BILL NUMBER: AB 366 AMENDED
BILL TEXT
AMENDED IN SENATE JULY 7, 2015
AMENDED IN ASSEMBLY MAY 28, 2015
AMENDED IN ASSEMBLY MAY 14, 2015
AMENDED IN ASSEMBLY APRIL 7, 2015
INTRODUCED BY Assembly Member Bonta
(Principal coauthor: Assembly Member Gomez)
(Principal coauthor: Senator Hernandez)
(Coauthors: Assembly Members Achadjian, Bigelow, Bonilla, Burke,
Campos, Chiu, Chu, Cooley, Cooper, Dababneh, Dodd, Frazier, Gatto,
Gonzalez, Gray, Roger Hernández, Jones-Sawyer, Lackey, Levine, Lopez,
Low, Maienschein, McCarty, Medina, Nazarian, O'Donnell, Perea,
Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth,
Mark Stone, Thurmond, Ting, Waldron, Wilk, and Wood)
(Coauthors: Senators Block, Cannella, Galgiani, Hall, Hertzberg,
Hill, Jackson, Pan, Pavley, Roth, Stone, Wieckowski, and Wolk)
FEBRUARY 17, 2015
An act to add Section 14105.2 to the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 366, as amended, Bonta. Medi-Cal: annual access monitoring
report.
Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which health care
services are provided to qualified, low-income persons. The Medi-Cal
program is, in part, governed and funded by federal Medicaid Program
provisions. Under the federal Patient Protection and Affordable Care
Act, existing state law extends Medi-Cal eligibility to childless
adults under 65 years of age.
This bill would require the State Department of Health Care
Services, by March 15, 2016, and annually thereafter by February 1,
to submit to the Legislature, and post on the department's Internet
Web site, a Medi-Cal access monitoring report providing an assessment
of access to care in Medi-Cal and identifying a basis to evaluate
the adequacy of Medi-Cal reimbursement rates and the existence of
other barriers to access to care, as specified. The bill would
require the department to hold a public meeting to present and
discuss the access monitoring report at least once annually, and
would require the department to accept public comment from
stakeholders at the public meeting. The bill would authorize the
department to enter into an interagency agreement with the
University of California a contract with an
independent entity to perform an ongoing assessment of access
to care and the adequacy of provider payments in Medi-Cal. The bill
would require, to the extent funding is provided in the annual Budget
Act and federal financial participation is available, rate increases
to be implemented for services, provider types, or geographic areas
for which rates are identified in the annual report as inadequate.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14105.2 is added to the Welfare and
Institutions Code, to read:
14105.2. (a) The Legislature finds and declares all of the
following:
(1) California has significantly reduced the number of uninsured
persons by expanding the Medi-Cal program under the federal Patient
Protection and Affordable Care Act (Public Law 111-148).
(2) It is important to ensure adequate access to care in the
Medi-Cal program as new enrollees seek appropriate care.
(3) The state needs to assess the gaps in access to care and act
swiftly to address those gaps.
(4) One area of anticipated need is the availability of more
Medi-Cal providers.
(5) California's Medi-Cal provider reimbursement rates have
historically been among the lowest in the nation.
(6) During recent years, the state has reduced reimbursement rates
to Medi-Cal providers due to budget constraints.
(7) An assessment of gaps in access should include a determination
of whether current provider rates are sufficient to ensure access to
care.
(b) Therefore, it is the intent of the Legislature that an annual
access monitoring report provide a valid, clear, and public
assessment of access to care in Medi-Cal, and provide a basis to
evaluate the adequacy of Medi-Cal rates and the existence of other
barriers to access to care.
(c) Notwithstanding Section 10231.5 of the Government Code, by
March 15, 2016, and annually thereafter by February 1, the department
shall submit to the Legislature, and post on the department's
Internet Web site, a Medi-Cal access monitoring report. The report
shall be submitted in compliance with Section 9795 of the Government
Code. The annual report shall:
(1) Present results of the department's ongoing access monitoring
efforts in fee-for-service and managed care. For managed care, the
report shall include results from the Department of Managed Health
Care's oversight of provider networks and timely access in Medi-Cal
managed care.
(2) Compare the level of access to care and services available
through Medi-Cal, to the level of access to care and services
available to the general population in different geographic areas of
California.
(3) Include access measurements of sufficient granularity to
reflect patient experience of access to particular services or
provider types, or in particular geographic areas.
(4) Identify particular services, provider types, or geographic
areas for which the level of access is less than the level of access
to care and services available to the general population in the
geographic area. For those services, provider types, or geographic
areas, the annual report shall assess and report on the adequacy of
provider payment rates and identify any other factors that impede
access.
(5) Use language clearly understandable to the public.
(6) Use more than one valid, generally accepted method to assess
access to care.
(d) At least once annually, the department shall hold a public
meeting to present and discuss the access monitoring report. The
department shall accept public comment from stakeholders at the
public meeting.
(e) The department may enter into an interagency
agreement with the University of California a contract
with an independent entity to perform an ongoing assessment of
access to care and the adequacy of provider payment rates in
Medi-Cal.
(f) For services, provider types, or geographic areas for which
rates are identified in the annual report as inadequate, rate
increases shall be implemented to the extent funding is provided in
the annual Budget Act and federal financial participation is
available.