CA SB1528

Establishes that injured persons whose health care is provided through a capitated health care service plan are entitled to recover the reasonable and necessary value of medical services as damages, when the provider is paid a set periodic amount and does not present itemized bills.

Medi-Cal beneficiaries are entitled to recover the reasonable and necessary value of medical services from the person or party responsible for their injury.

Expands county lien rights to include first lien status against judgments, settlements, compromises, arbitration awards, mediation settlements, and other recoveries for past medical expenses, subject to attorney's fees and costs liens.

Requires counties to consider four specific factors when deciding whether to compromise or waive medical liens, including the comparison of damages to recovery, other liens against the recovery, whether the county's claim would exceed 50 percent of recovery, and other just and equitable factors.

Defines "reasonable value of benefits" for Medi-Cal to mean either the Medi-Cal rate of payment or, for managed care arrangements, the rate paid to the provider or the usual and customary charge if the provider is paid on a capitated basis.