Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law generally prohibits a health care service plan or health insurer from subjecting antiretroviral drugs that are medically necessary for the prevention of HIV/AIDS to prior authorization or step therapy. This bill would prohibit a health care service plan and health insurer from subjecting direct-acting antiviral drugs that are medically necessary for the treatment of hepatitis C to prior authorization. The bill would specify that these provisions do not require a health care service plan or health insurer to cover all therapeutically equivalent versions without prior authorization, as specified. Because a violation of these provisions by a health care service plan would be a crime, this bill would 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.
Existing law establishes the California Community Colleges, under the administration of the Board of Governors of the California Community Colleges, the California State University, under the administration of the Trustees of the California State University, and the University of California, under the administration of the Regents of the University of California, as the 3 segments of public postsecondary education in the state. Existing law requires, on and after January 1, 2023, a student health center on a California State University or University of California campus to offer abortion by medication techniques, as specified. Existing law establishes the College Student Health Center Sexual and Reproductive Health Preparation Fund to be administered by the Commission on the Status of Women and Girls and continuously appropriates the moneys in that fund to the commission for specified activities related to providing abortion by medication techniques at student health centers. This bill would require a student health center on a California State University or University of California campus, on or before January 1, 2028, to promote awareness of the services for abortion by medication techniques that the student health center offers, provide information on those services to students, and post the availability of those services on its internet website. This bill would require a community college that has a student health center, upon appropriation by the Legislature, to, on and after January 1, 2029, offer access to abortion by medication techniques, promote awareness of those services, provide information on those services to students, and post the availability of those services on its internet website. The bill would require the commission to submit a report to the Legislature, on or before January 1, 2030, that includes, but is not limited to, specified information relating to abortion by medication techniques at or through community college student health centers. The bill would require the commission, in consultation with the office of the Chancellor of the California Community Colleges, to develop a standardized reporting framework that minimizes administrative burden and protects student privacy. The bill would authorize funds appropriated for these provisions to be used for implementation readiness activities and ongoing operational costs, as specified.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a violation of the act by a health care service plan a misdemeanor. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law defines "unreasonable rate increase," for these purposes, to have the same meaning as in the federal Patient Protection and Affordable Care Act, which is that an unreasonable rate increase exists when the federal Centers for Medicare and Medicaid Services makes a determination that a rate increase is excessive, unjustified, or unfairly discriminatory, among other things. This bill would instead define "unreasonable rate increase," for the above-described purposes, to mean a rate increase that the Director of the Department of Managed Health Care or the Insurance Commissioner, as applicable, determines is excessive, unjustified, unfairly discriminatory, or otherwise unreasonable. Existing law requires a health care service plan or health insurer to submit rates to their regulating entity for review and to demonstrate the impact of any changes in the rate of growth of health care costs resulting from health care cost targets. This bill would instead require a health care service plan or health insurer to demonstrate the impact of health care cost targets and to demonstrate whether a health care service plan's or health insurer's annual rate growth exceeds or will exceed the cost target for the rating period. The bill would require, if a health care service plan's or health insurer's rate growth is expected to exceed the cost target for a rating period, the health care service plan or health insurer to include specified information in its rate filing, including, among other things, a detailed list of any proactive steps it is taking, or plans to take, for annual rate growth to meet the cost targets. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. Existing law requires the director or the commissioner, as applicable, in determining if a rate is unreasonable or not justified for purposes of the above-described review, to consider the impact on changes in health care costs as a result of the health care cost targets described above. This bill would delete those provisions and instead require the Department of Managed Health Care and the Department of Insurance to report on if rates, by plan or policy and in aggregate, meet the affordability standard, as defined, for an individual, a couple, and a family of four. The bill would require the report to include the annual change in premiums and cost sharing for the prior 5 years. The bill would, as part of the existing rate submission process, require a health care service plan or health insurer to provide information on premiums, deductibles, cost sharing, and any other factors specified by the department as necessary to complete the reports. 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.
Existing law sets forth provisions, under the California Constitution, regarding the fundamental right to choose to have an abortion. Existing law, the Reproductive Privacy Act, prohibits the state from denying or interfering with a pregnant person's right to choose or obtain an abortion prior to viability of the fetus, or when the abortion is necessary to protect the life or health of the pregnant person. This bill, the Access to Safe Abortion Care Act, would make legislative findings about medication abortion, with a focus on use of the drugs mifepristone and misoprostol. Under the bill, the Legislature would reaffirm that it has been, and would continue to be, lawful to cause the delivery of, or mail, ship, take, receive, or otherwise transport, any drug, medicine, or instrument that can be designed or adapted to produce an abortion that is lawful in the State of California. The bill would set forth provisions regarding the lack of civil or criminal liability, or professional disciplinary action, for accessing or administering brand name or generic mifepristone or any drug used for medication abortion that is lawful under the laws of the state, on or after January 1, 2020, with this provision applied retroactively, as specified. The bill would make its provisions severable.
Existing law prohibits a state or local law enforcement agency or officer from knowingly arresting or knowingly participating in the arrest of any person for performing, supporting, or aiding in the performance of a legally protected health care activity, as defined, or for obtaining a legally protected health care activity, if the legally protected health care activity is lawful in this state. Existing law prohibits a state or local public agency from cooperating with or providing information to an individual or agency from another state or a federal law enforcement agency, as specified, regarding a legally protected health care activity. Existing law prohibits specified persons, including a judicial officer, a court employee, or an authorized attorney, among others, from issuing a subpoena in connection with a proceeding in another state regarding an individual performing, supporting, or aiding in the performance of a legally protected health care activity in this state, or an individual obtaining a legally protected health care activity in this state, if the legally protected health care activity is lawful in this state. This bill would make those provisions apply regardless of the patient's location. Existing law authorizes the Governor to surrender, on demand of the executive authority of any other state, any person in this state charged in the other state with committing an act in this state, or in a 3rd state, intentionally resulting in a crime in the state whose executive authority is making the demand. This bill would additionally prohibit a state or local law enforcement agency or officer from knowingly arresting or participating in the arrest of any person who the Governor has declined to surrender. Existing law requires any out-of-state subpoena, warrant, wiretap order, pen register trap and trace order, or other legal process to include an affidavit or declaration under penalty of perjury that the discovery request is not in connection with an out-of-state proceeding relating to a legally protected health care activity, except as specified. Existing law prohibits a California corporation that provides electronic communication services or remote computing services to the general public from complying with an out-of-state subpoena, warrant, wiretap order, pen register trap and trace order, other legal process, or request by a law enforcement agent or entity seeking records that would reveal the identity of the customers using those services, data stored by, or on behalf of, the customer, the customer's usage of those services, the recipient or destination of communications sent to or from those customers, or the content of those communications, unless the out-of-state subpoena, warrant, wiretap order, pen register trap and trace order, other legal process, or request from law enforcement includes the affidavit or declaration described above. This bill would extend those provisions to also apply to a California corporation that provides financial services, as defined, to the general public. By expanding the situations in which a declaration under penalty of perjury is required, this bill would expand the scope of the crime of perjury and impose a state-mandated local program. The bill would authorize the Attorney General to commence an action to enforce these provisions, as specified, and would authorize the court to assess a statutory penalty of $10,000 for a first violation, and $15,000 for a 2nd or subsequent violation, against any person or entity found to have intentionally, knowingly, willingly, or recklessly complied with or provided information in response to an inquiry, investigation, subpoena, or summons regarding legally protected health care activity in violation of these provisions. 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.
(1) Existing law provides for the licensure and regulation of health facilities, clinics, home health agencies, and hospice agencies, as defined, by the State Department of Public Health. Existing law provides for the certification of nurse assistants and home health aides by the department. A violation of these provisions by a licensee is a crime. Existing law authorizes the department to deny an application for, initiate an action to suspend or revoke a certificate for, or deny a training and examination application for a nurse assistant or home health aide under specified circumstances. Existing law requires, with some exceptions, the department to deny a training and examination application and deny, suspend, or revoke a certificate if the applicant or certificate holder has been convicted of a violation of or attempted violation of one or more specified crimes. This bill would instead authorize the department to deny an application for, a certificate for, or a training and examination application for, a nurse assistant or home health aide for various reasons, including if an applicant has been convicted of a crime, as specified, within the preceding 7 years from the date of the application that is directly and adversely related to the qualifications, functions, or duties of a certified nurse assistant or home health aide, regardless of whether the applicant was incarcerated for that crime, as specified, and if the applicant has been subjected to formal discipline by the department or a licensing board in or outside California within the preceding 7 years from the date of the application for professional misconduct that would have been cause for discipline, as specified, and that is directly and adversely related to the qualifications, functions, or duties of a certified nurse assistant or home health aide, as specified. The bill would authorize an applicant or certificate holder whose application to be a nurse assistant or home health aide was denied or certificate was suspended or revoked on the basis of a criminal conviction to, during a period of 2 years after the department receives the criminal record report, provide the department with evidence of good character and rehabilitation or provide the department with evidence that the criminal conviction is no longer grounds for denial, as specified. The bill would prescribe requirements for the department in requesting or acting on a nursing assistant or home health aide applicant's criminal history information, including if the department decides to deny a training and examination application or certificate. The bill would authorize the department to initiate an action to suspend or revoke a certificate for professional misconduct warranting cause for discipline, as specified. Upon a determination to revoke or suspend a certificate, the bill would prescribe the requirements for the department to notify the certificate holder in writing by certified mail, including providing information about the procedure for the certificate holder to challenge the determination or request reconsideration. By expanding the scope of a crime, this bill would impose a state-mandated local program. (2) Existing law governs the certification of a certified nurse assistant in a licensed skilled nursing or intermediate care facility. Existing law requires renewal of that certification to be conditional upon specified occurrences, including that the certificate holder submitted documentation of completion of 48 hours of in-service training every 2 years, as specified. Existing law requires at least 12 of the 48 hours of in-service training to be completed in each of the 2 years. Existing law requires that 24 of the 48 hours may be obtained through a specified online computer training program. In order to renew an unexpired certificate, existing law requires the certificate holder to, on or before the expiration date, apply for renewal on a form provided by the department and to submit documentation of the required in-service training. Existing law authorizes an expired certificate to be renewed at any time within 2 years of its expiration on the filing of an application for renewal on a form provided by the department and documentation of the required in-service education. This bill would additionally authorize the certificate holder to submit documentation of 48 hours of continuing education every 2 years. The bill would require at least 12 of the 48 hours of continuous education or in-service training to be completed in each of the 2 years. The bill would authorize the 48 continuing education or in-service hours to be obtained through in-person instructions, synchronous online instruction, asynchronous online instruction, or other distance learning formats approved by the department. This bill would require, to renew an unexpired certificate, or authorize, to renew an expired certificate within 2 years after expiration, the certificate holder to submit documentation of the continuing education or in-service training. (3) 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.
Existing law provides that reproductive health care services, gender-affirming health care services, and gender-affirming mental health care services are rights secured by the Constitution and laws of California, and interference with these rights, whether or not under the color of law, is against the public policy of California. Existing law defines "gender-affirming health care services" to mean medically necessary health care that respects the gender identity of the patient, as experienced and defined by the patient, as specified. Existing law provides for various protective measures for persons engaging in legally protected health care activity, including prohibiting a provider of health care, health care service plan, health insurer, or contractor from releasing medical information related to, among other things, an individual seeking or obtaining gender-affirming health care or gender-affirming mental health care, and prohibiting a state or local public agency, or any employee thereof acting in their official capacity, from cooperating with or providing information to an individual or agency from another state or a federal law enforcement agency, as specified, regarding a legally protected health care activity that is lawful in this state and performed in this state. Existing law defines "legally protected health care activity" for those purposes to include, among other things, the exercise and enjoyment, or attempted exercise and enjoyment, by a person of rights to the health care services described above and the provision of those health care services by a person duly licensed under the laws of California. This bill would require a person or entity that is located, headquartered, incorporated, or otherwise conducting business in California and receives, is served with, or is subject to a subpoena, discovery request, or other request for information that is part of a legal process related to a civil, criminal, regulatory, or legislative investigation regarding abortion, as defined, or gender-affirming health care services that are legally protected health care activities secured by the Constitution or laws of California to provide specified notice to the Attorney General at least 7 business days prior to producing records in response to the request unless a shorter response time is required by federal law or other federal obligation, as specified. If a shorter response time is required by federal law or other federal obligation, the bill would require the responding person or entity to provide notice to the Attorney General no later than contemporaneously with producing the responsive records. The bill would exempt a person or entity from the notice requirement if the subpoena, discovery request, or other request for information meets certain requirements, including that it is accompanied by an attestation verifying that the use or disclosure of the requested information meets certain requirements, including that the requested information is related to an investigation or proceeding regarding activity that is unlawful under California civil or criminal law, and it identifies the California law under which the activity is unlawful. The bill would prohibit a person or entity receiving, served with, or subject to a subpoena, discovery request, or other request for information described above who is not subject to the above-described exemption from producing the responsive records until at least 7 business days after providing notice to the Attorney General unless a shorter response time is required by federal law or other federal obligation, as specified. If a shorter response time is required by federal law or other federal obligation, the bill would require the responding person or entity to make best efforts to deliver the responsive records on the date on which the person or entity is required to respond to the subpoena, discovery request, or other request for information. The bill would authorize the Attorney General to make reasonable attempts to notify the individual who provided, sought, received, facilitated, or otherwise engaged in the abortion or gender-affirming health care service pertaining to the subpoena, discovery request, or other request for information. The bill would entitle a person or entity subject to these provisions to rely on the representations made in an attestation described above. The bill would authorize the Attorney General to intervene in any civil action instituted by a person or entity to protect against compliance with or providing information in response to the subpoena, discovery request, or other request for information. The bill would authorize the Attorney General to commence certain actions, including a civil action against any person or entity that attaches a false attestation described above, and would make the attachment of a false attestation by a person or entity punishable by a civil penalty of $15,000, as specified. The bill would require any action brought by the Attorney General to be commenced within 6 years of the date on which the Attorney General received the notice of the subpoena, discovery request, or other request for information at issue, and would require the court to award court costs and attorney's fees to the Attorney General in any civil action in which the court imposes any penalty authorized by the bill's provisions.
(1) The Confidentiality of Medical Information Act (CMIA) prohibits a provider of health care, a health care service plan, a contractor, or a corporation and its subsidiaries and affiliates from intentionally sharing, selling, using for marketing, or otherwise using any medical information, as defined, for any purpose not necessary to provide health care services to a patient, except as provided. Existing law makes a violation of these provisions that results in economic loss or personal injury punishable as a misdemeanor. Existing law deems a business that offers a mental health digital service or reproductive or sexual health digital service to a consumer for the purpose of allowing the individual to manage the individual's information, or for the diagnosis, treatment, or management of a medical condition of the individual, to be a provider of health care subject to the requirements of the CMIA. The bill would additionally deem a business that offers a health care chatbot, as defined, to a consumer for the above-described purposes to be a provider of health care subject to the requirements of the CMIA. Because the bill would expand the scope of a crime, it would impose a state-mandated local program. (2) Existing law requires a health facility, clinic, physician's office, or office of a group practice that uses generative artificial intelligence to generate written or verbal patient communications pertaining to patient clinical information, as defined, to ensure that those communications include both a disclaimer that indicates to the patient that a communication was generated by generative artificial intelligence, as specified, and clear instructions describing how a patient may contact a human health care provider, employee, or other appropriate person, except as specified. This bill would require a health facility, clinic, physician's office, or office of a group practice to take reasonable steps to ensure that a licensed health care professional, acting within their scope of practice, retains the ability to exercise independent professional judgment in their care of a patient whenever that care is informed by the output of a clinical decision support system, as defined. The bill would prohibit a health facility, clinic, physician's office, or office of a group practice from using or deploying a tool, system, or device that includes artificial intelligence to independently perform any clinical function that is required by law to be performed by a person with a professional license. The bill would make a violation of these provisions by a physician subject to the jurisdiction of the Medical Board of California or the Osteopathic Medical Board of California. The bill would also authorize the appropriate professional licensing board to pursue an injunction or restraining order to enforce these provisions to the extent that a violation constitutes the practice of a health care profession without a license. The bill would specify that these provisions do not apply to the use of automated decision systems for documentation and communication that does not involve the application of professional judgment, including automated messages to inform patients of updates to their health records. (3) 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.
Under existing law, when a person, as a result of a mental disorder, is a danger to others or to themselves, or is gravely disabled, they may, upon probable cause, be taken into custody for a period of up to 72 hours for assessment, evaluation, and crisis intervention, or placement for evaluation and treatment, as specified. Existing law prohibits mental health personnel from instructing a peace officer to take a person to, or keep the person at, a jail, solely because of the unavailability of an acute bed. This bill would require a peace officer who is transporting the above-described person to a designated facility for assessment to transport the person to the closest appropriate designated facility, either geographically or by time, from where the peace officer took the person into custody, as specified. If a person is being transported by a peace officer to a designated facility for assessment, the bill would authorize the person to affirmatively express their preference to the peace officer regarding the facility that they would prefer the peace officer to take them. By requiring a higher level of service from local law enforcement, this bill would 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, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
Existing law, the Confidentiality of Medical Information Act (CMIA) , generally prohibits a provider of health care, a health care service plan, or a contractor from disclosing medical information regarding a patient, enrollee, or subscriber without first obtaining an authorization, unless a specified exception applies. Existing law makes a violation of the CMIA that results in economic loss or personal injury to a patient punishable as a misdemeanor. Existing law requires specified businesses that electronically store or maintain medical information on the provision of sensitive services on behalf of a provider of health care, health care service plan, pharmaceutical company, contractor, or employer to develop capabilities, policies, and procedures, on or before July 1, 2024, to enable certain security features, including limiting user access privileges and segregating medical information related to gender affirming care, abortion and abortion-related services, and contraception, as specified. This bill would also require those specified businesses to enable the above-specified capabilities, policies, and procedures for those security features, as specified. Because the bill would expand the scope of an existing crime, it would 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.
