BILL ANALYSIS Ó
SB 296
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Date of Hearing: July 15, 2015
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Jimmy Gomez, Chair
SB 296
(Cannella) - As Amended July 2, 2015
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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
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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
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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