BILL NUMBER: AB 1485	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MAY 5, 2015
	AMENDED IN ASSEMBLY  APRIL 30, 2015
	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: 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 conditioning Medi-Cal
provider enrollment or reimbursement for 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 this
section shall not be a precedent for other types of health care
providers and that remotely located radiologists supplement, and do
not supplant,  in-state   on-site 
radiologists as an integral part of providing a high level of care in
local communities.
   (b) Notwithstanding Section 14122, the department shall not
condition Medi-Cal provider enrollment or reimbursement for 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.
   (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) 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.
   (d) This section shall be implemented only to the extent permitted
by federal law and to the extent that federal financial
participation is available.