Attorney General No.

SA97RF0080

Secretary of State No.

806

Description

HEALTH CARE BUSINESSES. CONSUMER AND PROVIDER SERVICES. INITIATIVE STATUTE. Imposes liability in damages on Health Care Businesses when they or those they influence fail to exercise ordinary care in making health care decisions. Prohibits limiting providers' advocacy for Consumer; penalizing or rewarding providers for providing or denying covered service; and refusing to authorize recommended covered service unless denied by appropriately licensed provider. Requires detailed written statement of reasons for denying benefit; reasons not specified are waived. Requires internal review procedures that ensure review within fourteen days. Requires prompt payment for covered service. Prohibits contracts requiring binding arbitration. Authorizes punitive damages. Summary of estimate by Legislative Analyst and Director of Finance of fiscal impact on state and local governments: The state and local governments could incur increased costs for health care services. These costs could range from tens of millions to hundreds of millions of dollars annually. Depending on the measure's interpretation, state tax revenues could increase or decrease by an unknown amount. The net effect on state revenues is unknown. Local tax revenues would decrease as a result of this measure.

Proponents

Susan Bergman Irwin Hoff John Metz James Forsyth Pauline Horvath Dolores M. Fisher Linda Ross C/O John Metz California Consumer Health Care Council, 200 Grand Avenue, Room 106, Oakland, California 94610 (888) 225-2686

Date

2-17-1998

Document Type

Initiative

Qualified

Failed to Qualify

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