BILL NUMBER: AB 359 AMENDED
BILL TEXT
AMENDED IN SENATE SEPTEMBER 4, 2009
AMENDED IN SENATE JULY 15, 2009
AMENDED IN ASSEMBLY JUNE 2, 2009
AMENDED IN ASSEMBLY APRIL 15, 2009
INTRODUCED BY Assembly Member Nava
(Coauthor: Assembly Member Blakeslee)
(Coauthors: Senators Maldonado and Strickland)
FEBRUARY 23, 2009
An act to amend Section 104150 of the Health and Safety
Code, and to amend Section 14105.18 of the Welfare and Institutions
Code, relating to cancer. An act to amend Section
30461.6 of the Revenue and Taxation Code, relating to cancer.
LEGISLATIVE COUNSEL'S DIGEST
AB 359, as amended, Nava. Breast and cervical cancer: early
detection screening: digital mammography: reimbursement rates.
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.
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, and
provider rates are required to be identical to the rates under the
Medi-Cal program.
This bill would, until January 1, 2014, require
authorize, to the extent permitted by federal law,
digital mammography screening to be covered when film or
analog mammography services are not available from the provider, to
be reimbursed at the Medi-Cal film or analog rate
, and would make conforming changes .
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 30461.6 of the
Revenue and Taxation Code is amended to read:
30461.6. (a) Notwithstanding Section 30461, the board shall
transmit the revenue derived from the increase in the cigarette tax
rate of one mill ($0.001) per cigarette imposed by Section 30101 on
and after January 1, 1994, to the Treasurer to be deposited in the
State Treasury to the credit of the Breast Cancer Fund, which fund is
hereby created. The Breast Cancer Fund shall consist of two
accounts: the Breast Cancer Research Account and the Breast Cancer
Control Account. The revenues deposited in the fund shall be divided
equally between the two accounts.
(b) The moneys in the accounts within the Breast Cancer Fund
shall, upon appropriation by the Legislature, be allocated as
follows:
(1) The moneys in the Breast Cancer Research Account shall be
allocated for research with respect to the cause, cure, treatment,
earlier detection, and prevention of breast cancer as follows:
(A) Ten percent to the Cancer Surveillance Section of the State
Department of Public Health Services
for the collection of breast cancer-related data and the conduct of
breast cancer-related epidemiological research by the state cancer
registry established pursuant to Section 103885 of the Health and
Safety Code.
(B) Ninety percent to the Breast Cancer Research Program, that is
hereby created at the University of California, for the awarding of
grants and contracts to researchers for research with respect to the
cause, cure, treatment, prevention, and earlier detection of breast
cancer and with respect to the cultural barriers to accessing the
health care system for early detection and treatment of breast
cancer.
(2) The moneys in the Breast Cancer Control Account shall be
allocated to the Breast Cancer Control Program, that is hereby
created for the provision of early breast cancer detection services
for uninsured and underinsured women. The Breast Cancer Control
Program shall be established in the State Department of Public
Health Services and shall be administered in
coordination with the breast and cervical cancer control program
established pursuant to Public Law 101-354.
(c) The early breast cancer detection services provided by the
Breast Cancer Control Program shall include all of the following:
(1) Screening, including mammography, of women for breast cancer
as an early detection health care measure.
(2) After screening, medical referral of screened women and
services necessary for definitive diagnosis, including
nonradiological techniques or biopsy.
(3) If a positive diagnosis is made, then assistance and advocacy
shall be provided to help the person obtain necessary treatment.
(4) Outreach and health education activities to ensure that
uninsured and underinsured women are aware of and appropriately
utilize the services provided by the Breast Cancer Control Program.
(d) (1) Any entity funded by the Breast
Cancer Control Program shall coordinate with other local providers of
breast cancer screening, diagnostic, followup, education, and
advocacy services to avoid duplication of effort. Any entity funded
by the program shall comply with any applicable state and federal
standards regarding mammography quality assurance.
(2) To the extent required or permitted by federal law, a provider
of breast cancer screening or diagnostic services may employ digital
mammography technology for the purposes of mammography screening and
diagnostic procedures that are conducted prior to January 1, 2014,
when film, otherwise known as analog, mammography technology is
unavailable. To the extent required or permitted by federal law and
notwithstanding paragraph (3) of subdivision (a) of Section 14105.18
of the Welfare and Institutions Code, the payment rate for all
mammography screening that is conducted prior to January 1, 2014,
shall be limited to the Medi-Cal payment rate for film mammography
screening.
(e) (1) The State Department of Public Health shall provide for
breast cancer screening services 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.
(e)
(2) Administrative costs of the State Department of
Public Health Services shall not exceed
10 percent of the funds allocated to the Breast Cancer Control
Program created pursuant to paragraph (2) of subdivision (b).
Indirect costs of the entities funded by this program shall not
exceed 12 percent. The department shall define "indirect costs" in
accordance with applicable state and federal law.
(f) Any entity funded by the Breast Cancer Control Program shall
collect data and maintain records that are determined by the State
Department of Public Health Services to
be necessary to facilitate the state department's ability to monitor
and evaluate the effectiveness of the entities and the program.
Commencing with the program's second year of operation, the State
Department of Public Health Services
shall submit an annual report to the Legislature and any other
appropriate entity. The costs associated with this report shall be
paid from the allocation made pursuant to paragraph (2) of
subdivision (b). The report shall describe the activities and
effectiveness of the program and shall include, but not be limited
to, the following types of information regarding those served by the
program:
(1) The number.
(2) The ethnic, geographic, and age breakdown.
(3) The stages of presentation.
(4) The diagnostic and treatment status.
(g) The Breast Cancer Control Program shall be conducted in
consultation with the Breast Cancer Research Program created pursuant
to subparagraph (B) of paragraph (1) of subdivision (b).
(h) In implementing the Breast Cancer Control Program, the State
Department of Public Health Services
may appoint and consult with an advisory panel appointed by the
State Director of Health Services Public
Health Officer and consisting of one ex officio, nonvoting
member from the Breast Cancer Research Program, breast cancer
researchers, and representatives from voluntary, nonprofit health
organizations, health care professional organizations, breast cancer
survivor groups, and breast cancer and health care-related advocacy
groups. It is the intent of the Legislature that breast
cancer-related survivors and advocates and health advocates for
low-income women compose at least one-third of the advisory panel. It
is also the intent of the Legislature that the State Department of
Public Health Services collaborate
closely with the panel.
(i) It is the intent of the Legislature in enacting the Breast
Cancer Control Program to decrease cancer mortality rates
attributable to breast cancer among uninsured and underinsured women,
with special emphasis on low-income, Native American, and minority
women. It is also the intent of the Legislature that the communities
served by the Breast Cancer Control Program reflect the ethnic,
racial, cultural, and geographic diversity of the state and that the
Breast Cancer Control Program fund entities where uninsured and
underinsured women are most likely to seek their health care.
(j) The State Department of Public Health
Services or any entity funded by the Breast Cancer Control
Program shall collect personal and medical information necessary to
administer this program from any individual applying for services
under the program. The information shall be confidential and shall
not be disclosed other than for purposes directly connected with the
administration of this program or except as otherwise provided by law
or pursuant to prior written consent of the subject of the
information.
The State Department of Public Health Services
or any entity funded by the Breast Cancer Control Program
may disclose the confidential information to medical personnel and
fiscal intermediaries of the state to the extent necessary to
administer this program, and to other state public health agencies or
medical researchers when the confidential information is necessary
to carry out the duties of those agencies or researchers in the
investigation, control, or surveillance of breast cancer.
(k) The State Department of Public Health
Services shall adopt regulations to implement this act in
accordance with 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 initial adoption of implementing
regulations shall be deemed an emergency and shall be considered as
necessary for the immediate preservation of the public peace, health
and safety, or general welfare, within the meaning of Section
11346.1. Emergency regulations adopted pursuant to this section shall
remain in effect for no more than 180 days.
() It is the intent of the Legislature in enacting this section
that this section supersede and be operative in place of Section
30461.6 of the Revenue and Taxation Code as added by Assembly Bill
478 of the 1993-94 Regular Session.
(m) To implement the Breast Cancer Control Program, the State
Department of Public Health Services
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
utilized 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 Breast Cancer
Control Program entered into by the State Department of Public
Health Services 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.
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) For all mammography screening procedures conducted prior to
January 1, 2014, the following provisions apply:
(A) A provider may employ digital mammography technology for the
purposes of this section when analog mammography technology is not
available.
(B) The mammography screening reimbursement rate under this
section shall be limited to the Medi-Cal reimbursement rate for
analog mammography screening.
(C) For purposes of this section, digital mammography screening
may be reimbursed, pursuant to Section 14132.16, only at the analog
rate and 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 14105.18 of the Welfare and
Institutions Code, as added by Section 2 of Chapter 496 of the
Statutes of 2008, is amended to read:
14105.18. (a) Notwithstanding any other provision of law,
provider rates of payment for services rendered in all of the
following programs shall be identical to the rates of payment for the
same service performed by the same provider type pursuant to the
Medi-Cal program.
(1) The California Children's Services Program established
pursuant to Article 5 (commencing with Section 123800) of Chapter 3
of Part 2 of Division 106 of the Health and Safety Code.
(2) The Genetically Handicapped Person's Program established
pursuant to Article 1 (commencing with Section 125125) of Chapter 2
of Part 5 of Division 106 of the Health and Safety Code.
(3) Except as specified in subdivision (b) of Section 104150 of
the Health and Safety Code, the Breast and Cervical Cancer Early
Detection Program established pursuant to Article 1.5 (commencing
with Section 104150) of Chapter 2 of Part 1 of Division 103 of the
Health and Safety Code and the breast cancer programs specified in
Section 30461.6 of the Revenue and Taxation Code.
(4) The State-Only Family Planning Program established pursuant to
Division 24 (commencing with Section 24000).
(5) The Family Planning, Access, Care, and Treatment (Family PACT)
Waiver Program established pursuant to subdivision (aa) of Section
14132.
(b) The director may identify in regulations other programs not
listed in subdivision (a) in which providers shall be paid rates of
payment that are identical to the rates of payments in the Medi-Cal
program pursuant to subdivision (a).
(c) Notwithstanding subdivision (a), services provided under the
programs described in subdivisions (a) and (b) may be reimbursed at
rates greater than the Medi-Cal rate that would otherwise be
applicable if those rates are adopted by the director in regulations.
(d) This section shall become operative on January 1, 2010.