BILL NUMBER: AB 1485 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 21, 2015
AMENDED IN ASSEMBLY MARCH 26, 2015
INTRODUCED BY Assembly Member Patterson
FEBRUARY 27, 2015
An act to add Section 14132.735 to the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 1485, as amended, Patterson. Medi-Cal: teleradiology.
radiology.
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.
This bill would prohibit the department from requiring a
radiologist to be located in California as a condition of
conditioning Medi-Cal provider enrollment or reimbursement
for teleradiology services, as defined,
radiology services provided to Medi-Cal beneficiaries
undergoing imaging procedures at locations within California on
the location of the radiologist , if the radiologist meets
specified conditions and criteria, as specified.
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 14132.735 is added to the Welfare and
Institutions Code, to read:
14132.735. (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, this
section not be considered a precedent for other types of health care
service providers because the services performed by radiologists are
provided to attending physicians and not to patients, and therefore
they do not supplant work performed by other
California health care providers.
(b) Notwithstanding Section 14122, the department shall not
require a radiologist to be located in California as a
condition of condition Medi-Cal provider
enrollment or reimbursement for teleradiology
radiology services provided to Medi-Cal beneficiaries
undergoing imaging procedures at locations within California on
the location of the radiologist , 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.
program.
(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)
(c) 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)
(d) This section shall be implemented only to the
extent permitted by federal law and to the extent that federal
financial participation is available.