BILL ANALYSIS Ó
SENATE COMMITTEE ON BUDGET AND FISCAL REVIEW
Mark Leno, Chair
Bill No: AB 1474
Author: Committee on Budget
As Amended: As proposed to be amended June 15, 2014
Consultant: Michelle Baass
Fiscal: Yes
Hearing Date: June 15, 2014
Subject: Budget Act of 2014 - Health
Summary: This is the Omnibus Health Trailer Bill for
2014-15. It contains necessary changes related to the
Budget Act of 2014.
Background: This bill makes the following statutory
changes to implement the 2014-15 budget:
1.Medi-Cal: Applied Behavioral Analysis (ABA). This bill
requires ABA, or behavioral health treatment (BHT), to be
a covered Medi-Cal service for individuals under age 21
to the extent required by the federal government. This
bill requires the Department of Health Care Services
(DHCS) to implement this new benefit only after
consultation with stakeholders.
The proposed amendment deletes the words "and obtains" to
provide the ability for DHCS to implement this benefit
prior to obtaining an appropriation.
2.Medi-Cal: Supplemental Managed Care Organization (MCO)
Drug Rebates for Specialty Drugs. This bill allows for
MCO supplemental rebates for specialty drugs, such as
Hepatitis C drugs like Sovaldi. This rebate collection
would occur when (1) DHCS reimburses health plans through
a separate capitated payment or other supplemental
payment ("kick-payment") for the specialty drug and (2)
health plans follow the clinical guidelines (coverage
policies) for this drug. It is estimated that this change
would result in $6 million General Fund savings in
2014-15, $20 million General Fund savings in 2015-16, and
$31 million General Fund savings annually thereafter.
3.Medi-Cal: Pediatric Vision Projects. This bill implements
a pilot program in Los Angeles County no sooner than
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January 1, 2015, and concluding December 31, 2017, to
expand pediatric vision examinations and services through
the use of mobile vision providers.
4.Medi-Cal: Program of All-Inclusive Care for Elderly
(PACE). This bill requires that PACE capitation rates be
no less than 95 percent of the fee-for-service equivalent
cost (current law is 90 percent). It is estimated that
this change would result in $1.8 million General Fund
costs in 2014-15, and $7.3 million General Fund costs
annually, thereafter.
5.Medi-Cal: Rates and Access. This bill expresses the
Legislature's intent that DHCS continue to monitor access
to and utilization of Medi-Cal services and to use this
information to evaluate the current reimbursement levels
and make targeted changes to those reimbursement levels
as it finds appropriate.
6.Robert F. Kennedy Health Plan. This bill provides $3.2
million in one-time funds from the Major Risk Medical
Insurance to DHCS to be allocated to the Robert F.
Kennedy Health Plan for purposes of purchasing stop loss
insurance.
7.Electronic Health Records - State Match. This bill
provides $3.75 million in one-time funds from the Major
Risk Medical Insurance to DHCS to be used as the state
match to draw down $37.5 million in federal funds to
support the meaningful use of electronic health records
in the state.
8.HIV Demonstration Projects. This bill establishes public
health demonstration projects for innovative,
evidence-based approaches to provide outreach, HIV and
Hepatitis C screenings, and linkages to, and retention
in, quality health care for underserved individuals with
high-risk for HIV infection.
9.Song-Brown Program - New Residency Slots. This bill
specifies criteria for funds appropriated in the budget
act for Song-Brown grants to primary care residency
training programs. This bill specifies that priority
shall be given to support new primary care physician
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slots and shall be given to physicians who have graduated
from a California-based medical school.
Fiscal Effect: The funding related to the changes in this
bill is contained in the 2014-15 budget. This bill
reappropriates Department of Developmental Services' funds.
Support: NA
Opposed: NA
Comments: This bill provides the necessary statutory
references to enact the 2014-15 budget related to health.
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