BILL NUMBER: AB 530	CHAPTERED  09/28/06

	CHAPTER  543
	FILED WITH SECRETARY OF STATE  SEPTEMBER 28, 2006
	APPROVED BY GOVERNOR  SEPTEMBER 28, 2006
	PASSED THE ASSEMBLY  AUGUST 29, 2006
	PASSED THE SENATE  AUGUST 28, 2006
	AMENDED IN SENATE  JUNE 23, 2005
	AMENDED IN ASSEMBLY  APRIL 18, 2005

INTRODUCED BY   Assembly Member Plescia

                        FEBRUARY 16, 2005

   An act to add Section 14123.05 to the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 530, Plescia  Medi-Cal: withholding payments or suspension:
informal hearing.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Services and under
which qualified low-income persons receive health care services.
   Existing law authorizes the department to suspend a provider of
service from further participation in the Medi-Cal program in order
to protect the health of recipients and the funds appropriated to
carry out the Medi-Cal program. The suspension may be for an
indefinite or specified period of time, with or without conditions,
or imposed with the operation of the suspension stayed or probation
granted.
   Existing law authorizes the department to withhold payment for any
goods, services, supplies, or merchandise upon receipt of reliable
evidence of fraud or willful misrepresentation by the provider or the
commencement of suspension proceedings.
   This bill would require the department to develop, in consultation
with provider representatives, including, but not limited to,
physician, pharmacy, and medical supplies providers, a process that
enables a provider to meet and confer with the appropriate department
officials within 30 days after the issuance of a letter notifying
the provider of a temporary withhold of payments or a temporary
suspension sanction for the purpose of presenting and discussing
information and evidence that may impact the department's decision to
initiate the sanction or modify or terminate the sanction.


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


  SECTION 1.  Section 14123.05 is added to the Welfare and
Institutions Code, to read:
   14123.05.  The department shall develop, in consultation with
provider representatives, including, but not limited to, physician,
pharmacy and medical supplies providers, a process that enables a
provider to meet and confer with the appropriate department officials
within 30 days after the issuance of a letter notifying the provider
of a temporary withhold of payments, pursuant to Section 14107.11,
or a temporary suspension, pursuant to subdivision (a) of Section
14043.36, for the purpose of presenting and discussing information
and evidence that may impact the department's decision to modify or
terminate the sanction.