BILL ANALYSIS Ó
AB 1803
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1803 (Mitchell)
As Amended June 12, 2012
Majority vote
-----------------------------------------------------------------
|ASSEMBLY: |57-14|(May 17, 2012) |SENATE: |36-0 |(August 22, |
| | | | | |2012) |
-----------------------------------------------------------------
Original Committee Reference: HEALTH
SUMMARY : Provides that emergency services and care that are
necessary for the treatment of an emergency medical condition
are a covered benefit in the fee-for-service (FFS) Medi-Cal
program. Defines "emergency services and care," "emergency
medical condition," and other related definitions. Specifies
that this bill shall not be construed to change the obligation
of a Medi-Cal Managed Care (MCMC) plan to provide emergency
services and care.
The Senate amendments are technical and clarifying.
AS PASSED BY THE ASSEMBLY , this bill was substantially similar
to the bill as passed by the Senate.
FISCAL EFFECT : According to the Senate Appropriations
Committee, by placing the "reasonable layperson" standard in
statute, the bill would preclude the Department of Health Care
Services (DHCS) from reducing or eliminating payment for
services provided in an emergency department that were not
thought to be immediately necessary under the reasonable
layperson standard. The extent to which DHCS could reduce
Medi-Cal expenditures by limiting payment for such non-emergency
services provided in an emergency department is unknown.
COMMENTS : According to the author, this bill would codify the
"reasonable layperson standard" for emergency medical services
for persons in the Medi-Cal FFS program. The author states that
this change will create a uniform policy and ensure that FFS
Medi-Cal patients have this important and fundamental patient
protection. According to the author, under California law, the
reasonable layperson standard for emergency medical services is
in place for health plans regulated by the Department of Managed
Health Care including MCMC plans. However, the author argues,
AB 1803
Page 2
the standard is not in place for Medi-Cal FFS enrollees and this
gap in California law, where no reasonable layperson standard
exists, threatens patient safety and needs to be closed. This
bill seeks to cure this by adding emergency medical care and
services to the list of covered benefits and by referencing the
"reasonable person" standard from other existing provisions.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097
FN: 0004985