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