BILL NUMBER: SB 94	CHAPTERED  10/13/07

	CHAPTER  636
	FILED WITH SECRETARY OF STATE  OCTOBER 13, 2007
	APPROVED BY GOVERNOR  OCTOBER 13, 2007
	PASSED THE SENATE  SEPTEMBER 12, 2007
	PASSED THE ASSEMBLY  SEPTEMBER 10, 2007
	AMENDED IN ASSEMBLY  SEPTEMBER 6, 2007
	AMENDED IN ASSEMBLY  JULY 16, 2007

INTRODUCED BY   Senator Kuehl
   (Principal coauthors: Assembly Members Hayashi and Laird)

                        JANUARY 17, 2007

   An act to add Section 14105.181 to the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 94, Kuehl. Medi-Cal: reimbursement rates.
   Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which basic health
care services, including certain family planning services, are
provided to qualified low-income persons. Existing law prescribes
various requirements governing reimbursement rates for these
services.
   This bill would require reimbursement rates for office visits
billed as comprehensive clinical family planning services by Family
PACT waiver providers and for office visits billed as family planning
services by Medi-Cal providers to receive a rate augmentation equal
to the weighted average of at least 80% of the amount that the
federal Medicare program reimburses for these same or similar office
visits, as provided. The bill would require the augmentation of
reimbursement rates to be made for office visits rendered on or after
January 1, 2008.


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

  SECTION 1.  Section 14105.181 is added to the Welfare and
Institutions Code, to read:
   14105.181.  (a) For purposes of this section, the following
definitions shall apply:
   (1) "The Family Planning, Access, Care, and Treatment (Family
PACT) waiver" or "Family PACT waiver" means the program described in
subdivision (aa) of Section 14132, as approved by a federal
demonstration waiver.
   (2) "Comprehensive clinical family planning services" means those
services described in paragraph (8) of subdivision (aa) of Section
14132.
   (3) "Office visits" means those procedures billed under Common
Procedure Terminology codes 99201, 99202, 99203, 99204, 99211, 99212,
99213, and 99214.
   (b) Reimbursement rates for office visits billed as comprehensive
clinical family planning services by Family PACT waiver providers and
for office visits billed as family planning services by Medi-Cal
providers shall receive a rate augmentation equal to the weighted
average of at least 80 percent of the amount that the federal
Medicare program reimburses for these same or similar office visits.
The rate augmentation shall be based upon Medicare rates in effect on
December 31, 2007.
   (c) The augmentation of reimbursement rates described in
subdivision (b) shall be made for office visits rendered on or after
January 1, 2008.
   (d) (1) The director may adopt regulations as necessary to
implement this section. These regulations may be adopted as emergency
regulations in accordance with the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code. For
purposes of this section, the adoption of the regulations shall be
deemed an emergency and necessary for the immediate preservation of
the public peace, health and safety, or the general welfare.
   (2) As an alternative to paragraph (1), and notwithstanding the
rulemaking provisions of the Administrative Procedure Act (Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code), the director may administer this section,
in whole or in part, by means of a provider bulletin, or other
similar instructions, without taking regulatory action.