BILL NUMBER: SB 435	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  JULY 7, 2015
	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, 3rd-party purchasers,  and
 health care  providers   providers,
and health care consumer representatives  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 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,  and health care consumer representatives,
 as  necessary   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   providers, and health
care consumer representatives  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) Identify ways to create alignment regarding payment,
reporting, and infrastructure investments.
   (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.
   (4) Propose participation in relevant federally funded pilot and
demonstration projects.
   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.