Amended in Assembly March 26, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 1485

Introduced by Assembly Member Patterson

February 27, 2015

An act to begin delete amend Section 4620 of end delete begin insert add Section 14132.735 to end insert the Welfare and Institutions Code, relating to begin delete developmental services end delete begin insert Medi-Cal end insert .

LEGISLATIVE COUNSEL’S DIGEST

AB 1485, as amended, Patterson. begin delete Developmental services: regional centers. end delete begin insert Medi-Cal: teleradiology. end insert

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Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law prohibits a requirement of in-person contact between a health care provider and patient under the Medi-Cal program for any service otherwise covered by the Medi-Cal program when the service is appropriately provided by telehealth, as defined. Existing law, for purposes of payment of covered treatment or services provided through telehealth, prohibits the department from limiting the type of setting where services are provided for the patient or by the health care provider.

end insert begin insert

This bill would prohibit the department from requiring a radiologist to be located in California as a condition of Medi-Cal provider enrollment or reimbursement for teleradiology services, as defined, provided to Medi-Cal beneficiaries undergoing imaging procedures at locations within California, if the radiologist meets specified conditions and criteria, as specified.

end insert begin delete

Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to enter into contracts with private nonprofit corporations to operate regional centers to provide community services and supports for persons with developmental disabilities and their families. Existing law states the intent of the Legislature that the design and activities of regional centers reflect, among other things, a strong commitment to the delivery of direct service coordination to persons with disabilities and their families.

end delete begin delete

This bill would make technical, nonsubstantive changes to those provisions.

end delete

Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

end insert

begin insert Section 14132.735 is added to the end insert begin insert Welfare and
Institutions Code end insert begin insert , to read: end insert

begin insert

begin insert 14132.735. end insert   

(a) It is the intent of the Legislature that the
utilization of national teleradiology networks in the delivery of
timely and cost-effective health care services to Medi-Cal
beneficiaries supplement, and not supplant, work performed by
California health care providers.

(b) Notwithstanding Section 14122, the department shall not
require a radiologist to be located in California as a condition of
Medi-Cal provider enrollment or reimbursement for teleradiology
services provided to Medi-Cal beneficiaries undergoing imaging
procedures at locations within California, if the radiologist meets
all of the following conditions and criteria:

(1) The radiologist is licensed pursuant to Division 2
(commencing with Section 500) of the Business and Professions
Code.

(2) The radiologist is enrolled and in good standing in the
Medicaid program for the state where the radiologist is located,
is enrolled in good standing in Medicare, or is enrolled in good
standing in both programs.

(3) The radiologist is not located outside the United States of
America.

(4) The radiologist satisfies all requirements for enrollment and
participation in the Medi-Cal program, and other statutory
requirements for providing telehealth services.

(5) The radiologist consents to Medi-Cal acting through the
state Medicaid program where the radiologist is located and the
Medicare Program with respect to any issues concerning the
radiologist’s enrollment or participation in Medi-Cal.

(6) The radiologist consents to jurisdiction and venue in
Sacramento, California, for any and all legal proceedings in any
way related to the radiologist’s enrollment in Medi-Cal, including,
but not limited to, formal or informal proceedings, as well as
administrative, civil, and criminal proceedings.

(c) For purposes of this section, “teleradiology services” means
professional diagnostic review and interpretation of medical
imaging studies by remote means, including asynchronous store
and forward transmission.

(d) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
the department may implement, interpret, and make specific this
section by means of all-county letters, provider bulletins, and
similar instructions.

(e) This section shall be implemented only to the extent permitted
by federal law and to the extent that federal financial participation
is available.

end insert

begin delete

SECTION 1.  

Section 4620 of the Welfare and Institutions Code
is amended to read:

4620.  

(a) In order for the state to carry out its responsibilities
as established in this division, the state shall contract with
appropriate agencies to provide fixed points of contact in the
community for persons with developmental disabilities and their
families, to the end that these persons may have access to the
services and supports best suited to them throughout their lifetime.
It is the intent of the Legislature in enacting this division that the
network of regional centers for persons with developmental
disabilities and their families be accessible to every family in need
of regional center services. It is the further intent of the Legislature
that the design and activities of regional centers reflect a strong
commitment to the delivery of direct service coordination, and
that all other operational expenditures of regional centers are
necessary to support and enhance the delivery of direct service
coordination and services and supports identified in individual
program plans.

(b) The Legislature finds that the service provided to individuals
and their families by regional centers is of such a special and
unique nature that it cannot be satisfactorily provided by state
agencies. Therefore, private nonprofit community agencies shall
be utilized by the state for the purpose of operating regional centers.

end delete