Fabio
116 lines
11 KiB
Markdown
116 lines
11 KiB
Markdown
---
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type: "Bill"
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title: "Health care debt and fair billing."
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description: "Existing law requires a hospital to maintain an understandable written policy regarding discount payments for financially qualified patients and an understandable written charity care policy. Existing law requires that uninsured patients or patients with high medical costs who are at or below 350% of the federal poverty level be eligible for charity care or discount payments from a hospital. Existing law defines \"high medical costs\" to mean, among other things, annual out-of-pocket costs at the hospital that exceed 10% of the patient's family income in the prior 12 months. Existing law authorizes a hospital to grant eligibility for charity care or discount payments to patients with incomes over 350% of the federal poverty level. Existing law requires a hospital to provide the Department of Health Care Access and Information with a copy of its discount payment policy and charity care policy, and requires the department to make the information public. Existing law requires a hospital to post notice of its policy for financially qualified and self-pay patients in designated locations that are visible to the public."
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jurisdiction: "us/states/ca"
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legislature: "California Legislature"
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session: "20212022"
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identifier: "AB 1020"
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citation: "California AB 1020 (20212022)"
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classification: ["bill"]
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subjects: ["Health care debt and fair billing."]
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status: "enacted"
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primary_sponsors: ["Friedman"]
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version_count: 12
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action_count: 37
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vote_count: 10
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first_action: "2021-02-18"
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last_action: "2021-10-04"
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source: "openstates"
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source_identifier: "ocd-bill/859b4075-c62f-4b34-bad4-1d6246850aaa"
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source_url: "http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB1020"
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source_hash: "de15ac134019411dc238718ff2dc93d2c359d3b65daa42567f325add84a55f8a"
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vintage: "2026-07-01"
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source_snapshot: "https://data.openstates.org/daily/2026-07-01/public.pgdump"
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retrieved_at: "2026-07-06"
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confidence: "reported"
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tags: ["legislation", "bill", "us-ca"]
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---
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# California AB 1020 (20212022) — Health care debt and fair billing.
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Existing law requires a hospital to maintain an understandable written policy regarding discount payments for financially qualified patients and an understandable written charity care policy. Existing law requires that uninsured patients or patients with high medical costs who are at or below 350% of the federal poverty level be eligible for charity care or discount payments from a hospital. Existing law defines "high medical costs" to mean, among other things, annual out-of-pocket costs at the hospital that exceed 10% of the patient's family income in the prior 12 months. Existing law authorizes a hospital to grant eligibility for charity care or discount payments to patients with incomes over 350% of the federal poverty level. Existing law requires a hospital to provide the Department of Health Care Access and Information with a copy of its discount payment policy and charity care policy, and requires the department to make the information public. Existing law requires a hospital to post notice of its policy for financially qualified and self-pay patients in designated locations that are visible to the public.
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## Version chain
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The bill's text revisions, in order — the diff chain from filing to enrollment.
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1. **02/18/21 - Introduced** (filed) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102099INT)
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2. **03/18/21 - Amended Assembly** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102098AMD)
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3. **03/25/21 - Amended Assembly** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102097AMD)
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4. **03/30/21 - Amended Assembly** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102096AMD)
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5. **04/07/21 - Amended Assembly** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102095AMD)
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6. **05/27/21 - Amended Assembly** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102094AMD)
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7. **07/01/21 - Amended Senate** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102093AMD)
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8. **08/16/21 - Amended Senate** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102092AMD)
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9. **08/26/21 - Amended Senate** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102091AMD)
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10. **10/04/21 - Chaptered** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102089CHP)
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11. **AB1020** (committee substitute) — [source](http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB1020)
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12. **09/09/21 - Enrolled** (enrolled) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB1020&version=20210AB102090ENR)
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## Votes
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- Placed on suspense file — **7–0** (pass) · upper
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- Do pass as amended — **7–0** (pass) · upper
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- Do pass, but first be re-referred to the Committee on [Judiciary] — **10–0** (pass) · upper
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- Do pass. — **12–0** (pass) · lower
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- Do pass as amended and be re-referred to the Committee on [Health] — **9–2** (pass) · lower
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- Do pass and be re-referred to the Committee on [Appropriations] — **13–0** (pass) · lower
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- Do pass, but first be re-referred to the Committee on [Appropriations] — **9–0** (pass) · upper
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- AB 1020 Friedman Assembly Third Reading — **65–3** (pass) · lower
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- AB 1020 Friedman Concurrence in Senate Amendments — **72–0** (pass) · lower
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- 3rd Reading AB1020 Friedman et al. By Umberg — **39–0** (pass) · upper
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## Sponsors
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- Friedman — primary (person)
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- Kalra — coauthor (person)
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- Wood — coauthor (person)
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## Timeline
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The legislative action history — every referral, reading, and vote.
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- **2021-02-18** Read first time. To print. `reading-1`
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- **2021-02-19** From printer. May be heard in committee March 21.
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- **2021-03-18** Referred to Coms. on HEALTH and JUD. `referral-committee`
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- **2021-03-18** From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended. `amendment-introduction, amendment-passage, reading-1, reading-2`
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- **2021-03-22** Re-referred to Com. on HEALTH. `referral-committee`
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- **2021-03-25** Re-referred to Coms. on JUD. and HEALTH pursuant to Assembly Rule 96. `referral-committee`
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- **2021-03-25** From committee chair, with author's amendments: Amend, and re-refer to Com. on JUD. Read second time and amended. `amendment-introduction, amendment-passage, reading-1, reading-2`
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- **2021-03-26** Re-referred to Com. on JUD. `referral-committee`
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- **2021-03-30** From committee chair, with author's amendments: Amend, and re-refer to Com. on JUD. Read second time and amended. `amendment-introduction, amendment-passage, reading-1, reading-2`
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- **2021-04-05** Re-referred to Com. on JUD. `referral-committee`
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- **2021-04-06** From committee: Amend, and do pass as amended and re-refer to Com. on HEALTH. (Ayes 9. Noes 2.) (April 6). `amendment-introduction, amendment-passage, committee-passage, referral-committee`
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- **2021-04-07** Read second time and amended. `amendment-passage, reading-1, reading-2`
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- **2021-04-08** Re-referred to Com. on HEALTH. `referral-committee`
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- **2021-04-21** Coauthors revised.
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- **2021-04-21** From committee: Do pass and re-refer to Com. on APPR. (Ayes 13. Noes 0.) (April 20). Re-referred to Com. on APPR. `committee-passage, committee-passage-favorable, referral-committee`
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- **2021-05-05** In committee: Set, first hearing. Referred to APPR. suspense file. `referral-committee`
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- **2021-05-20** From committee: Do pass. (Ayes 12. Noes 0.) (May 20). `committee-passage, committee-passage-favorable`
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- **2021-05-24** Read second time. Ordered to third reading. `reading-1, reading-2`
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- **2021-05-27** Read third time and amended. Ordered to third reading. (Page 1579.) `amendment-passage, reading-1, reading-3`
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- **2021-06-01** Read third time. Passed. Ordered to the Senate. (Ayes 65. Noes 3. Page 1738.) `passage, reading-1, reading-3`
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- **2021-06-02** In Senate. Read first time. To Com. on RLS. for assignment. `reading-1`
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- **2021-06-16** Referred to Coms. on HEALTH and JUD. `referral-committee`
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- **2021-06-30** From committee: Do pass and re-refer to Com. on JUD. (Ayes 10. Noes 0.) (June 30). Re-referred to Com. on JUD. `committee-passage, committee-passage-favorable, referral-committee`
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- **2021-07-01** From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on JUD. `amendment-introduction, amendment-passage, reading-1, reading-2, referral-committee`
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- **2021-07-14** From committee: Do pass and re-refer to Com. on APPR. (Ayes 9. Noes 0.) (July 13). Re-referred to Com. on APPR. `committee-passage, committee-passage-favorable, referral-committee`
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- **2021-08-16** In committee: Hearing postponed by committee.
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- **2021-08-16** From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on APPR. `amendment-introduction, amendment-passage, reading-1, reading-2, referral-committee`
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- **2021-08-23** In committee: Referred to APPR suspense file. `referral-committee`
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- **2021-08-26** From committee: Amend, and do pass as amended. (Ayes 7. Noes 0.) (August 26). `amendment-introduction, amendment-passage, committee-passage`
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- **2021-08-26** Read second time and amended. Ordered returned to second reading. `amendment-passage, reading-1, reading-2`
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- **2021-08-30** Read second time. Ordered to third reading. `reading-1, reading-2`
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- **2021-09-02** Read third time. Passed. Ordered to the Assembly. (Ayes 39. Noes 0. Page 2342.). `passage, reading-1, reading-3`
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- **2021-09-02** In Assembly. Concurrence in Senate amendments pending. May be considered on or after September 4 pursuant to Assembly Rule 77.
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- **2021-09-07** Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 72. Noes 0. Page 2833.). `amendment-passage, committee-passage-favorable`
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- **2021-09-13** Enrolled and presented to the Governor at 3 p.m.
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- **2021-10-04** Approved by the Governor. `executive-signature`
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- **2021-10-04** Chaptered by Secretary of State - Chapter 473, Statutes of 2021. `became-law`
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## Source
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OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/859b4075-c62f-4b34-bad4-1d6246850aaa`. Confidence: reported (aggregated from official California legislature records).
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