BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 860
                                                                  Page  1

          Date of Hearing:   May 1, 2013

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

              AB 860 (Perea and Bocanegra) - As Amended:  April 8, 2013 

          Policy Committee:                              HealthVote:18-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill revises the distribution scheme for funds from the  
          Managed Care Administrative Fines and Penalties Fund (Penalty  
          Fund) by requiring $600,000 to be transferred to the Steven M.  
          Thompson Medical School Scholarship Program (Steve Thompson  
          Scholarship Fund) before any funds are transferred to the Major  
          Risk Medical Insurance Program (MRMIP).

           FISCAL EFFECT  

          Potentially significant impact on MRMIP up to a maximum of  
          $600,000.  The size of the Penalty Fund varies based on  
          Department of Managed Health Care (DMHC) enforcement actions.  
          Penalty Fund transfers to MRMIP have been as high as $10 million  
          (2008-09) and as low as $93,000 (2012-13).  

           COMMENTS  

           1)Rationale  .  Existing law requires the first $1 million in the  
            Penalty Fund to go to the Medically Underserved Account for  
            Physicians (MUAP) to be used for the Steven M. Thompson  
            Physician Corps Loan Repayment Fund (Steve Thompson Loan  
            Fund). Any amounts above the first $1 million go to MRMIP.   
            The author intends to address California's chronic undersupply  
            of primary care services and asserts MRMIP's role is being  
            filled by Covered California, the new health benefit exchange  
            created as a result of federal health reform, freeing up money  
            in the Penalty Fund for other uses. Supporters, including the  
            California Chapter of the American College of Emergency  
            Physicians and the California Academy of Family Physicians,  
            argue this bill will improve access to care in underserved  
            areas.








                                                                  AB 860
                                                                  Page  2


           2)MRMIP Background  .  MRMIP is a high-risk insurance pool  
            operated by the Managed Risk Medical Insurance Board (MRMIB)  
            since 1991 to provide coverage to individuals unable to buy  
            coverage in the individual insurance market due to  
            pre-existing conditions.  Most of MRMIP's funding comes from  
            the Proposition 99 Cigarette and Tobacco Products Surtax.  The  
            Governor's proposed budget indicates MRMIP will phase-out with  
            implementation of health reform, but it is unclear exactly  
            when this will occur.  MRMIB uses the money it receives from  
            the Penalty Fund for amounts owed to health plans for  
            reconciliation of prior year services. 

           3)Related Legislation  .  SB 20 (Ed Hernandez), pending on the  
            Senate Appropriations Committee Suspense File, requires all  
            the Penalty Fund monies to be used for the Steve Thompson Loan  
            Fund.  

            AB 1176 (Bocanegra), pending in this committee, establishes  
            the Graduate Medical Education Fund (GME) and requires an  
            annual assessment, on health insurers and health plans, of  
            five dollars for each covered life, to fund the GME.   




           Analysis Prepared by  :    Debra Roth / APPR. / (916) 319-2081