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CA AB2533
Bill
Status
5/13/2010
Primary Sponsor
Felipe Fuentes
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AI Summary
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Requires health care service plans and health insurers to file descriptions of economic profiling and quality rating policies with their respective departments immediately upon adoption and within 30 days of any changes (replacing previous annual filing requirement).
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Expands filing requirements to cover quality rating practices in addition to economic profiling, including how ratings are used to designate providers within networks and encourage patients to see only designated providers.
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Mandates that plans and insurers provide profiled or rated providers, medical groups, and individual practice associations access to their economic profiling and quality rating information upon request for 60 days after contract termination.
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Requires plans and insurers to include in filings a description of how economic profiling and quality rating results are shared with patients and how risk adjustments are applied to account for case mix, data reliability, illness severity, age, and other relevant factors.
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Requires entities that filed descriptions prior to January 1, 2011 to update their filings by March 31, 2011 to comply with the bill's requirements and reflect current policies and procedures.
Legislative Description
Health care coverage: quality rating.
Last Action
From Consent Calendar. Ordered to third reading. To inactive file on motion of Senator Padilla.
8/5/2010