BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 208
                                                                  Page  1

          Date of Hearing:   September 11, 2013

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                   SB 208 (Lara) - As Amended:  September 6, 2013 

          Policy Committee:                             HealthVote:18-0
                       Human Services                   Vote: 7-0

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

           SUMMARY  

          This bill establishes requirements for requests for proposals  
          (RFPs) for services procured by regional centers under contract  
          with the Department of Developmental Services (DDS), and removes  
          a prohibition on a specified payment method for Medi-Cal managed  
          care plans subcontracts.  Specifically, this bill:

          1)Requires an RFP prepared by a regional center for consumer  
            services and supports to include a section on issues of equity  
            and diversity, and requires an RFP that applies only to  
            specific consumers to instead request information on how the  
            applicant plans to provide culturally and linguistically  
            competent services to those specific consumers.

          2)Deletes a prohibition on Medi-Cal managed care plans entering  
            into subcontracts in which payment is determined by a  
            percentage of the plan's payment from the Department of Health  
            Care Services (DHCS), allowing these arrangements unless DHCS  
            objects.
           
          FISCAL EFFECT  

          Minor and absorbable costs to DHCS for health plan oversight,  
          and to DDS to modify RFPs.

           COMMENTS  

           1)Rationale  . The author indicates the provision related to  
            Medi-Cal managed care plans is necessary to allow health plans  
            to subcontract on a consistent basis for Medicare and Medi-Cal  
            services. The author notes it is important to change this  








                                                                  SB 208
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            prohibition now, given this mechanism is used for Medicare  
            payments and some plans will be subcontracting for Medi-Cal  
            and Medicare services on a combined basis through a  
            demonstration project beginning in 2014.  Provisions related  
            to regional centers seek to address disparities in access to  
            services by prompting providers to indicate their capacity for  
            serving diverse populations.

           2)Percent of Premium Prohibition  . Paying a subcontractor based  
            on a percentage of the payment received from DHCS to be a  
            reasonable payment mechanism, since Medi-Cal payments received  
            by plans are adjusted to reflect expected health care  
            utilization.  The current-law prohibition appears to have been  
            associated with a targeted effort to combat fraud in Medi-Cal  
            managed care in the late 1970's, when plans were less tightly  
            regulated.

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081