BILL ANALYSIS Ó
AB 344
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Date of Hearing: April 29, 2015
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Jimmy Gomez, Chair
AB
344 (Chávez) - As Introduced February 13, 2015
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Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY:
This bill, as proposed to be amended, provides that if a payment
is made to a non-designated public hospital (NDPH), as
specified, the payment is not be subject to a peer group
inpatient reimbursement limitation established by the Department
AB 344
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of Health Care Services (DHCS), unless otherwise required under
federal law.
FISCAL EFFECT:
Negligible state fiscal effect.
COMMENTS:
1)Purpose. According to the sponsor, the District Hospital
Leadership Forum, this bill addresses a technical issue
related to the Peer Grouping Inpatient Reimbursement
Limitation (PIRL) that non-contract district/municipal
hospitals (otherwise known as NDPHs) were subject to prior to
January 1, 2014. The PIRL is a reimbursement limitation that
in certain circumstances could restrict Medi-Cal payment to
hospitals. The sponsor states that this bill seeks to prevent
application of an existing statutory or regulatory rate
limitation on a NDPH with the conversion to a new Medi-Cal
inpatient reimbursement methodology called Diagnosis-Related
Group (DRG).
2)Necessity of this bill? As the reimbursement methodology for
NDPHs has recently changed, this bill does not appear
necessary. The PIRL applied to the prior reimbursement
methodology. DHCS does not plan to apply this to the new
methodology. The PIRL is defined in regulations, not in
statute, so a statutory clarification does not appear
necessary when this could be clarified in regulation. The
transition to DRG payments occurred July 1, 2014 and the PIRL
does not appear to be an issue.
3)Amendments are technical and correct a code reference.
AB 344
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Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081