BILL NUMBER: AB 366	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 2, 2009

INTRODUCED BY   Assembly Member Ruskin
    (   Coauthors:   Assembly Members 
 Adams   and Portantino   ) 

                        FEBRUARY 23, 2009

   An act to  amend Section 14083 of   add
Section 14083.7 to  the Welfare and Institutions Code, relating
to Medi-Cal.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 366, as amended, Ruskin. Medi-Cal: inpatient hospital services
contracts.
   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.
   Under existing law, the California Medical Assistance Commission
is authorized to negotiate inpatient hospital services contracts 
that are  binding upon the  State Department of Health
Care Services   department  . Existing law requires
the commission to consider certain factors in negotiating inpatient
hospital services contracts. 
   This bill would make technical, nonsubstantive changes to these
provisions.  
   This bill would additionally require the California Medical
Assistance Commission, in negotiating contracts or in drawing
specifications for competitive bidding, to provide for separate
reimbursement for hospitals for the full cost of orthopedic implants
for cancers of the bone. 
   Vote: majority. Appropriation: no. Fiscal committee:  no
  yes  . State-mandated local program: no.


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

   SECTION 1.    Section 14083.7 is added to the 
 Welfare and Institutions Code   , to read:  
   14083.7.  In addition to considering the factors specified in
Sections 14083 and 14083.5, the California Medical Assistance
Commission, in negotiating contracts under this article, or in
drawing specifications for competitive bidding, shall provide for
separate reimbursement for hospitals for the full cost of orthopedic
implants for cancers of the bone.  
  SECTION 1.    Section 14083 of the Welfare and
Institutions Code is amended to read:
   14083.  The factors to be considered by the negotiator in
negotiating contracts under this article, or in drawing
specifications for competitive bidding, include, but are not limited
to, all of the following:
   (a) Beneficiary access.
   (b) Utilization controls.
   (c) Ability to render quality services efficiently and
economically.
   (d) Demonstrated ability to provide or arrange needed specialized
services.
   (e) Protection against fraud and abuse.
   (f) Any other factor that would reduce costs, promote access, or
enhance the quality of care.
   (g) The capacity to provide a given tertiary service, such as
specialized children's services, on a regional basis.
   (h) Recognition of the variations in severity of illness and
complexity of care.
   (i) Existing labor-management collective bargaining agreements.
   (j) The situation of county hospitals and university medical
centers contracting with counties for provision of health care to
indigent persons entitled to care under Section 17000, which are
burdened to a greater extent than private hospitals with bad debts,
indirect costs, medical education programs, and capital needs.
   (k) The special circumstances of hospitals serving a
disproportionate number of Medi-Cal beneficiaries and patients who
are not covered by other third-party payers, including the costs
associated with assuring an adequate supply of registered nurses.
   () The costs of providing complex emergency services, including
the costs of meeting and maintaining state and local requirements for
trauma center designation.
   (m) The hospital does any of the following:
   (1) Provides additional obstetrical beds.
   (2) Contracts with one or more comprehensive perinatal providers.
   (3) Permits certified nurse midwives, subject to hospital rules,
and consistent with existing laws and regulations, to admit patients
to the health facility.
   (4) Expands overall obstetrical services in the hospital.
   (n) The special circumstances of hospitals whose Medi-Cal
inpatient utilization rate exceeds the mean Medicaid inpatient
utilization rate by at least one-half of one standard deviation.
   (o) The ability and capacity of the contracting hospital in a
closed health facility planning area to provide health care services
to beneficiaries who are in life threatening or emergency situations,
but have been sufficiently stabilized at another noncontracting
facility in order to facilitate transportation to the contracting
hospital.
   (p) The ability of the contracting hospital to provide a secure
environment for the provision of health care services. In this
regard, the negotiator shall consider additional security measures
that the contracting hospital may have taken to provide a secure
environment, including, but not limited to, the use of detection
equipment or procedures to detect lethal weapons, the appropriate use
of surveillance cameras, limiting access of unauthorized personnel
to the emergency department, installation of bullet proof glass as
appropriate in designated areas, the use of emergency "panic" buttons
to alert local law enforcement agencies, and assigning full-time
security personnel to the emergency department.