BILL NUMBER: AB 900 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MAY 24, 2013
AMENDED IN ASSEMBLY APRIL 19, 2013
INTRODUCED BY Assembly Member Alejo
(Coauthors: Assembly Members Ammiano, Chesbro, and Perea)
FEBRUARY 22, 2013
An act to add Section 14105.194 to the Welfare and Institutions
Code, relating to Medi-Cal, and declaring the urgency thereof, to
take effect immediately.
LEGISLATIVE COUNSEL'S DIGEST
AB 900, as amended, Alejo. Medi-Cal: reimbursement:
provider payments. distinct part nursing facilities.
The Medi-Cal Act establishes
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. Existing law requires, except as
otherwise provided, Medi-Cal provider payments to be reduced by 1%
or 5%, and provider payments for specified non-Medi-Cal programs to
be reduced by 1%, for dates of service on and after March 1, 2009,
and until June 1, 2011. Existing law requires, except as otherwise
provided, Medi-Cal provider payments and payments for specified
non-Medi-Cal programs to be reduced by 10% for dates of service on
and after June 1, 2011.
This bill would instead require that , to the extent
permitted by federal law, this payment reduction not apply
to skilled nursing facilities or subacute care units
that are a distinct part of a general acute care hospital,
or to specified Medi-Cal provider payments for
fee-for-service benefits, including payments to pharmacies,
for dates of service on or after June 1, 2011
July 1, 2013 . The bill would also provide that
this payment reduction shall not apply to managed health care plans
for dates of service after the effective date of the bill.
This bill would declare that it is to take effect immediately as
an urgency statute.
Vote: 2/3. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14105.194 is added to the
Welfare and Institutions Code , to read:
14105.194. (a) Notwithstanding Sections 14105.191 and 14105.192,
reimbursement for services provided by skilled nursing facilities
that are distinct parts of general acute care hospitals shall be
determined, for dates of service on or after July 1, 2013, without
application of the reductions set forth in Sections 14105.191 and
14105.192.
(b) The director shall do all of the following in the event that
he or she is prevented from implementing subdivision (a) for any
dates of service on or after July 1, 2013:
(1) Implement subdivision (a) to the maximum extent permitted by
law.
(2) Increase payments to facilities described in subdivision (a)
for services provided on or after July 1, 2013, or on or after the
first date of service permitted by law and for which federal
financial participation is available.
(c) The director shall promptly seek all necessary federal
approvals to implement this section.
(d) Notwithstanding 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 section by means of provider bulletins
or notices, policy letters, or other similar instructions, without
taking regulatory action.
SEC. 2. 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 ensure and maintain access to medically necessary care
for the patients and residents needing skilled nursing services, it
is necessary that this act take effect immediately.
SECTION 1. Section 14105.194 is added to the
Welfare and Institutions Code, to read:
14105.194. (a) Notwithstanding Section 14105.192, except as
otherwise provided in this section, payments for fee-for-service
benefits for dates of service on or after June 1, 2011, shall be
determined without application of the reductions in Section
14105.192.
(b) Notwithstanding Sections 14105.191 and 14105.192, except as
otherwise provided in this section, payments for the classes of
providers specified in subparagraphs (B) and (D) of paragraph (2) and
paragraph (3) of subdivision (b) of Section 14105.191 for dates of
service on or after June 1, 2011, shall be determined without
application of the reductions set forth in Sections 14105.191 and
14105.192.
(c) Notwithstanding subdivisions (a) and (b), for dates of service
prior to the effective date of the act adding this section, in no
event shall the payments exceed the reimbursement rate at which
payment has been made by the department prior to the effective date
of the act adding this section.
(d) Notwithstanding Section 14105.192, except as otherwise
provided in this section, for managed care health plans that contract
with the department pursuant to this chapter or Chapter 8
(commencing with Section 14200), payments for dates of service
following the effective date of the act adding this section shall be
determined without application of the reductions in Section
14105.192.
(e) The director shall implement subdivisions (a), (b), and (d) to
the maximum extent permitted by law and for the maximum time period
for which the director obtains federal approval for federal financial
participation for the increase provided for in this section.
(f) The director shall promptly seek all necessary federal
approvals to implement this section.
(g) Notwithstanding 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 section by means of provider bulletins
or notices, policy letters, or other similar instructions, without
taking regulatory action.
SEC. 2. 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 ensure and maintain access to medically necessary care
for the patients and residents needing skilled nursing services or
subacute care, it is necessary that this act take effect immediately.