BILL NUMBER: SB 435 AMENDED
BILL TEXT
AMENDED IN SENATE JUNE 2, 2015
AMENDED IN SENATE APRIL 6, 2015
INTRODUCED BY Senator Pan
FEBRUARY 25, 2015
An act to add Chapter 3.5 (commencing with Section 24300) to
Division 20 of the Health and Safety Code, relating to health care.
LEGISLATIVE COUNSEL'S DIGEST
SB 435, as amended, Pan. Medical home: health care delivery
model.
Existing law requires the Office of Statewide Health Planning and
Development to perform various functions and duties with respect to
health policy and planning and health professions development.
Existing law states the Legislature's finding that there is a need to
improve the effectiveness of health care delivery systems. Existing
law generally defines a medical home as a single provider, facility,
or team that coordinates an individual's health care services.
This bill would require the Secretary of California Health and
Human Services to convene a working group of public payers, private
health insurance carriers, third-party
3rd-party purchasers, and health care providers to identify
appropriate payment methods to align incentives in support of patient
centered medical homes. The bill would prescribe the powers and
duties of the working group, including consulting with, and providing
recommendations to, the Legislature and relevant state agencies on
matters relating to the implementation of the patient centered
medical home care model. The bill would be implemented using
state and federal funds, grants, donations, and other financial
support, as prescribed. require the secretary to
convene the working group only after making a
determination that sufficient nonstate funds have been received to
pay for all costs of implementing the bill.
This bill would make legislative findings and declarations
regarding the intent of the Legislature to exempt and immunize
activities undertaken in connection with patient centered medical
homes from state and federal antitrust laws, as specified.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares as follows:
(a) It is the intent of the Legislature in enacting this act to
provide for collaboration among public payers, private health
insurance carriers, third-party purchasers, and health care
providers, as necessary to identify consistent appropriate payment
methods to support chronic care management in, and to align
incentives in support of, patient centered medical homes.
(b) It is the intent of the Legislature to exempt from state
antitrust laws and to provide immunity from federal antitrust laws,
pursuant to the state action doctrine for, any activities undertaken
pursuant to this act that otherwise might be constrained by those
laws. It is not the intent of the Legislature to authorize any person
or entity to engage in or conspire to engage in any activity that
would constitute a per se violation of state or federal antitrust
laws, including, but not limited to, an agreement among competing
health care providers or health insurance carriers as to the price or
specific level of payment for a health care service.
(c) It is the intent of the Legislature that the state shall
articulate a clear and affirmative policy describing its intent to
displace competition with respect to the implementation of this act,
and shall actively supervise anticompetitive conduct and its results
with ongoing oversight.
SEC. 2. Chapter 3.5 (commencing with Section 24300) is added to
Division 20 of the Health and Safety Code, to read:
CHAPTER 3.5. PATIENT CENTERED MEDICAL HOME HEALTH CARE
DELIVERY MODEL
24300. The Secretary of California Health and Human Services
shall convene a working group of public payers, private health
insurance carriers, third-party purchasers, and health care providers
to identify appropriate payment methods to align incentives in
support of patient centered medical homes.
24301. (a) The working group convened pursuant to this chapter
shall consult with, and provide recommendations to, the Legislature
and relevant state agencies on all matters relating to the
implementation of a patient centered medical home care model.
(b) The working group shall have the authority to do all of the
following:
(1) Develop consensus on strategies for implementing the patient
centered medical home care model and service delivery change at the
practice, community, and health care system level.
(2) Create Identify ways to create
alignment regarding payment, reporting, and infrastructure
investments.
(3) Design and compose pilot projects, including multipayer pilot
projects.
(4) Utilize
(3) Identify ways to utilize
public and private purchasing power and ways to enable
competing payers to work collaboratively to establish common patient
centered medical home initiatives.
(5)
(4) Propose participation in relevant federally funded
pilot and demonstration projects.
24302. The state shall use existing state resources and available
federal funds to implement this chapter. If state or federal funds
are not available, the secretary may apply for and accept grants, or
receive donations and other financial support from public or private
sources, for purposes of this chapter.
24302. The secretary shall convene the working group only after
he or she makes a determination that sufficient nonstate funds have
been received to pay for all costs of implementing this chapter.