the opportunity to decline health care coverage pursuant to this section in a manner to be prescribed by the Exchange.

(d) An individual for whom an application has been initiated by the transfer of information shall be given the opportunity to provide informed consent for the use of the transferred information to commence eligibility determination and complete enrollment as well as the opportunity to correct any transferred information or provide additional information before a final eligibility determination is made. If the individual fails to consent or fails to respond to the opportunity to provide informed consent within a reasonable period of time, that failure to consent or respond shall be construed to mean that the individual is declining coverage.

SEC. 12.

 The State Public Health officer, with respect to the notice required by Sections 104164, 120971.5, 120971.6, and 127420 of the Health and Safety Code, the Managed Risk Medical Insurance Board, with respect to the notice required by Sections 12693.78, 12693.79, 12734, and 12739.615 of the Insurance Code, and the Director of Health Care Services, with respect to the notice required by Sections 14029.9 and 14105.182 of the Welfare and Institutions Code, may, by regulation, modify the wording of the notice for purposes of clarity, readability, and accuracy, but may not change the substantive meaning of the notice. Each notice shall also be provided in threshold languages.