BILL NUMBER: AB 525 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Chu
FEBRUARY 16, 2005
An act to add Section 14148.033 to the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 525, as introduced, Chu. Health care.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Services, pursuant to
which medical benefits are provided to public assistance recipients
and certain other low -income persons.
Existing law requires the State Department of Health Services to
implement, as a Medi-Cal program benefit, a program to provide
comprehensive clinical family planning services to any person who has
a family income at or below 200% of the federal poverty level, as
revised annually, and who is otherwise eligible to receive these
services, to be known as the Family Planning, Access, Care, and
Treatment (Family PACT) Waiver Program.
This bill would provide that certain individuals who are, or who
would be, but for being pregnant at the time of application, eligible
for Family PACT program benefits shall also be deemed to be eligible
for additional pregnancy -related care, for cervical cancer
screening and treatment, and for diagnostic and other treatment for
certain other cancers that threaten reproductive capability.
This bill would require the department to develop and implement an
enrollment system and card for purposes of implementing this bill,
to be known as the UniHealth Access Card by July 1, 2006.
Under existing law, counties are responsible for determining
eligibility for benefits under the Medi-Cal program.
By revising eligibility standards for the receipt of benefits
under the Medi-Cal program, this bill would impose a state-mandated
local program.
The 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.
This 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.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14148.033 is added to the Welfare and
Institutions Code , to read:
14148.033. (a) Any individual who is determined to be eligible
for benefits under subdivision (aa) of Section 14132 for
comprehensive clinical family planning shall be deemed to have
applied and been determined to be eligible for the following:(1)
Medi-Cal benefits for pregnancy-related care under this chapter if
the individual becomes pregnant during the period for which the
individual has been certified as being eligible to receive Family
PACT services under subdivision (a) of Section 14132.
(2) Breast and cervical cancer screening and treatment for
uninsured or underinsured women as described in Sections 104160 and
104161 of the Health and Safety Code and Section 14007.71.
(3) Prostate cancer screening and treatment upon exhaustion of
eligibility for Family PACT Services under paragraph (8) of
subdivision (aa) of Section 14132 for diagnoses and treatment
services for cancers that threaten reproductive capability.
(b) For purposes of paragraph (2) of subdivision (a):
(1) "Uninsured" means not covered for breast or cervical cancer
treatment services by any of the following:
(A) No cost full scope Medi-Cal.
(B) Medicare.
(C) A health care service plan contract or policy of disability
insurance.
(D) Any other form of health care coverage.
(2) "Underinsured" means either of the following:
(A) Covered for breast or cervical cancer treatment services by
any health care insurance listed in subparagraph (B), (C), or (D) of
paragraph (1), but the sum of the individual's insurance deductible,
premiums, and expected copayments in the initial 12-month period that
breast or cervical cancer treatment services are needed exceeds
seven hundred fifty dollars ($750).
(B) Covered by share-of-cost or limited scope Medi-Cal, if the
individual is not otherwise eligible for treatment services pursuant
to Section 14007.71.
(c) Any individual who has undergone screening under this section
and would be eligible for Family Pact benefits under subdivision (aa)
of Section 14132, but for the fact that she is pregnant at the time
of application for those services, shall be deemed to have applied
and been determined to be eligible for those pregnancy-related and
other health care benefits specified in subdivision (a).
(d) (1) By July 1, 2006, the department shall develop and
implement an enrollment system and card for the implementation of
this section, to be known as the UniHealth Access Card, that is
consistent with this section and Section 14148.03.
(2) The department shall consult with representatives of
providers, consumers, counties, and health plans in the development
and implementation of the UniHealth Access Card.
SEC. 2.
If the Commission on State Mandates determines that this act
contains costs mandated by the state, reimbursement to local agencies
and school districts for those costs shall be made pursuant to Part
7 (commencing with Section 17500) of Division 4 of Title 2 of the
Government Code.