BILL ANALYSIS
AB 2352
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CORRECTED - 06/02/2010 Technical change (Member name)
ASSEMBLY THIRD READING
AB 2352 (John A. Perez)
As Introduced February 19, 2010
Majority vote
HEALTH 17-0 APPROPRIATIONS 12-5
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|Ayes:|Monning, Fletcher, |Ayes:|Fuentes, Ammiano, |
| |Ammiano, Carter, Conway, | |Bradford, |
| |Caballero, Emmerson, Eng, | |Charles Calderon, Coto, |
| |Hayashi, Hernandez, | |Davis, |
| |Jones, | |Monning, Ruskin, Skinner, |
| |Bonnie Lowenthal, Nava, | |Solorio, |
| |V. Manuel Perez, Salas, | |Torlakson, Torrico |
| |Smyth, Audra Strickland | | |
|-----+--------------------------+-----+--------------------------|
| | |Nays:|Conway, Harkey, Miller, |
| | | |Nielsen, Norby |
| | | | |
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SUMMARY : Requires Medi-Cal beneficiaries to remain eligible to
receive Medi-Cal coverage for anti-rejection medication for up
to two years following an organ transplant unless during that
time the beneficiary becomes eligible for Medicare or private
health insurance that would cover the medication.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Annual costs of $500,000 (100% General Fund) 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.
AB 2352
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COMMENTS : According to the author, there are currently some
patients that qualify for Medi-Cal under a federal rule allowing
coverage for patients with end-stage renal disease (on
dialysis). Those patients, if they are able to receive a kidney
and have an organ transplant, will only receive coverage for
their immunosuppressive medication for one year post-transplant
as the person's Medi-Cal eligibility ends when he or she no
longer meets the eligibility requirement of end-stage renal
disease.
Patients in this particular group may not be eligible for
Medi-Cal under any other eligibility criteria, and they may also
be ineligible for Medicare, either because they have not paid
into Social Security for a sufficient time or because of their
immigration status. The author states that if these patients
were dual-eligible for Medicare and Medi-Cal, Medicare would pay
for immunosuppressive coverage for an additional two years, so
the patient would have immunosuppressive drugs for a total of
three years post-transplant. Because patients who have had a
kidney transplant must have immunosuppressive drugs or their
body will naturally reject the organ, they have a medical need
for the anti-rejection medication to prevent kidney failure,
being placed back on dialysis or, in a worst-case scenario,
death. The author argues the state has already paid for the
organ transplant surgery (the cost of transplant surgery is
$50,000 to $100,000 according to the author) and it makes no
sense to drop Medi-Cal coverage for these patients after only a
year when many organ transplant patients are not yet stable or
ready to enter the workforce.
The Patient Protection and Affordable Care Act (P. L. 111-148),
among other provisions, requires states, as of January 2014 to
include all adults with income up to 133% of the Federal Poverty
Level (FPL) in its Medicaid Program and provides enhanced
federal matching assistance funds.. States have the option to
begin providing medical assistance to individuals eligible under
this new group as of April 1, 2010. Transplant patients who
have income under 133% of FPL will have full-scope Medi-Cal once
this is implemented.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097
AB 2352
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FN: 0004653