BILL ANALYSIS                                                                                                                                                                                                    



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          AB 1231 (Wood) - Medi-Cal:  nonmedical transportation
          
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          |Version: June 19, 2015          |Policy Vote: HEALTH 9 - 0       |
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          |Urgency: No                     |Mandate: No                     |
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          |Hearing Date: August 27, 2015   |Consultant: Brendan McCarthy    |
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          *********** ANALYSIS ADDENDUM - SUSPENSE FILE ***********
             The following information is revised to reflect amendments 
                     adopted by the committee on August 27, 2015


          Bill  
          Summary:  AB 1231 would require the Department of Health Care  
          Services to provide nonmedical transportation as a covered  
          benefit in the Medi-Cal program.


          Fiscal  
          Impact:  
           One-time costs, likely about $150,000 to $300,000 for one to  
            two years to develop program requirements, amend the state's  
            Medicaid plan, and adopt regulations to implement the bill  
            (General Fund and federal funds).

           Ongoing costs of $1.5 million to $6.5 million to provide  
            nonmedical transportation to Medi-Cal beneficiaries enrolled  
            in Medi-Cal managed care plans that do not already provide  
            nonmedical transportation as a covered benefit (General Fund  
            and federal funds). According to the Department of Health Care  







          AB 1231 (Wood)                                         Page 1 of  
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            Services, 17 out of 21 Medi-Cal managed care plans already  
            provide coverage for nonmedical transportation, covering  
            between 50% and 70% of all existing Medi-Cal managed care plan  
            enrollees. The Department estimates the annual cost per member  
            to provide nonmedical transportation is between $0.50 and  
            $2.00 per year.

           Ongoing costs of $1.5 million to $3.0 million per year to  
            provide coverage for nonmedical transportation to Medi-Cal  
            beneficiaries not enrolled in Medi-Cal managed care. The  
            Department currently does not provide coverage for nonmedical  
            transportation in the fee for service system (except for  
            children).

           Unknown impact on overall utilization of specialty health care  
            services in the Medi-Cal program (General Fund and federal  
            funds). By ensuring that Medi-Cal beneficiaries have access to  
            nonmedical transportation to specialty care, the bill is  
            likely to allow for increased access to specialty care by  
            Medi-Cal beneficiaries, particularly those in rural areas of  
            the state. This is likely to increase utilization of those  
            services. On the other hand, timely access to specialty  
            services may allow beneficiaries and their providers to better  
            manage serious medical conditions, potentially reducing future  
            needs for additional specialty services or hospitalization.  
            The net impact of these factors is unknown.


          Author  
          Amendments:  Require a beneficiary to demonstrate that other  
          available resources have been exhausted and make technical and  
          clarifying corrections.


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