BILL NUMBER: SB 945	ENROLLED
	BILL TEXT

	PASSED THE SENATE  JUNE 2, 2011
	PASSED THE ASSEMBLY  SEPTEMBER 1, 2011
	AMENDED IN SENATE  MAY 31, 2011

INTRODUCED BY   Committee on Health (Senators Hernandez (Chair),
Alquist, Anderson, Blakeslee, De León, DeSaulnier, Rubio, Strickland,
and Wolk)

                        MARCH 31, 2011

   An act to add and repeal Article 1.5 (commencing with Section
14046) to Chapter 7 of Part 3 of Division 9 of the Welfare and
Institutions Code, relating to Medi-Cal, and declaring the urgency
thereof, to take effect immediately.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 945, Committee on Health. Medi-Cal: electronic records.
   Existing law establishes the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which basic health care services are provided to qualified low-income
persons. The Medi-Cal program is, in part, governed and funded by
federal Medicaid provisions.
   This bill, until July 1, 2021, and only to the extent that federal
participation is available, would require the department to
establish and administer the Medi-Cal Electronic Health Records
Incentive Program to provide federal incentive payments to Medi-Cal
providers for the implementation and use of electronic health records
systems. The bill would require the department to develop the State
Medicaid Health Information Technology Plan, as specified, for
federal approval, and would require the department to accept
applications from, and make incentive payments to, eligible
professionals and facilities that meet all of the standards of the
federal Electronic Health Record Technology Program. The bill would
require the department to provide annual reports to appropriate
fiscal and policy committees of the Legislature and the Legislative
Analyst's Office within 30 days of the close of each fiscal year,
commencing July 1, 2012, on the implementation of this program.
   This bill would declare that it is to take effect immediately as
an urgency statute.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) The purpose of the Medi-Cal Electronic Health Records
Incentive Program is to provide eligible professionals and hospitals
incentive payments to adopt, implement, upgrade, and meaningfully use
certified electronic health records (EHR) technology using federal
funds made available through Section 4201 of the federal American
Recovery and Reinvestment Act of 2009 (Public Law 111-5).
   (b) This program provides a source of funding to safety net
providers to upgrade, incorporate, and use EHR systems in their
practice. An anticipated one billion four hundred million dollars
($1,400,000,000) may be distributed to Medi-Cal providers over the
next 10 years to support EHR adoption through this program.
  SEC. 2.  Article 1.5 (commencing with Section 14046) is added to
Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
Code, to read:

      Article 1.5.  Electronic Medical Records


   14046.  The department shall establish and administer the Medi-Cal
Electronic Health Records Incentive Program for the purposes of
providing federal incentive payments to Medi-Cal providers for the
implementation and use of electronic health records systems.
   14046.1.  (a) The program shall be administered in accordance with
the State Medicaid Health Information Technology Plan, as developed
by the department and approved by the federal Centers for Medicare
and Medicaid Services. Upon federal approval, the department shall
provide copies of the plan to the appropriate fiscal and policy
committees of the Legislature.
   (b) The State Medicaid Health Information Technology Plan shall
address all of the following:
   (1) Identify and establish the planning, policies, and procedures
required to operationalize the Medi-Cal Electronic Health Record
Incentive Program.
   (2) Specify the criteria for enrollment, eligibility, and data
collection.
   (3) Specify timeframes for technology modifications.
   (4) Specify the process for provider outreach and department
coordination with established regional extension centers in the
state, established to provide technical support to providers.
   (5) Establish the audit and appeals processes.
   (6) Participate in the National Level Registry.
   14046.2.  (a) Upon receipt of all necessary federal approvals, and
in accordance with the State Medicaid Health Information Technology
Plan, the department shall accept applications from, and make
incentive payments to, eligible professionals and facilities.
   (b) Each eligible professional and each eligible facility seeking
to receive incentive payments under this article shall meet all of
the standards of the federal Electronic Health Record Technology
Program, including criteria for meaningful use pursuant to Part 495
of Title 42 of the Code of Federal Regulations or any other
applicable federal Medicaid laws and regulations.
   (c) Appeals under this article shall be conducted pursuant to
Section 14043.65.
   14046.3.  (a) To implement this article, the department may
contract with public or private entities and may utilize existing
health care service provider enrollment and payment mechanisms,
including the Medi-Cal program's fiscal intermediary.
   (b) Contracts entered into for the purpose of implementing this
article, including any contract amendment, any system change pursuant
to a change order, and any project or systems development notice,
may be developed using a competitive process established by the
department and shall be exempt from Article 4 (commencing with
Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the
Government Code and Part 2 (commencing with Section 10100) of
Division 2 of the Public Contract Code, and any associated policies,
procedures, or regulations under these provisions, and shall be
exempt from review or approval by any division of the Department of
General Services.
   14046.4.  Notwithstanding the Administrative Procedure Act
(Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code), the department may implement this
article through provider bulletins or similar instructions without
taking regulatory action.
   14046.5.  The department shall provide the appropriate fiscal and
policy committees of the Legislature and the Legislative Analyst's
Office with annual reports on the implementation of this article.
These reports shall be provided within 30 days of the close of each
fiscal year, commencing July 1, 2012, and continuing throughout the
life of the program. These reports shall include all of the following
information:
   (a) A project status summary that identifies the progress or key
milestones and objectives.
   (b) An assessment of provider uptake of the program, barriers
faced by eligible providers not participating in the program, and
strategies to address those barriers.
   (c) Copies of reports or updates developed by the department for
submission to the federal government relating to this program.
   (d) Copies of oversight reports developed by department
contractors and any subsequent responses from the department.
   (e) A description of changes made to the program, including those
required by federal law or regulations.
   14046.6.  (a) It is the intent of the Legislature that the
activities associated with health information exchange be funded
solely through federal funds and private contributions identified by
the department.
   (b) Notwithstanding any other law, and only when all necessary
federal approvals have been obtained, this article shall be
implemented only to the extent federal financial participation is
available.
   14046.7.  General Fund moneys shall not be used for the purposes
of this article.
   14046.8.  This article shall become inoperative on July 1, 2021,
and, as of January 1, 2022, is repealed, unless a later enacted
statute, that is enacted before January 1, 2022, deletes or extends
the dates on which it becomes inoperative and is repealed.
  SEC. 3.  This act is an urgency statute necessary for the immediate
preservation of the public peace, health, or safety within the
meaning of Article IV of the Constitution and shall go into immediate
effect. The facts constituting the necessity are:
   In order to make the necessary statutory changes to authorize the
state to disburse incentive payments to eligible professionals and
hospitals, issue provider bulletins or similar instructions without
regulatory action, and administer an appeals process at the earliest
possible time, it is necessary that this act take effect immediately.