BILL ANALYSIS AB 2352 Page 1 Date of Hearing: May 5, 2010 ASSEMBLY COMMITTEE ON APPROPRIATIONS Felipe Fuentes, Chair AB 2352 (John A. Perez) - As Introduced: February 19, 2010 Policy Committee: HealthVote:17-0 Urgency: No State Mandated Local Program: No Reimbursable: SUMMARY This bill establishes a state-only program to ensure dialysis-only Medi-Cal beneficiaries remain eligible for anti-rejection medication following a kidney transplant for up to two years, unless the beneficiary becomes eligible for Medicare or private health insurance that covers the medication. FISCAL EFFECT 1)Annual costs of $500,000 (100% GF) to provide post-transplant anti-rejection medication to Medi-Cal beneficiaries who had formerly been on dialysis-only Medi-Cal and who would either return to that program or require a new kidney transplant. 2)Reduced Medi-Cal costs to the extent this bill reduces the need for a return to dialysis-only Medi-cal or a new transplant. An additional transplant or continuation of dialysis-only treatment costs between $50,000 and $100,000 per year. COMMENTS 1)Rationale . This bill creates continuity of treatment for patients who are initially on a specific dialysis-only Medi-Cal program which serves beneficiaries with chronic kidney disease and who require dialysis. Dialysis is a substitute for the normal functioning of the kidneys. It filters waste products from the blood. Following a kidney transplant, these patients no longer require dialysis and are no longer deemed disabled for the purposes of their very narrow Medi-Cal coverage. 2)Background . Under current law, Medi-Cal pays for AB 2352 Page 2 post-transplant medications during the first year after surgery due to a continued patient disability status under federal law. As a patient recovers, this disability status is lost and the patient loses payment for the medications. If a patient has no Medi-Cal, private insurance, or Medicare coverage, they are at risk for organ failure, a return to dialysis, death, or a new transplant. The author indicates a significant investment has already been made via the transplant and patients should be afforded continuity of care at a much lower costs than alternatives. 3)Related Legislation . AB 998 (J. Perez) in 2009 was similar to this bill but provided the state-only benefit for a longer duration of time. AB 998 was held on the Suspense File of this committee. Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081