BILL NUMBER: AB 359	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 15, 2009

INTRODUCED BY   Assembly Member Nava

                        FEBRUARY 23, 2009

   An act to amend Section 104150 of the Health and Safety Code, 
  and to add Section 14132.165 to the Welfare and Institutions Code,
  relating to cancer.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 359, as amended, Nava. Breast and cervical cancer: early
detection screening: digital  mammography.  
mammography: reimbursement rates. 
   Under existing law, the State Department of Public Health
participates in a grant program through the federal Centers for
Disease Control and Prevention to provide breast and cervical cancer
early detection screening. Providers participating in the grant
program may only provide screening services to individuals whose
family income does not exceed 200% of the federal poverty level.
   This bill would require digital mammography screening to be
covered when analog mammography services are not available from the
provider. It would permit  the department to authorize
 coverage of digital mammography screening where digital and
analog mammography are both available. 
   Existing law provides for the Medi-Cal program, administered by
the State Department of Health Care Services, under which qualified
low-income persons are provided with health care services, including
breast and cervical cancer services.  
   This bill would authorize digital screening eligibility and
reimbursement under these programs only for those screenings where
the provider agrees to receive reimbursement in full at the analog
rate. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


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

  SECTION 1.  Section 104150 of the Health and Safety Code is amended
to read:
   104150.  (a) A provider or entity that participates in the grant
made to the department by the federal Centers for Disease Control and
Prevention breast and cervical cancer early detection program
established under Title XV of the Public Health Service Act (42
U.S.C. Sec. 300k et seq.) in accordance with requirements of Section
1504 of that act (42 U.S.C. Sec. 300n) may only render screening
services under the grant to an individual if the provider or entity
determines that the individual's family income does not exceed 200
percent of the federal poverty level.
   (b) (1) The department shall provide for breast cancer and
cervical cancer screening services under the grant at the level of
funding budgeted from state and other resources during the fiscal
year in which the Legislature has appropriated funds to the
department for this purpose. These screening services shall not be
deemed to be an entitlement.
   (2) Digital mammography screening shall be covered when analog
mammography services are not available from the provider. The
department may authorize coverage of digital mammography screening
where digital and analog mammography are both available from the
provider.  Digital mammography screening is covered under this
section, and may be reimbursed only if the provider agrees to receive
reimbursement in full at the analog rate. 
   (c) To implement the federal breast and cervical cancer early
detection program specified in this section, the department may
contract, to the extent permitted by Section 19130 of the Government
Code, with public and private entities, or utilize existing health
care service provider enrollment and payment mechanisms, including
the Medi-Cal program's fiscal intermediary. However, the Medi-Cal
program's fiscal intermediary shall only be used if services provided
under the program are specifically identified and reimbursed in a
manner that does not claim federal financial reimbursement. Any
contracts with, and the utilization of, the Medi-Cal program's fiscal
intermediary shall not be subject to Chapter 3 (commencing with
Section 12100) of Part 2 of Division 2 of the Public Contract Code.
Contracts to implement the federal breast and cervical cancer early
detection program entered into by the department with entities other
than the Medi-Cal program's fiscal intermediary shall not be subject
to Part 2 (commencing with Section 10100) of Division 2 of the Public
Contract Code.
   SEC. 2.    Section 14132.165 is added to the 
 Welfare and Institutions Code   , immediately following
Section 14132.16, to read:  
   14132.165.  Digital mammography screening may be reimbursed
pursuant to Section 14132.16, but only at the analog rate and only if
the provider agrees to receive reimbursement in full at the analog
rate.