BILL ANALYSIS �
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THIRD READING
Bill No: AB 100
Author: Assembly Budget Committee
Amended: 6/13/13 in Senate
Vote: 21
ASSEMBLY FLOOR : Not relevant
SUBJECT : Budget Act of 2013: Coordinated Care Initiative
SOURCE : Author
DIGEST : This bill changes existing law regarding the
Coordinated Care Initiative (CCI) and delinks CCI components to
allow the mandatory enrollment of Medi-Cal and Medicare
beneficiaries (dual eligibles) into Medi-Cal managed care, the
integration of long-term supports and services (LTSS) into
managed care plans, and the commencement of the In-Home
Supportive Services (IHSS) Statewide Public Authority, to
proceed separately from the CCI Duals Demonstration Project (now
called Cal MediConnect).
ANALYSIS : The 2012 Budget authorized the CCI, by which dual
eligibles receive medical, behavioral, long-term supports and
services, and home- and community-based services coordinated
through a single health plan in eight demonstration counties
(Alameda, Los Angeles, Orange, Riverside, San Bernardino, San
Diego, San Mateo, and Santa Clara).
CCI contains three key components, (1) Cal MediConnect -
Individuals who are dual eligibles receive all of their services
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through a managed care plan, (2) mandatory enrollment of dual
eligibles into Medi-Cal managed care, and (3) integration of
long-term supports and services into managed care. Existing law
sets forth certain circumstances that renders these components
inoperative and links these components together so that each
component cannot function or operate exclusive of the other.
This bill:
1.Delinks the operation of Cal MediConnect from mandatory
enrollment of duals into Medi-Cal managed care, the
integration of Medi-Cal long-term supports and services into
managed care plans, and the commencement of the IHSS Statewide
Public Authority.
2.Requires the Department of Health Care Services (DHCS) to
offer Medicare D-SNP contracts to existing D-SNP plans in
2014. Additionally, in 2014, beneficiaries enrolled in a
Medicare Advantage or D-SNP plan operating in a CCI county
shall be exempt from passive enrollment into Cal MediConnect.
3.Provides for health plan risk corridors for populations and
services that are part of the CCI.
4.Requires DHCS, commencing August 1, 2013, to convene
stakeholders at least quarterly to review progress on CCI and
makes recommendations to DHCS and the Legislature for the
duration of CCI.
5.Deletes previous requirements (i.e., the poison pill)
regarding the ongoing operation of CCI.
6.Specifies that if, at least 30 days prior to the enrollment of
beneficiaries into the CCI, the Director of Finance estimates
that CCI will not generate net General Fund savings, then, the
CCI becomes inoperative July 1, 2014.
7.Specifies that CCI counties include the counties of Alameda,
Los Angeles, Orange, Riverside, San Bernardino, San Diego, San
Mateo, and Santa Clara.
8.Declares that, if the LTSS portion of CCI is implemented, the
provisions of existing law with respect to the rights of
recipients to select, direct, supervise, and terminate IHSS
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providers, and the obligations of health plans to enter into
memorandums of understanding with county agencies that would
continue to perform specified functions and responsibilities
related to the IHSS program, remain in effect.
9.Deletes a provision of existing law that would have eliminated
an existing county IHSS Maintenance of Effort (MOE)
requirement if the Duals Demonstration Project ceased to be
operative. At the same time, the MOE still becomes
inoperative if the larger CCI becomes inoperative.
10.Makes additional, technical changes.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
JA:ej 6/14/13 Senate Floor Analyses
SUPPORT/OPPOSITION: NONE RECEIVED
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