Effective January 1, 2017, SB 1365 (Chapter 501, Statutes of 2016), will require GACHs to notify those patients scheduled for services at its hospital-based outpatient clinic that the service may be available at another location that is not hospital-based, unless the GACH is exempt.
The patient notification must be in substantially the following form:
"The location where you are being scheduled to receive services is a hospital-based clinic and, therefore, may have higher costs. The same services may be available at another location within our health system that is not hospital-based, which may cost less. Check with the [insert name of office] at [insert telephone number] for another location within our health system, or check with your health insurance company, for more information about other locations that may cost less."
GACHs operated by a non-profit corporation under common control with a nonprofit health care service plan licensed pursuant to the Knox-Keene Health Care Service Plan Act of 1975, that exclusively contract with no more than two medical groups in the state to provide and arrange for medical services for the enrollees of the health care service plan are exempt from this requirement, so long as the cost-sharing design does not vary based on whether the care is provided in a hospital-based clinic or a medical office building.
This AFL is a brief summary of the provisions of SB 1365. Facilities are responsible for following all applicable laws. The California Department of Public Health’s failure to expressly notify facilities of statutory or regulatory requirements does not relieve facilities of their responsibility for following all laws and regulations. Facilities should refer to the full text of all applicable sections of the Health and Safety Code and the California Code of Regulations to ensure compliance.
If you have questions regarding this AFL, please contact your respective district office.
Original signed by Scott Vivona for