BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 407 (Morrell) - Comprehensive Perinatal Services Program:
licensed midwives
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|Version: April 21, 2015 |Policy Vote: HEALTH 9 - 0 |
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|Urgency: No |Mandate: No |
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|Hearing Date: May 11, 2015 |Consultant: Brendan McCarthy |
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This bill does not meet the criteria for referral to the
Suspense File.
Bill
Summary: SB 407 would add licensed midwives to the list of
health care providers who are authorized to provide services in
the Comprehensive Perinatal Services Program.
Fiscal
Impact:
One-time costs, less than $50,000, to revise existing
regulations and develop a state plan amendment to allow
licensed midwives to provide services in the Comprehensive
Perinatal Services Program, under Medi-Cal (General Fund and
federal funds).
No significant impact to the utilization of services in the
SB 407 (Morrell) Page 1 of
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Medi-Cal managed care program is anticipated. Under current
law and practice, the services that are authorized under the
Comprehensive Perinatal Services Program are required benefits
for Medi-Cal managed care beneficiaries. Because those
beneficiaries already have access to those services through
managed care, it is not likely that adding an additional
authorized provider will increased the utilization of those
services. (For example, if a licensed midwife who is seeing a
pregnant woman in Medi-Cal managed care wished to order a
covered service, that midwife could simply work with another
eligible practitioner to order the services.)
Unknown potential increase in costs to provide services in the
fee-for-service Medi-Cal system (local funds and federal
funds). Under current practice, Medi-Cal beneficiaries in
fee-for-service can receive Comprehensive Perinatal Services
Program services from their health care provider. In the
fee-for-service system, those costs are paid for with local
funds and federal matching funds. The state does not provide
General Fund support for those costs. It is possible that
there could be an increase in the utilization of services
under this bill, to the extent that Medi-Cal beneficiaries are
being provided care by a licensed midwife and it is not easy
for that provider to get another authorized provider to order
the specified services. The extent to which the fact that
licensed midwives are not eligible to provide the specified
services is actually a barrier to women getting those services
in not known, so it is difficult to estimate whether there
would actually be an increase is service utilization. The bill
does not create a new program or mandate a higher level of
service (the legal test for whether a state mandate is
reimbursable). Therefore, it is not likely that the state
would be required to reimburse counties for any increased
costs under the bill, even if utilization of services does
increase.
Background: Under state and federal law, the Department of Health Care
Services operates the Medi-Cal program, which provides health
care coverage to low income individuals, families, and children.
Medi-Cal provides coverage to childless adults and parents with
household incomes up to 138 percent of the federal poverty level
and to children with household incomes up to 266 percent of the
federal poverty level. The federal government provides matching
SB 407 (Morrell) Page 2 of
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funds that vary from 50 percent to 90 percent of expenditures
depending on the category of beneficiary.
The Comprehensive Perinatal Services Program is an additional
benefit provided through the Medi-Cal program. Under the
Comprehensive Perinatal Services Program, pregnant and
post-partum women are eligible for additional services, such as
early entry into prenatal care, vitamins, case coordination, an
additional post-partum visit, and other supportive services. All
of those additional benefits are required to be provided, when
appropriate, by Medi-Cal managed care plans.
As noted above, Comprehensive Perinatal Services Program
benefits in the Medi-Cal fee-for-service program are paid for
using local funds and federal matching funds.
Proposed Law:
SB 407 would add licensed midwives to the list of health care
providers who are authorized to provide services in the
Comprehensive Perinatal Services Program.
The bill would require the Department of Health Care Services to
revise any existing regulations, as needed, beginning by March
1, 2016.
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