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  








                                                                     SB 296  


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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