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AB-1038 Health data: rates for health care services: physicians and surgeons.(2019-2020)

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Date Published: 04/03/2019 09:00 PM
AB1038:v98#DOCUMENT

Amended  IN  Assembly  April 03, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 1038


Introduced by Assembly Member Muratsuchi

February 21, 2019


An act to add Article 10 (commencing with Section 42000) to Chapter 3 of Part 4 of Division 26 of the Health and Safety Code, relating to nonvehicular air pollution. An act to add Chapter 4 (commencing with Section 128900) to Part 5 of Division 107 of the Health and Safety Code, relating to health data.


LEGISLATIVE COUNSEL'S DIGEST


AB 1038, as amended, Muratsuchi. Air quality management districts: scientific and engineering review. Health data: rates for health care services: physicians and surgeons.
Existing law states the intent of the Legislature to establish a Health Care Cost Transparency Database to collect information regarding the cost of health care. Existing law requires the Office of Statewide Health Planning and Development to convene a review committee for purposes of advising the office on the establishment and implementation of the database. Existing law requires the office, by July 1, 2020, to submit a report to the Legislature, based on recommendations of the review committee and any third-party vendor, that includes prescribed elements. Existing law requires the office to establish, implement, and administer the database. Existing law requires certain health care entities, including a physician and surgeon, to provide specified information to the office for collection in the database. Under existing law, implementation of these provisions is subject to budget appropriation for that purpose.
This bill would require the Medical Board of California to provide to the office, no less than annually, a comprehensive list of all physicians and surgeons practicing in California, including prescribed information. The bill would require a board-licensed physician and surgeon to provide to the office specified information relating to negotiated rates and charges imposed for services provided. The bill would require the office to make public certain aggregate data on negotiated rates.

Existing law imposes various limitations on emissions of air contaminants for the control of air pollution from vehicular and nonvehicular sources. Existing law generally designates the State Air Resources Board as the state agency with the primary responsibility for the control of vehicular air pollution and air pollution control and air quality management districts with the primary responsibility for the control of air pollution from all sources other than vehicular sources.

This bill would authorize an air district to impose a charge equal to the costs the air district expends in contracting with a third party to review the scientific or engineering information provided to the air district at the air district’s request by a facility regulated pursuant to specified provisions in order to verify the information provided is accurate. The bill would state that this provision is declaratory of existing law.

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: NOYES   Local Program: NO  

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


SECTION 1.

 Chapter 4 (commencing with Section 128900) is added to Part 5 of Division 107 of the Health and Safety Code, to read:
CHAPTER  4. Rates for Health Care Services

128900.
 (a) The Legislature finds and declares that negotiated rates for services provided by physicians and surgeons are not publicly available, impeding the ability of the payers of health care services to determine the price of care and the oversight of the Legislature of health care costs.
(b) It is the intent of the Legislature in enacting this chapter to provide transparency of pricing information for services provided by physicians and surgeons in order to allow payers of health care services to determine the price of care.

128901.
 As used in this chapter, “office” means the Office of Statewide Health Planning and Development.

128902.
 (a) The Medical Board of California shall provide to the office no less than annually a comprehensive list of all physicians and surgeons licensed in California, including the following information:
(1) Name.
(2) Address and contact information.
(3) Specialty.
(4) Certificate number.
(5) Other information as may be required by the office to determine whether a physician and surgeon is subject to this chapter.
(b) A physician and surgeon licensed by the Medical Board of California under the Medical Practice Act (Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code) shall provide to the office, in a manner and format specified by the office, the following data:
(1) The negotiated rate for each service for each health care service plan or insurer with which the physician and surgeon has a contract.
(2) The charge for each service provided by the physician and surgeon.
(3) If the physician and surgeon is a member of a risk-bearing organization, independent practice association, or other organized medical group, the group may provide this data if the office can determine from the provided data the negotiated rate for each service for each physician and surgeon.
(c) The office shall make public aggregate data indicating the following:
(1) Negotiated rates by physician and surgeon specialty by geographic region.
(2) Negotiated rates compared to Medicare rates by physician and surgeon specialty by geographic region.

SECTION 1.Article 10 (commencing with Section 42000) is added to Chapter 3 of Part 4 of Division 26 of the Health and Safety Code, to read:
10.Scientific and Engineering Review
42000.

A district may impose a charge equal to the costs the district expends in contracting with a third party to review the scientific or engineering information provided to the district at the district’s request by a facility regulated pursuant to this part in order to verify the information provided is accurate.

SEC. 2.

The addition of Section 42000 to the Health and Safety Code does not constitute a change in, but is declaratory of, existing law.