Health Care Laws in California

Because health care coverage is often a confusing topic, it is necessary to fully understand the laws set forth by the state and other government agencies. Working in line with the laws and regulations set forth by U.S. Department of Health and Human Services and the Health Insurance Portability and Accountability Act of 1996, the State of California has put solid laws in place to protect its citizens.

Continuous Care, Second Opinions, Referrals and Information

• Typically, a relationship is established between a patient and his physician when the patient receives his first physical examination by the doctor. By California law, the patient has the right to receive care from his physician and should be referred to other providers and specialists when it is necessary. He may also discuss any treatments or care procedures during his visit. When a patient or his physician sees the need for a second opinion, California allows that right. If a patient requires a second opinion or care from another physician, the health insurance provider must provide authorization within three days.

Informed Consent

• Before undergoing treatment, a patient has the right to discuss and comprehend the condition and possible treatment. A patient who necessitates treatment for any medical condition has the right to the discuss risks and benefits of the procedure or medication. The patient may also inquire about alternative treatment before undergoing treatment. If the patient elects to decline treatment, he has that right under the health care laws of California.

Medical Records and Confidentiality

• Because of the personal information contained within, medical records must remain highly confidential. Only those that the patient permits may receive access to his medical information. If sensitive medical information is released without proper consent, the patient has the right under California laws to sue the party at fault. However, the patient is always permitted to obtain these records. The office of the physician must provide complete medical records within five days of receive a written request from the patient.

Emergency Medical Care

• Regardless of financial or insurance status, a California resident has the right to obtain medical care in a facility that contains emergency facilities. A condition is considered an emergency if the life, body parts or bodily functions of a patient are at risk. When the condition of the patient is stabilized, he may choose to be transferred to a hospital room. If the patient is discharged or transferred, emergency room personnel must provide the reason in writing.

Coverage for Pre-Existing Conditions

• Health insurance providers can not reject a California resident's health insurance coverage due to health status, pre-existing medical conditions, genetic information or disability. A patient has the right to receive health insurance if he has had 18 months of constant insurance coverage. Pre-existing conditions may require a six- to 12-month waiting period; however, if the patient enrolled in a plan following a diagnosis that elects for new coverage, some or all of the waiting period may be waived. Some circumstances can not be included in a pre-existing condition clause, including pregnancy or newborn care.