BILL NUMBER: SB 1358	CHAPTERED  07/23/04

	CHAPTER  185
	FILED WITH SECRETARY OF STATE  JULY 23, 2004
	APPROVED BY GOVERNOR  JULY 23, 2004
	PASSED THE SENATE  JULY 12, 2004
	PASSED THE ASSEMBLY  JULY 1, 2004
	AMENDED IN ASSEMBLY  JUNE 15, 2004
	AMENDED IN SENATE  APRIL 28, 2004
	AMENDED IN SENATE  APRIL 12, 2004

INTRODUCED BY   Senators Escutia and Brulte

                        FEBRUARY 18, 2004

   An act to add Section 12528.1 to the Government Code, relating to
Medi-Cal.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1358, Escutia.  Medi-Cal:  provider inspections.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Services, pursuant to
which medical benefits are provided to public assistance recipients
and other low-income persons.  Existing law establishes within the
office of the Attorney General the Bureau of Medi-Cal Fraud for the
investigation and prosecution of violations of applicable laws
pertaining to the Medi-Cal program, and to review complaints alleging
abuse or neglect of patients in health care facilities receiving
payments under the Medi-Cal program.
   This bill would authorize any agent, investigator, or auditor of
the bureau investigating fraud under the Medi-Cal program to inspect,
at any time, the business location of any Medi-Cal provider for the
purpose of carrying out the duties of the bureau.  This bill would
require the Department of Justice to provide each investigator and
auditor leading a facility inspection team with prescribed training.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  Section 12528.1 is added to the Government Code, to
read:
   12528.1.  (a) Any agent, investigator, or auditor of the Bureau of
Medi-Cal Fraud within the office of the Attorney General shall have
the authority to inspect, at any time, the business location of any
Medi-Cal provider for the purpose of carrying out the duties of the
bureau as set forth in Section 12528.  For purposes of this
subdivision, "provider" includes an applicant as defined in Section
14043.1 of the Welfare and Institutions Code and a billing agent, as
defined in Section 14040.1 of the Welfare and Institutions Code.
   (b) The department shall provide all investigators and auditors
assigned to lead a facility inspection team of a health facility
licensed under Chapter 2 (commencing with Section 1250) of Division 2
of the Health and Safety Code with basic training on the relevant
statutes and regulations governing the types of facilities to be
inspected.  Unless it is impracticable, the training shall include a
facility tour, unrelated to an actual inspection, to observe the
operations of the type of facilities to be inspected.
   (c) The Bureau of Medi-Cal Fraud shall develop protocols to ensure
that inspections conducted pursuant to this section are conducted
during normal business hours and are completed in the least intrusive
manner possible.