BILL ANALYSIS Ó
AB 461
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Date of Hearing: April 29, 2015
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Jimmy Gomez, Chair
AB
461 (Mullin) - As Amended April 21, 2015
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Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY:
This bill authorizes Medi-Cal beneficiaries receiving services
through a regional center, and who reside in the County of San
Mateo, to voluntarily enroll in the Cal MediConnect
demonstration project under the Coordinated Care Initiative
(CCI) (a demonstration project that is providing coordinated
AB 461
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Medicare and Medi-Cal benefits in certain counties).
FISCAL EFFECT:
Negligible fiscal effect. The impacted individuals are already
Medi-Cal-eligible and costs are already being incurred, but
current law does not allow them to enroll in the CCI. This bill
will allow them to enroll in a different delivery system, but it
should not increase costs for their care.
COMMENTS:
1)Purpose. According to the author, in San Mateo County, Health
Plan of San Mateo (HPSM) served about 12,000 dual eligible
beneficiaries through a dual eligible-special needs plan (or
D-SNP, a plan that coordinates benefits for individuals dually
enrolled in Medicare and Medi-Cal). The vast majority of D-SNP
enrollees transitioned into the the HPSM Cal MediConnect plan
this year. The author states that approximately 600 dually
eligible developmentally disabled individuals remain in the
D-SNP; however, HPSM may close its D-SNP due to the costly
nature of running a program for such a small population. By
allowing this population to voluntarily enroll in the CCI,
HPSM will be able to continue to provide these individuals
with the option of managed care.
2)Background. Cal MediConnect is a Medi-Cal initiative intended
to integrate and coordinate the delivery of health benefits,
including behavioral health benefits and long-term care, to
dual eligibles and SPDs living in seven California counties:
Los Angeles, Orange, Riverside, San Bernardino, San Diego, San
Mateo and Santa Clara. Cal MediConnect plans are paid a
monthly capitated rate for each enrollee, and are responsible
for providing a package of Medicare and Medi-Cal services in
exchange for that rate. Certain vulnerable populations were
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excluded from the enrollment in the CCI and Cal MediConnect,
including individuals with developmental disabilities
receiving services through a regional center.
3)Related Legislation. SB 492 (Liu), pending in the Senate
Health Committee, establishes the CCI Consumer Bill of Rights.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081