Bill Text

Bill Information


Add To My Favorites | print page

AB-1045 Payers’ Bill of Rights: procedure charges.(2005-2006)

SHARE THIS: share this bill in Facebook share this bill in Twitter
AB1045:v92#DOCUMENT

Assembly Bill No. 1045
CHAPTER 532

An act to amend Sections 1339.56 and 1339.59 of, to add Section 1339.585 to, and to repeal Section 1339.57 of, the Health and Safety Code, relating to the Payers’ Bill of Rights.

[ Approved by Governor  October 05, 2005. Filed with Secretary of State  October 05, 2005. ]

LEGISLATIVE COUNSEL'S DIGEST


AB 1045, Frommer. Payers’ Bill of Rights: procedure charges.
Existing law provides for the licensure and regulation of health facilities by the State Department of Health Services. A violation of those provisions is a misdemeanor.
The existing Payers’ Bill of Rights requires each hospital to compile a list of the charges for 25 services or procedures commonly charged to patients. Beginning July 1, 2004, existing law requires each hospital to make that list available to any person upon request and to file the list annually with the Office of Statewide Health Planning and Development.
This bill would recast those provisions to require each hospital to compile a list of the average charges for 25 common outpatient procedures and the 25 most common inpatient procedures, as grouped by Medicare diagnostic‑related group (DRG), and to submit these lists to the office. The bill would require each hospital to provide a list of average charges for outpatient procedures to the office and would require the office to publish this information on its Internet Web site. The bill would require certain information to be updated by the office at least annually.
Existing law authorizes the Office of Statewide Health Planning and Development to compile a list of the 10 most common Medicare DRGs and the average charge for each of these DRGs per hospital and to publish that information on its Internet Web site.
This bill would repeal those provisions.
Except for the provision of emergency services, this bill would require a hospital, upon the request of a person with no health coverage, to provide the person with a written estimate of the amount the hospital will require the person to pay for the health care services, procedures, and supplies that are reasonably expected to be provided to the person by the hospital and an application for financial assistance or charity care.
This bill would provide that any hospital that does not file the information required by the Payers’ Bill of Rights may be liable for civil penalties.
By changing existing duties of a hospital, the bill would change the definition of a crime, and would thereby impose a state‑mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

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


SECTION 1.

 Section 1339.56 of the Health and Safety Code is amended to read:

1339.56.
 (a) Each hospital shall compile a list of 25 common outpatient procedures and shall submit annually to the office a list of its average charges for those procedures, in a method determined by the office. The office may develop a uniform reporting form for the purposes of this subdivision and may require hospitals to file this completed form with the office. The office shall publish this information on its Internet Web site.
(b) The office shall establish a list of the 25 most commonly performed inpatient procedures in California hospitals, as grouped by Medicare diagnostic‑related group. The office shall develop a list of each hospital’s average charges for those procedures, if applicable, and shall update the list at least annually. The office shall publish this information on its Internet Web site.
(c) Each hospital shall provide a copy of the lists described in subdivisions (a) and (b) to any person upon request.

SEC. 2.

 Section 1339.57 of the Health and Safety Code is repealed.

SEC. 3.

 Section 1339.585 is added to the Health and Safety Code, to read:

1339.585.
 Upon the request of a person without health coverage, a hospital shall provide the person with a written estimate of the amount the hospital will require the person to pay for the health care services, procedures, and supplies that are reasonably expected to be provided to the person by the hospital, based upon an average length of stay and services provided for the person’s diagnosis. The hospital may provide this estimate during normal business office hours. In addition to the estimate, the hospital shall provide information about its financial assistance and charity care policies and contact information for a hospital employee or office from which the person may obtain further information about these policies. If requested, the hospital shall also provide the person with an application form for financial assistance or charity care. This section shall not apply to emergency services provided to a person pursuant to Section 1317.

SEC. 4.

 Section 1339.59 of the Health and Safety Code is amended to read:

1339.59.
 (a) A hospital shall be in violation of this article if it knowingly or negligently fails to comply with the requirements of this article.
(b) A hospital that does not file with the office the information required by this article may be liable for civil penalties as specified in Section 128770.

SEC. 5.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.