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SB-639 Medical services: credit or loan.(2019-2020)

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Date Published: 04/11/2019 09:00 PM
SB639:v98#DOCUMENT

Amended  IN  Senate  April 11, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Senate Bill No. 639


Introduced by Senator Mitchell

February 22, 2019


An act to amend Section 654.3 of the Business and Professions Code, relating to healing arts.


LEGISLATIVE COUNSEL'S DIGEST


SB 639, as amended, Mitchell. Medical services: credit or loan.
Existing law prohibits a healing arts licensee, as defined, or an employee or agent of that licensee from charging treatment or costs to a an open-end credit or loan extended by a 3rd third party that is arranged for or established in the licensee’s office before the date on which the treatment is rendered or costs are incurred without first providing a specified written treatment plan, a specified written or electronic notice, and a specified list of which treatment and services are being charged. Existing law prohibits a licensee, or the licensee’s employee or agent, from arranging for or establishing credit or a loan that is extended by a third party for a patient who has been administered or is under the influence of general anesthesia, conscious sedation, or nitrous oxide. Existing law provides that a person who willfully violates these provisions is subject to specified civil liability.
This bill would also prohibit a licensee or employee or agent of that licensee from charging treatment or costs to an open-end credit or loan that is extended by a third party and that is arranged for, or established in, that licensee’s office before the date on which the treatment is rendered or costs are incurred without providing that plan or list. The bill would additionally prohibit a licensee or employee or agent of that licensee from offering an open-end credit or loan that contains a deferred interest provision, as defined. The bill would require a licensee, if the licensee accepts Medi-Cal, to indicate on the treatment plan for a Medi-Cal patient if Medi-Cal would cover an alternate, medically appropriate service. The bill would prohibit a licensee or the licensee’s employee or agent from arranging for or establishing credit or a loan that is extended by a third party for a patient in a treatment area where medical treatment is administered. The bill would also revise the content of the required written or electronic notice.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 654.3 of the Business and Professions Code is amended to read:

654.3.
 (a) For purposes of this section, the following definitions shall apply:
(1) “Deferred interest provision” means a contractual provision that allows for interest to be charged on portions of the original balance that have already been paid off.
(2) “Licensee” means an individual, firm, partnership, association, corporation, limited liability company, or cooperative association licensed under this division or under any initiative act or division referred to in this division.
(3) “Licensee’s office” means either of the following:
(A) An office of a licensee in solo practice.
(B) An office in which services or goods are personally provided by the licensee or by employees in that office, or personally by independent contractors in that office, in accordance with law. Employees and independent contractors shall be licensed or certified when licensure or certification is required by law.
(4) “Open-end credit” means credit extended by a creditor under a plan in which the creditor reasonably contemplates repeated transactions, the creditor may impose a finance charge from time to time on an outstanding unpaid balance, and the amount of credit that may be extended to the debtor during the term of the plan, up to any limit set by the creditor, is generally made available to the extent that any outstanding balance is repaid.
(5) “Patient” includes, but is not limited to, the patient’s parent or other legal representative.
(b) It is unlawful for a licensee, or employee or agent of that licensee, to offer an open-end credit or loan that contains a deferred interest provision.
(c) It is unlawful for a licensee, or employee or agent of that licensee, to charge treatment or costs to an open-end credit or loan, that is extended by a third party and that is arranged for, or established in, that licensee’s office, before the date upon which the treatment is rendered or costs are incurred. It is also unlawful for a licensee, or employee or agent of that licensee, to charge treatment or costs to an open-end credit or loan, that is extended by a third party and that is arranged for, or established in, that licensee’s office, without first providing the patient with a treatment plan, as required by subdivision (f) and a list of which treatment and services are being charged in advance of rendering or incurring of costs.
(d) A licensee shall, within 15 business days of a patient’s request, refund to the lender any payment received through credit or a loan extended by a third party that is arranged for, or established in, that licensee’s office for treatment that has not been rendered or costs that have not been incurred.
(e) A licensee, or an employee or agent of that licensee, shall not arrange for or establish credit or a loan extended by a third party for a patient without first providing the following written or electronic notice, on one page or screen, respectively, in at least 14-point type, and obtaining a signature from the patient:

“Credit or Loan for Health Care Services
The attached application and information is for a credit card or loan to help you pay for your health care treatment. You should know that:
You are applying for a ____ credit card or a ____ loan for $____.
You do not have to apply for the credit card or the loan. You may pay your health care provider for treatment in another manner.
This credit card or loan is not a payment plan with the provider’s office. It is credit with, or a loan made by, [name of company issuing the credit card or loan]. Your health care provider does not work for this company.
Before applying for this credit card or loan, you have the right to a written treatment plan from your health care provider. This plan must include the expected treatment to be provided and the estimated costs of each service.
Your health care provider cannot charge your credit card or loan account before you get treatment.
If you do not get treatment, you have the right to have your credit card or loan account refunded for any costs charged for that treatment. Your health care provider must refund the amount of the charges to the lender within 15 business days of your request. The lender must take refunded charges off your account. Your health care provider may still charge costs spent preparing for your treatment if you change your mind.
Please read carefully the terms and conditions of this credit card or loan.
You may be required to pay interest rates on the amount charged to the credit card or the amount of the loan. If you pay late, you may have to pay a penalty and a higher interest rate.
You may use this credit card or loan to pay for future health care services.
If you do not pay the money that you owe on the credit card or loan, your missed payments can be reported and could hurt your credit rating. You could also be sued.
[Patient’s Signature]”

(f) Prior to arranging for or establishing credit or a loan extended by a third party, a licensee shall give a patient a written treatment plan. The treatment plan shall include each anticipated service to be provided and the estimated cost of each service. If a patient is covered by a private or government medical benefit plan or medical insurance, from which the licensee takes assignment of benefits, the treatment plan shall indicate the patient’s private or government-estimated share of cost for each service. If the licensee accepts Medi-Cal, the treatment plan for a Medi-Cal patient shall indicate if Medi-Cal would cover an alternate, medically appropriate service. If the licensee does not take assignment of benefits from a patient’s medical benefit plan or insurance, the treatment plan shall indicate that the treatment may or may not be covered by a patient’s medical benefit or insurance plan, and that the patient has the right to confirm medical benefit or insurance information from the patient’s plan, insurer, or employer before beginning treatment.
(g) A licensee, or an employee or agent of that licensee, shall not arrange for or establish credit or a loan extended by a third party for a patient with whom the licensee, or an employee or agent of that licensee, communicates primarily in a language other than English that is one of the Medi-Cal threshold languages, unless the written notice information required by subdivision (e) is also provided in that language.
(h) A licensee, or an employee or agent of that licensee, shall not arrange for or establish credit or a loan that is extended by a third party for a patient who under either of the following circumstances:
(1) The patient has been administered or is under the influence of general anesthesia, conscious sedation, or nitrous oxide.
(2) The patient is in a treatment area, including, but not limited to, an exam room, surgical room, or other area where medical treatment is administered.
(i) A patient who suffers any damage as a result of the use or employment by any person of a method, act, or practice that willfully violates this section may seek the relief provided by Chapter 4 (commencing with Section 1780) of Title 1.5 of Part 4 of Division 3 of the Civil Code.
(j) The rights, remedies, and penalties established by this article are cumulative, and shall not supersede the rights, remedies, or penalties established under other laws.