BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1468|
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THIRD READING
Bill No: AB 1468
Author: Assembly Budget Committee
Amended: 8/21/12 in Senate
Vote: 21
SENATE BUDGET & FISCAL REVIEW COMMITTEE : 11-5, 6/27/12
AYES: Leno, Alquist, DeSaulnier, Evans, Hancock, Liu,
Lowenthal, Negrete McLeod, Simitian, Wolk, Wright
NOES: Emmerson, Anderson, Fuller, Gaines, La Malfa
ASSEMBLY FLOOR : Not relevant
SUBJECT : Budget Act of 2012: health
SOURCE : Author
DIGEST : This bill makes statutory revisions affecting
health programs necessary to implement the Budget Act of
2012.
Senate Floor Amendments of 8/21/12 delete the prior version
of the bill and now make statutory revisions affecting
health programs necessary to implement the Budget Act of
2012.
ANALYSIS : This bill includes the following provisions:
1. Duals Demonstration Project . The Budget Act of 2012
included changes to authorize a duals demonstration
project in eight counties that integrates the delivery
CONTINUED
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of medical services, long-term services and supports
(including In-Home Supportive Services), and behavioral
health services through Medi-Cal managed care plans for
persons who are eligible for both Medicare and Medi-Cal.
This bill makes technical corrections and
clarifications to the duals demonstration project. In
addition, it:
A. Requires persons enrolled in a Medi-Cal home and
community-based waiver program to be mandatorily
enrolled in Medi-Cal managed care (for medical
services and long-term supports and services). This
change is consistent with how Seniors and Persons
with Disabilities, who are enrolled in a Medi-Cal
home and community-based waiver program, are
mandatorily enrolled in Medi-Cal managed care. These
persons would still receive their home and
community-based wavier program services through the
waiver program/provider.
B. Eliminates the requirement that the Department of
Managed Health Care (DMHC) monitor health plans
participating in the duals demonstration project on a
quarterly basis to determine whether the
beneficiaries are able to receive timely access to
primary and specialty care services as federal law
(42 Code of Federal Regulations Section 422.402)
preempts DMHC from performing this activity on
Medicare plans.
2. Hospital Supplemental Payments . Makes technical
corrections to the eligibility language for various
hospital supplemental funds. AB 1467 (Assembly Budget
Committee), a Budget Trailer Bill, amended Welfare and
Institutions Code Sections 14166.12 and 14166.17 to
include the eligibility requirements for various
hospital supplemental funds. These sections should
reference the Selective Provider Contract program's
statute.
3. Primary Care Provider Payments . Makes technical
corrections to ensure that Medi-Cal primary care
provider payment increases (as required by federal
health care reform and implemented by AB 1467) do not
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apply to state-only programs.
Federal health care reform requires that specified
primary care services be reimbursed at no less than the
Medicare rate from January 1, 2013 through December 31,
2014. The marginal rate increase is fully funded by the
federal government for services provided in the Medi-Cal
program. This change is necessary to clarify that no
increases will be provided in state-only programs.
4. Healthy Families Program Transfer to Medi-Cal . The
Budget Act of 2012 transferred the Healthy Families
Program to Medi-Cal (starting no sooner than January 1,
2013). This bill makes various technical corrections to
the statute that transfers the Healthy Families Program
to Medi-Cal.
Additionally, it includes language allowing the
Department of Health Care Services (DHCS) to have
exemptions from contracting competitive bidding rules
for the purposes of implementing and maintaining the
necessary systems and activities for providing health
care coverage to optional targeted low-income children
in the Medi-Cal Program for purposes of Accelerated
Enrollment application processing by Single Point of
Entry, non-eligibility-related case maintenance and
premium collection, maintenance of the Health-E-App web
portal, call center staffing and operations, Certified
Application Assistant services, and reporting
capabilities. This bill also permits DHCS to enter into
a contract with the Health Care Options Broker of the
department for purposes of managed care enrollment
activities. These specified contracts may be initially
completed on a noncompetitive bid basis and are exempt
from the Public Contract Code. Subsequent contracts for
these purposes shall use a competitive bid basis and
shall be subject to the Public Contract Code.
5. Inadvertent Chaptering Out of Omnibus Health Trailer
Bill Changes . Sections of AB 1467 regarding the rural
expansion of Medi-Cal managed care and the consideration
of safety net providers when factoring managed care plan
costs in the default managed care assignment algorithm
were inadvertently chaptered out by another budget
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trailer bill (SB 1008). This bill restores the AB 1467
changes.
6. References to the Department of Mental Health (DMH) .
Changes references to DMH to the appropriate state
departments, as DMH was eliminated in Budget Act of
2012.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
CTW:k 8/22/12 Senate Floor Analyses
SUPPORT/OPPOSITION: NONE RECEIVED
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