AB 2389 Summary

• Prohibits health care service plans and health insurers from restricting their ability to furnish cost range and quality information about health care facilities to subscribers, enrollees, policyholders, and insureds, effective January 1, 2011.

• Requires cost information to be limited to elective, uncomplicated procedures displayed as episodes of care, and prohibits disclosure of negotiated capitation rates or prepaid arrangements unless allocated capitation payments are included with appropriate methodology.

• Mandates quality information developed by plans or insurers be based on nationally recognized evidence-based guidelines, use risk adjustment factors, be updated at least annually, and link quality measurements with cost information when appropriate.

• Requires plans and insurers to provide health care facilities at least 45 days' written notice to review information before disclosure, including methodology summaries, error correction rights, and a transparent appeal process.

• Makes any contractual provision inconsistent with these requirements void and unenforceable, and requires plans and insurers to disclose to enrollees and policyholders where cost and quality information can be found and that such information is only a guide for facility selection.