BILL ANALYSIS Ó
AB 1216
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Date of Hearing: April 21, 2015
ASSEMBLY COMMITTEE ON HEALTH
Rob Bonta, Chair
AB 1216
(Bonta) - As Introduced February 27, 2015
SUBJECT: Medi-Cal: plan amendments and waiver applications.
SUMMARY: Changes the amount of time the Department of Health
Care Services (DHCS) has to post all state plan amendments
(SPAs), federal waiver applications, and requests for new
waivers on its Internet Website from 10 business days, to seven
business days from the date they are submitted for approval to
the federal Centers for Medicare and Medicaid Services (CMS).
EXISTING LAW:
1)Establishes the Medi-Cal program to provide comprehensive
health benefits to low-income persons, which is in part,
governed and funded by federal Medicaid Program provisions.
2)Grants DHCS the rights and duties necessary to conform to
requirements for securing approval of an agreement, or state
plan, between the state and federal government.
3)Establishes a demonstration project (also known as the 1115
Waiver) under the Medi-Cal program until October 31, 2015, to
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implement specified objectives, including better care
coordination for Seniors and Persons with Disabilities and
maximization of opportunities to reduce the number of
uninsured.
4)Requires DHCS to post on its Internet Website all submitted
SPAs and all federal waiver applications and requests for new
waivers, waiver amendments, and waiver renewals and extension,
within 10 business days from the date of submission of those
documents to CMS.
FISCAL EFFECT: This bill has not been analyzed by a fiscal
committee.
COMMENTS:
1)PURPOSE OF THIS BILL. The author notes that the state is in
the process of renewing its Section 1115 Waiver with CMS, and
this bill will help provide the public and advocates with more
timely information during this process.
2)BACKGROUND. Medi-Cal is a $90 billion program - funded with
state and federal funds. Medicaid expansion is central to the
Patient Protection and Affordable Care Act. In California,
there are almost 12 million people enrolled. This means that
one third of the state population and half of the state's
children are on Medi-Cal.
As noted by the author, the state is in the process of
renewing our Section 1115 Waiver. Medi-Cal is a state and
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federal program, and we must administer the program in
accordance with various federal laws. Through the Section
1115 Waiver, the federal government allows us to waive some of
the laws in order to provide health care in innovative ways in
demonstration programs. The state has sought a variety of
waivers to ease administration of the program.
Historically we have used the waiver to improve reimbursement
for safety net hospitals and to expand coverage. The waiver
is set to expire this October and DHCS, with input from a vast
array of stakeholders is, working to renew the waiver for
another five years.
3)SUPPORT. The California Primary Care Association supports
this bill because in order to protect their patients they must
have access to state plan amendments and waiver applications
in order to effectively advocate on their behalf to CMS.
The American Federation of State, County and Municipal
Employees and the California Labor Federation support this
bill because it will allow for sustained public input to the
current and future waiver applications by allowing for more
time to review the provisions.
4)RELATED LEGISLATION.
a) AB 72 (Bonta and Atkins) and SB 36 (Ed Hernandez) are
similar bills which require DHCS to submit an application
to CMS for a waiver to implement a demonstration project.
AB 72 passed this Committee on April 7, 2015 with a vote of
18-0, and SB 36 passed the Senate Health Committee on April
8, 2015 with a vote of 9-0. Both bills are currently
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pending hearings in their respective Appropriations
Committee.
b) AB 294 (Lackey and Steinorth) requires any department
within the California Health and Human Services Agency to
post on its Website information about any federally
approved state plan or waiver of federal laws or
regulations. AB 294 passed this Committee with a vote of
18-0.
REGISTERED SUPPORT / OPPOSITION:
Support
American Federation of State, County and Municipal Employees,
AFL-CIO
California Academy of Family Physicians
California Association of Public Authorities for IHSS
California Labor Federation
California Primary Care Association
Western Center on Law & Poverty
Opposition
None on file.
AB 1216
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Analysis Prepared by:Lara Flynn / HEALTH / (916) 319-2097