BILL NUMBER: AB 525 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JANUARY 23, 2006
AMENDED IN ASSEMBLY APRIL 26, 2005
AMENDED IN ASSEMBLY APRIL 4, 2005
INTRODUCED BY Assembly Member Chu
FEBRUARY 16, 2005
An act to add Section 12698.02 to the Insurance Code, and
to amend Section 14005.30 of, and to add Section 14148.033 to, the
Welfare and Institutions Code, relating to the
Insurance Code, relating to health care.
LEGISLATIVE COUNSEL'S DIGEST
AB 525, as amended, Chu Health care : Access for Infants and
Mothers Program .
Existing law establishes the Access for Infants and Mothers (AIM)
Program, administered by the Managed Risk Medical Insurance Board, to
provide health insurance care coverage
for certain eligible persons who pay a subscriber contribution. The
AIM Program provides coverage, at a minimum, to subscribers during
one pregnancy, and for 60 days thereafter, and to children less than
2 years of age who were born of a pregnancy covered under this
program to a woman enrolled in the program before July 1, 2004.
This bill would prohibit the board from imposing 3
requirements as conditions a written verification of
pregnancy requirement as a condition of eligibility for the AIM
Program.
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 department, to the extent that federal
financial participation is available, to provide Medi-Cal benefits to
eligible individuals who meet certain income and resource standards,
including to individuals eligible through the exercise of options
under federal law made available to and exercised by the state.
This bill would require the department, to the extent that federal
financial participation is available, to provide for the eligibility
of pregnant women beginning in the first trimester of pregnancy. The
bill would require, if a federal waiver or federal approval is
necessary, the department to submit a request for the waiver or
approval by March 1, 2006.
Existing law requires the department, to the extent that federal
financial participation is available, to exercise its option under
federal law to expand eligibility for Medi-Cal by establishing the
amount of countable resources individuals or families are allowed to
retain at the same amount medically needy individuals and families
are allowed to retain, with an exception for a family of one.
This bill would, by March 1, 2006, require the department, to the
extent federal financial participation is available, to exercise an
option under federal law, if one exists, to exempt pregnant women
from any asset standard, including an asset standard under this
resource standard, or to seek a federal waiver if a federal option
does not exist.
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 Waiver Program benefits shall be deemed to be
eligible under certain circumstances for pregnancy-related care and
breast and cervical cancer screening and treatment, to the extent
federal financial participation is available, and for diagnostic and
other treatment for certain other cancers that threaten reproductive
capability.
This bill would also provide that any individual who has undergone
screening under these provisions who would be eligible for Family
PACT Waiver Program benefits, but for an income in excess of 200% of
the federal poverty level, and who meets certain requirements, shall
be deemed to be eligible for the AIM program.
This bill would require the department to develop and implement,
for purposes of implementing these provisions related to Family Pact
Waiver Program benefits, an enrollment system, and a card to be known
as the Health Access Programs 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.
Under existing law, certain dental services are covered Medi-Cal
benefits.
This bill would declare that the Legislature has appropriated
money in the Budget Act of 2001 and each subsequent Budget Act, for
the provision under the Medi-Cal program of nonemergency benefits for
the prevention and treatment of dental and periodontal disease for
all beneficiaries during pregnancy to prevent premature deliveries
and low birthweights. The bill would require the department to
immediately implement the provision of these services by informing
Denti-Cal and other Medi-Cal providers through provider bulletins
that these benefits are included for all pregnant beneficiaries. The
bill would provide that the implementation of this provision shall
not be delayed pending adoption of administrative regulations.
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
no . State-mandated local program: yes
no .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 12698.02 is added to the Insurance Code, to
read:
12698.02. The board shall not impose any of the
following as a condition of eligibility for the
AIM Program: program
(a) A
a written verification of pregnancy requirement. All
matter omitted in this version of the bill appears in the bill as
amended in Assembly, April 26, 2005 (JR11)