BILL ANALYSIS Ó SB 296 Page 1 Date of Hearing: July 15, 2015 ASSEMBLY COMMITTEE ON APPROPRIATIONS Jimmy Gomez, Chair SB 296 (Cannella) - As Amended July 2, 2015 ----------------------------------------------------------------- |Policy |Health |Vote:|18 - 0 | |Committee: | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | ----------------------------------------------------------------- Urgency: No State Mandated Local Program: NoReimbursable: No SUMMARY: This bill requires the Department of Health Care Services (DHCS) to develop a single set of billing documentation standards, with consultation from various entities as specified, for the provision of Medi-Cal specialty mental health (SMH) services by SB 296 Page 2 January 1, 2017, for use commencing July 1, 2017. Specifically, this bill: 1)Requires standards to minimize time and paperwork required of counties and providers. 2)Requires DHCS to update the standards every two years through a stakeholder process. 3)After adoption of standards, prohibits counties from requiring additional billing documentation for SMH services that go beyond these standards, unless the documentation is necessary for funding from other funding sources, or for purposes other than for billing documentation. FISCAL EFFECT: This bill is estimated to result in administrative staff costs to DHCS in the range of $850,000 ($320,000 GF/remainder federal) for at least two years, and possibly three years depending on implementation timing. DHCS currently conducts some activities to ensure consistency across counties, but the bill will require a more comprehensive effort, including modifying contracts and promulgating regulations. COMMENTS: 1)Purpose. This bill is intended to streamline administrative requirements associated with billing for SMH services in Medi-Cal. This bill will create a single minimum set of documentation requirements developed by the state that is designed to limit audit disallowances. This bill is sponsored SB 296 Page 3 by the California Council of Community Mental Health Agencies, a membership organization of non-profit mental health agencies, many of whom contract with counties to provide SMH services. 2)Background. Pursuant to a federal waiver, SMH services are provided by county-run mental health plans. The state's 2011 realignment made counties fully responsible for funding these services as well. However, DHCS retains oversight over the system as the responsible state agency, and audits and disallows claims as part of that effort. This bill attempts to address high rates of disallowances, and reduce administrative effort, by simplifying billing. Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081