BILL NUMBER: AB 50 AMENDED
BILL TEXT
AMENDED IN SENATE SEPTEMBER 5, 2013
AMENDED IN SENATE SEPTEMBER 3, 2013
AMENDED IN SENATE AUGUST 15, 2013
AMENDED IN ASSEMBLY MAY 13, 2013
AMENDED IN ASSEMBLY MAY 1, 2013
INTRODUCED BY Assembly Member Pan
DECEMBER 21, 2012
An act to amend Sections 14005.28, 14005.30, 14005.36,
14005.37, 14005.39, 14005.61, 14011.66, 14015.8, 14016.6, 14102,
14132.02, 14154, and 15926 of, and to add Section 14005.22
to, to the Welfare and Institutions
Code, relating to health care coverage, and declaring the
urgency thereof, to take effect immediately coverage
.
LEGISLATIVE COUNSEL'S DIGEST
AB 50, as amended, Pan. Health care coverage: Medi-Cal:
eligibility.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. Chapters 3 and 4 of the First
Extraordinary Session of 2013-14, to be effective on the 91st day
after adjournment of that session, implement various provisions of
the federal Patient Protection and Affordable Care Act (PPACA)
relating to determining eligibility for the Medi-Cal program.
This bill would authorize the department to implement
some of those provisions by, among other things, all-county letters,
until the time any necessary regulations are adopted. The bill would
require the department to adopt regulations implementing those
provisions by July 1, 2015. This bill would, effective
January 1, 2014, and under specified federal provisions applicable to
qualified pregnant women and children, provide that a woman shall be
eligible for full-scope Medi-Cal benefits if her income is less than
100% of the federal poverty level as determined, counted, and valued
in accordance with federal law. The bill would require the
department to adopt regulations implementing that provision by
January 1, 2017, and to provide semiannual status reports to the
Legislature until that time.
Because counties are required to make Medi-Cal eligibility
determinations and this bill would expand Medi-Cal eligibility, the
bill would impose a state-mandated local program.
Existing law, to be effective on the 91st day after adjournment of
the First Extraordinary Session of 2013-14, would, commencing
January 1, 2014, require the department to develop a program to
implement provisions that would authorize individuals or their
authorized representatives to select Medi-Cal managed care plans via
the California Healthcare Eligibility, Enrollment, and Retention
System (CalHEERS), as specified. In this regard, the program is
required to include training of specialized county employees to carry
out the program.
This bill would, instead, require the program to include training
of individuals, including county human services staff, to carry out
the program.
Existing law requires the department to establish and maintain a
County Administrative Cost Control Plan under which costs for county
administration for the determination of eligibility for benefits are
controlled, as specified. Existing law requires the department to
develop and implement a new budgeting methodology for Medi-Cal county
administrative costs to be used to reimburse counties for
eligibility determinations for applicants and beneficiaries, and
requires that the budgeting methodology include identification of the
costs of eligibility determinations for applicants, and the costs of
eligibility redeterminations and case maintenance activities for
recipients, for different groupings of cases.
This bill would instead provide that the budgeting methodology may
include identification of the costs of eligibility determinations
for applicants, and the costs of eligibility redeterminations and
case maintenance activities for recipients, for different groupings
of cases. The bill would authorize the development of the new
budgeting methodology to include, among other things, county survey
of costs, time and motion studies, and in-person observations by
department staff. The bill would require that the new budgeting
methodology be implemented no sooner than the 2015-16 fiscal year and
that it reflect the impact of PPACA implementation on county
administrative work.
Existing law requires the California Health and Human Services
Agency, in consultation with specified entities, to establish a
standardized single, accessible application form and related renewal
procedures for state health subsidy programs, as defined, in
accordance with specified requirements. Existing law authorizes the
form to include questions that are voluntary for applicants to answer
regarding demographic data categories, including race, ethnicity,
primary language, disability status, and other categories recognized
by the federal Secretary of Health and Human Services pursuant to
federal law.
This bill would authorize the form to also include questions that
are voluntary for applicants to answer regarding sexual orientation
and gender identity or expression. The bill would, effective January
1, 2015, require the form to include questions that are voluntary for
applicants to answer regarding the demographic data categories
specified. This bill would make other technical changes.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
This bill would declare that it is to take effect immediately as
an urgency statute.
Vote: 2/3 majority . Appropriation:
no. Fiscal committee: yes. State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14005.22 is added to the Welfare and
Institutions Code, to read:
14005.22. (a) Effective January 1, 2014, a woman shall be
eligible for full-scope Medi-Cal benefits under Section 1396a(a)(10)
(A)(i)(III) of Title 42 of the United States Code if her income is
less than 100 percent of the federal poverty level as determined,
counted, and valued in accordance with the requirements of Section
1396a(e)(14) of Title 42 of the United States Code, as added by the
federal Patient Protection and Affordable Care Act (Public Law
111-148) and as amended by the federal Health Care and Education
Reconciliation Act of 2010 (Public Law 111-152) and any subsequent
amendments, and she meets all other eligibility requirements.
(b) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department, without taking any further regulatory action, shall
implement, interpret, or make specific this section by means of
all-county letters, plan letters, plan or provider bulletins, or
similar instructions until the time regulations are adopted. The
department shall adopt regulations by January 1, 2017, in accordance
with the requirements of Chapter 3.5 (commencing with Section 11340)
of Part 1 of Division 3 of Title 2 of the Government Code. Beginning
six months after the effective date of this section, notwithstanding
Section 10321.5 of the Government Code, the department shall provide
a status report to the Legislature on a semiannual basis, in
compliance with Section 9795 of the Government Code, until
regulations have been adopted.
(c) This section shall be implemented only if and to the extent
that federal financial participation is available and any necessary
federal approvals have been obtained.
SEC. 2. If the Commission on State Mandates
determines that this act contains costs mandated by the state,
reimbursement to local agencies and school districts for those costs
shall be made pursuant to Part 7 (commencing with Section 17500) of
Division 4 of Title 2 of the Government Code. All matter
omitted in this version of the bill appears in the bill as amended in
the Senate, September 3, 2013. (JR11)