SB 296, as introduced, Cannella. Medi-Cal: specialty mental health services: documentation requirements.
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, including specialty mental health services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. In order to facilitate the receipt of medically necessary specialty mental health services by a foster child who is placed outside of his or her county of original jurisdiction, existing law requires the department to create a standardized set of documentation standards and forms.
This bill would require the department, in consultation with specified stakeholders, to develop a single set of service documentation requirements for the provision of specialty mental health services by March 31, 2016, for use commencing July 1, 2016, and would require the department to update the documentation requirements no less than every 2 years. The bill would generally prohibit counties from requiring additional documentation requirements for Medi-Cal specialty mental health services that go beyond the documentation requirements developed by the department.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
The Legislature finds and declares all of the
2following:
3(a) Counties and private providers that contract for service
4delivery estimate that over 40 cents out of every dollar spent on
5Medi-Cal mental health services goes to paperwork to document
6that the services meet federal billing standards and to avoid
7potential state audit disallowances.
8(b) A national expert reviewed what counties in California were
9requiring of providers and noted that it took 20 minutes of
10documentation to prepare progress notes for a single session of
11psychotherapy, as compared to an estimated five minutes in other
12states.
13(c) State
guidelines on billing are not significantly different
14from the requirements of other states, however, counties have
15added other documentation requirements based on the fear that
16interpretations of the guidelines during audits may result in some
17services being disallowed if the additional documentation is not
18included.
19(d) In order to eliminate this pattern, it is necessary for the State
20Department of Health Care Services to develop a single set of
21documentation requirements, in consultation with counties and
22providers, that limits audit disallowances to circumstances clearly
23spelled out in the requirements.
Section 14727 is added to the Welfare and Institutions
25Code, immediately following Section 14726, to read:
(a) The State Department of Health Care Services shall
27consult with counties, providers, national experts, other states, and
28other stakeholders to develop a single set of service documentation
29requirements for the provision of specialty mental health services.
30(b) The documentation requirements developed pursuant to this
31section shall do all of the following:
32(1) Minimize time and paperwork required of counties and
33providers, consistent with federal standards and practices of other
34states.
35(2) Eliminate duplicative or outdated requirements.
36(3) Reflect
outcome reporting requirements developed pursuant
37to the performance outcome system for Early and Periodic
P3 1Screening, Diagnosis, and Treatment mental health services
2developed pursuant to Section 14707.5.
3(c) The documentation requirements shall be completed by
4March 31, 2016, for use commencing on July 1, 2016, and shall
5thereafter be updated no less than every two years through a
6stakeholder process, unless changes in the state Medi-Cal plan or
7other federal rules require that the requirements be updated more
8often.
9(d) After adoption of the standard requirements by the
10department, a county may not require additional documentation
11for Medi-Cal specialty mental health services that go beyond these
12requirements unless necessary for funding from other funding
13sources that are also used to pay for the services.
O
99