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SB-1320 Retainer practices.(2011-2012)

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SB1320:v98#DOCUMENT

Amended  IN  Senate  March 28, 2012

CALIFORNIA LEGISLATURE— 2011–2012 REGULAR SESSION

Senate Bill No. 1320


Introduced  by  Senator Harman

February 23, 2012


An act to add Chapter 2.23 (commencing with Section 1399.875) to Division 2 of the Health and Safety Code, and to add Section 106.5 to the Insurance Code, relating to health care.


LEGISLATIVE COUNSEL'S DIGEST


SB 1320, as amended, Harman. Direct primary care Retainer practices.
Existing law provides for the licensure and regulation of various healings healing arts practitioners. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans. Existing law also provides for the regulation of health insurers by the Department of Insurance.
This bill would state various findings with respect to the use of direct primary care retainer practices in which a patient enters into a direct relationship with a physician and pays the physician a fixed amount for primary care services. The bill would state the intent of the Legislature to enact legislation that would define a direct primary care retainer practice and specify that such a practice is not subject to regulation as a health care service plan or a health insurer.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: NOYES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 (a)The Legislature hereby finds and declares that California needs a multipronged approach to make health care services more readily available and affordable to the many residents of the state who lack adequate access to those services. Direct primary care Retainer practices, in which a patient enters into a direct relationship with a physician and pays a fixed amount directly to the physician for primary care services, represent an innovative, affordable option that could improve access to medical care, reduce the number of people who lack this access, reduce emergency room use for primary care purposes, and make emergency rooms more available to treat actual emergencies.

(b)It

It is the intent of the Legislature to enact legislation that would do both of the following:
(1)Define define the term “direct primary care “retainer practice” in a manner that ensures patient safety and allows this innovative model to operate efficiently and unencumbered by unnecessary state government regulation.

(2)Specify that a direct primary care practice is not a health care service plan subject to regulation under the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code) or a health insurer subject to regulation by the Insurance Commissioner under the Insurance Code.

SEC. 2.

 Chapter 2.23 (commencing with Section 1399.875) is added to Division 2 of the Health and Safety Code, to read:
CHAPTER  2.23. Retainer Practices

1399.875.
 Notwithstanding any other law, a retainer practice is not a health care service plan subject to regulation under the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340)).

1399.876.
 (a) For purposes of this chapter, a “retainer practice” means any person who meets both of the following requirements:
(1) Licensed to practice medicine by the Medical Board of California pursuant to Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code.
(2) Contracts with patients to provide primary care services, in whole or in part, based on a periodic fee.
(b) For purposes of this section, “primary care services” means medical services for which no specialty is commonly required, and specifically excludes all of the following services:
(1) Acupuncture.
(2) Chiropractic.
(3) Dental.
(4) Emergency.
(5) Hospital.
(6) Vision.

SEC. 3.

 Section 106.5 is added to the Insurance Code, to read:

106.5.
 (a) Notwithstanding any other law, a retainer practice is not subject to regulation as a health insurer by the Insurance Commissioner.
(b) For purposes of this section, a “retainer practice” means any person who meets both of the following requirements:
(1) Licensed to practice medicine by the Medical Board of California pursuant to Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code.
(2) Contracts with patients to provide primary care services, in whole or in part, based on a periodic fee.
(b) For purposes of this section, “primary care services” means medical services for which no specialty is commonly required, and specifically excludes all of the following services:
(1) Acupuncture.
(2) Chiropractic.
(3) Dental.
(4) Emergency.
(5) Hospital.
(6) Vision.