SB 1418,
as amended, Lara. begin deleteClinical laboratory testing. end deletebegin insertMedi-Cal: immigration status.end insert
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. The federal Medicaid program provisions prohibit payment to a state for medical assistance furnished to an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law.
end insertbegin insertThis bill would extend eligibility for full-scope Medi-Cal benefits to individuals 19 years of age and older who are otherwise eligible for those benefits but for their immigration status if the department determines that sufficient funding is available, or for limited scope Medi-Cal benefits if funding for full-scope benefits is not available. The bill would require these individuals to enroll into Medi-Cal managed care health plans, and to pay copayments and premium contributions, to the extent required of otherwise eligible Medi-Cal recipients who are similarly situated. The bill would require that benefits for those services to be provided with state-only funds only if federal financial participation is not available. Because counties are required to make Medi-Cal eligibility determinations and this bill would expand Medi-Cal eligibility, the bill would impose a state-mandated local program.
end insertbegin insertThe bill would require the department to adopt regulations by July 1, 2018, and, commencing July 1, 2016, would require the department to provide a status report to the Legislature on a semiannual basis until regulations have been adopted.
end insertbegin insertThe California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
end insertbegin insertThis bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.
end insertbegin insertThis bill would declare that it is to take effect immediately as an urgency statute.
end insertExisting law provides for the regulation and licensure of clinical laboratories and clinical laboratory personnel by the State Department of Public Health and makes a violation of a provision under this law a misdemeanor. Existing law authorizes a person to request, and a licensed clinical laboratory or public health laboratory to perform specified clinical laboratory tests, including pregnancy, glucose level, cholesterol, and occult blood tests. Existing law authorizes a registered clinical laboratory to perform these tests if the test is subject to a certificate of waiver under the Clinical Laboratory Improvement Amendments of 1988 and the laboratory has registered with the State Department of Public Health.
end deleteExisting law authorizes the results of the test to be provided directly to the person requesting the test if the test is on or for his or her own body. Existing law requires that those test results be provided in a manner that presents clear information and that identifies results indicating the need for referral to a physician.
end deleteThis bill would repeal those provisions and instead allow a person to request, and a licensed clinical laboratory or public health laboratory to perform, any laboratory test that the laboratory offers to the public on a direct access basis without a healing arts licensee’s order. If a laboratory test is conducted without an order from a healing arts licensee, the bill would require any report of the test results to be provided to the person who was the subject of the test. The bill would require the report to state in bold type that it is the responsibility of the person who was tested to arrange with his or her health care provider for consultation and interpretation of the test results. The bill would make additional conforming changes. By changing the definition of an existing crime, this bill would impose a state-mandated local program.
end deleteThe California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
end deleteThis bill would provide that no reimbursement is required by this act for a specified reason.
end deleteVote: begin deletemajority end deletebegin insert2⁄3end insert.
Appropriation: no.
Fiscal committee: yes.
State-mandated local program: yes.
The people of the State of California do enact as follows:
begin insert(a)end insertbegin insert end insertbegin insertThe Legislature finds and declares all of the
2following:end insert
3
(1) The Legislature and the Governor, through the enactment
4of the Budget Act of 2015 (Chapter 11 of the Statutes of 2015),
5expanded Medi-Cal eligibility for children to ensure that no child
6in California who is income eligible will be denied access to health
7care coverage on the basis of immigration status.
8
(2) Expanding access and increasing enrollment in
9comprehensive health care coverage is of benefit to the health and
10welfare of all Californians.
11
(3) Longstanding California law provides full-scope Medi-Cal
12benefits to United States citizens, lawful permanent residents, and
13individuals permanently residing in the United States under color
14of law, including those granted deferred action.
15
(b) It is the intent of the Legislature in enacting this act to
16increase opportunities for enrollment in comprehensive health
17care coverage for adults, regardless of immigration status.
begin insertSection 14102.1 is added to the end insertbegin insertWelfare and Institutions
19Codeend insertbegin insert, to read:end insert
(a) (1) Notwithstanding any other law, an individual
219 years of age or older who meets all of the eligibility
3requirements for full-scope Medi-Cal benefits under this chapter,
4but for his or her immigration status, may be enrolled for full-scope
5Medi-Cal benefits, pursuant to paragraph (2).
6
(2) When a county completes the Medi-Cal eligibility
7determination process for an individual 19 years of age or older
8who meets all of the eligibility requirements for full-scope
9Medi-Cal benefits under this chapter, but for his or her
10immigration status, the county shall transmit this information to
11the department to determine if sufficient funding is available for
12this individual to receive full-scope Medi-Cal benefits. If
sufficient
13funding is available, the individual shall be eligible for full-scope
14benefits. If sufficient funding is not available, the individual shall
15be eligible for limited scope Medi-Cal benefits.
16
(b) This section shall not apply to individuals eligible for
17coverage pursuant to Section 14102.
18
(c) An individual who is eligible for coverage under subdivision
19(a) shall be required to enroll into Medi-Cal managed care health
20plans to the extent required of otherwise eligible Medi-Cal
21recipients who are similarly situated.
22
(d) An individual who is eligible for coverage under subdivision
23(a) shall pay copayments and premium contributions to the extent
24required of otherwise eligible Medi-Cal recipients who are
25similarly situated.
26
(e) Benefits for services
under this section shall be provided
27with state-only funds only if federal financial participation is not
28available for those services. The department shall maximize federal
29financial participation in implementing this section to the extent
30allowable.
31
(f) Eligibility for full-scope Medi-Cal benefits for an individual
3219 years of age or older pursuant to subdivision (a) shall not be
33an entitlement. The department shall have the authority to
34determine eligibility, determine the number of individuals who
35may be enrolled, establish limits on the number enrolled, and
36establish processes for waiting lists needed to maintain program
37expenditures within available funds.
38
(g) Notwithstanding Chapter 3.5 (commencing with Section
3911340) of Part 1 of Division 3 of Title 2 of the Government Code,
40the department, without taking any further regulatory action, shall
P5 1implement, interpret, or make
specific this section by means of
2all-county letters, plan letters, plan or provider bulletins, or similar
3instructions until the time regulations are adopted. The department
4shall adopt regulations by July 1, 2018, in accordance with the
5requirements of Chapter 3.5 (commencing with Section 11340) of
6Part 1 of Division 3 of Title 2 of the Government Code.
7Commencing July 1, 2016, the department shall provide a status
8report to the Legislature on a semiannual basis, in compliance
9with Section 9795 of the Government Code, until regulations have
10been adopted.
If the Commission on State Mandates determines that
12this act contains costs mandated by the state, reimbursement to
13local agencies and school districts for those costs shall be made
14pursuant to Part 7 (commencing with Section 17500) of Division
154 of Title 2 of the Government Code.
This act is an urgency statute necessary for the
17immediate preservation of the public peace, health, or safety within
18the meaning of Article IV of the Constitution and shall go into
19immediate effect. The facts constituting the necessity are:
20
In order to expand access to health care coverage to every
21Californian as quickly as possible, it is necessary that this act go
22into immediate effect.
Section 1246.5 of the Business and Professions
24Code is repealed.
Section 1246.5 is added to the Business and Professions
26Code, to read:
(a) Notwithstanding any other law, a person may
28request, and a licensed clinical laboratory or public health
29laboratory may perform, any laboratory test that the laboratory
30offers to the public without an order from a healing arts licensee
31or his or her representative.
32(b) If a laboratory test of a person is conducted without an order
33from a healing arts licensee or his or her representative, the test
34results shall be provided to the person who was the subject of the
35test. The test results report shall state in bold type that it is the
36responsibility
of the person who was tested to arrange with his or
37her health care provider for consultation and interpretation of the
38test results.
39(c) A healing arts licensee is not required to review or act on a
40laboratory test
result if the healing arts licensee or his or her
P6 1representative did not order the laboratory test. A healing arts
2licensee is not subject to liability or disciplinary actions for failure
3to review or act on the results of
a laboratory test of any person if
4the healing arts licensee or his or her representative did not order
5the laboratory test.
6(d) This section does not require that any laboratory test be
7covered by a health care service plan contract or health insurance
8policy.
Section 1288 of the Business and Professions Code is
10amended to read:
A report of results issuing from a clinical laboratory shall
12show clearly the name and address of the laboratory and the name
13of the director.
No reimbursement is required by this act pursuant to
15Section 6 of Article XIII B of the California Constitution because
16the only costs that may be incurred by a local agency or school
17district will be incurred because this act creates a new crime or
18infraction, eliminates a crime or infraction, or changes the penalty
19for a crime or infraction, within the meaning of Section 17556 of
20the Government Code, or changes the definition of a crime within
21the meaning of Section 6 of Article XIII B of the California
22Constitution.
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