BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 296 (Cannella) - Medi-Cal: specialty mental health services:
documentation requirements
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|Version: April 20, 2015 |Policy Vote: HEALTH 9 - 0 |
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|Urgency: No |Mandate: No |
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|Hearing Date: May 4, 2015 |Consultant: Brendan McCarthy |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: SB 296 would require the Department of Health Care
Services to develop a single set of billing documentation
requirements for use by counties in the provision of specialty
mental health services in the Medi-Cal program.
Fiscal
Impact:
Likely one-time costs up to $150,000 to consult with
stakeholders, develop the documentation guidelines, and adopt
regulations (General Fund and federal funds).
No significant impact on local mental health plans is expected
(local funds). Under current law, Medi-Cal specialty mental
health services are provided through county mental health
SB 296 (Cannella) Page 1 of
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plans. Under this bill, those mental health plans would be
required to use the documentation requirements developed under
the bill. It is not likely that creating uniform documentation
requirements will significantly increase local administrative
costs or significantly change the utilization of services.
Background: Under state and federal law, the Department of Health Care
Services operates the Medi-Cal program, which provides health
care coverage to pregnant women, children and their parents with
low incomes, as well as blind, disabled, and certain other
populations. Generally, the federal government provides a 50
percent federal match for state expenditures.
Pursuant to the federal Affordable Care Act, California has
opted to expand eligibility for Medi-Cal up to 138 percent of
the federal poverty level and to include childless adults. The
Affordable Care Act provides a significantly enhanced federal
match for the Medi-Cal expansion. Under the law, the federal
government will pay for 100 percent of the cost of the Medi-Cal
expansion in 2013-14, declining to a 90 percent federal match in
the 2020 federal fiscal year and thereafter.
Under current law and practice, specialty mental health services
for Medi-Cal beneficiaries with serious mental illness are
provided through county mental health plans. The non-federal
share of the costs for those services are paid for with county
funds, such as realignment funds.
Proposed Law:
SB 296 would require the Department of Health Care Services to
develop a single set of billing documentation requirements for
the provision of specialty mental health services in the
Medi-Cal program.
The bill requires the Department to develop billing
documentation requirements that minimize time and paperwork
required of counties and providers and that eliminate
duplicative requirements.
SB 296 (Cannella) Page 2 of
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The bill requires the billing documentation requirements to be
developed by January 1, 2017 for use beginning on July 1, 2017.
Upon adoption of the billing standards, the bill would prohibit
counties from requiring additional billing documentation
standards for specialty mental health services.
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