BILL NUMBER: AB 915	CHAPTERED  10/11/07

	CHAPTER  500
	FILED WITH SECRETARY OF STATE  OCTOBER 11, 2007
	APPROVED BY GOVERNOR  OCTOBER 11, 2007
	PASSED THE SENATE  AUGUST 30, 2007
	PASSED THE ASSEMBLY  SEPTEMBER 4, 2007
	AMENDED IN SENATE  AUGUST 27, 2007
	AMENDED IN ASSEMBLY  MAY 1, 2007
	AMENDED IN ASSEMBLY  APRIL 18, 2007
	AMENDED IN ASSEMBLY  MARCH 29, 2007

INTRODUCED BY   Assembly Member Hernandez

                        FEBRUARY 22, 2007

   An act to amend Section 14407.1 of the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 915, Hernandez. Medi-Cal managed care.
   Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which basic health
care services are provided to qualified low-income persons. Existing
law provides that a Medi-Cal managed care health plan contractor that
has entered into a contract with the department may offer
nonmonetary incentives to promote good health practices by Medi-Cal
enrollees, if approved by the department.
   This bill would, in the absence of countervailing considerations
and to the extent permitted by federal law, require the department to
approve the use by health plans of nonmonetary incentives for health
education to accomplished specified purposes, and would require the
department to develop and publish written guidelines for the
appropriate use of nonmonetary incentives that may be offered.


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

  SECTION 1.  Section 14407.1 of the Welfare and Institutions Code is
amended to read:
   14407.1.  (a) A contractor that has entered into a contract with
the department under this chapter, or under any other Medi-Cal
managed care contracting authority, may offer nonmonetary incentives
to promote good health practices by its existing Medi-Cal enrollees.
   (b) No Medi-Cal managed care contractor may offer any incentive to
promote good health practices by its Medi-Cal enrollees prior to
written approval by the department. In the absence of other
countervailing considerations, the department shall approve, to the
extent permitted by federal law, the use by health plans of
nonmonetary incentives to enhance health education program efforts to
increase member participation, learning, and motivation to do any of
the following:
   (1) Effectively use managed health care services, including
preventive and primary care services, obstetrical care, and health
education services.
   (2) Modify personal health behaviors, achieving and maintaining
healthy lifestyles and treatment therapies and positive health
outcomes.
   (3) Following self-care regimens and treatment therapies for
existing medical conditions, chronic diseases, or health conditions.
   (c) If a contractor is a publicly operated entity, the offering of
a department-approved, nonmonetary incentive to promote good health
practices by enrollees shall not constitute a gift of public funds.
   (d) Violations of this section shall be subject to the
requirements and penalties set forth in Sections 14408 and 14409, and
any regulations adopted by the department pursuant to this article.
   (e) The department shall develop and publish written guidelines
for the appropriate use of nonmonetary incentives that may be offered
to Medi-Cal enrollees.