BILL ANALYSIS
AB 158
Page 1
ASSEMBLY THIRD READING
AB 158 (Ma)
As Amended January 24, 2008
Majority vote
HEALTH 15-2 APPROPRIATIONS 11-5
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|Ayes:|Dymally, Bass, Berg, De |Ayes:|Leno, Caballero, Davis, |
| |La Torre, De Leon, | |DeSaulnier, Huffman, |
| |Emmerson, Hancock, | |Karnette, Krekorian, |
| |Hayashi, Hernandez, Huff, | |Lieu, Ma, Nava, Solorio |
| |Jones, Lieber, Ma, Salas, | | |
| |Strickland | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Nakanishi, Gaines |Nays:|Walters, Emmerson, La |
| | | |Malfa, Nakanishi, Sharon |
| | | |Runner |
| | | | |
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SUMMARY : Establishes a new Medi-Cal eligibility category for
non-disabled persons with chronic hepatitis B virus infection
(CHBV) contingent on federal approval and federal financial
participation (FFP). Specifically, this bill :
1)Requires the Department of Health Care Services (DHCS) to
expand Medi-Cal eligibility to any person with CHBV who would
otherwise qualify for Medi-Cal if the person were disabled.
Requires this expansion to begin on July 1, 2009, or the date
that all necessary federal waivers have been obtained,
whichever is later.
2)Requires DHCS to develop an allocation mechanism to enroll
individuals eligible pursuant to #1) above on a first-come,
first-served basis.
3)Requires individuals eligible for Medi-Cal pursuant to #1)
above to elect a Medi-Cal managed care (MCMC) plan in those
counties in which a MCMC plan is available, unless DHCS
determines that the cost neutrality requirements and
enrollment goals of this bill can be achieved without
requiring the MCMC election.
AB 158
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4)Requires DHCS to ensure that specified existing MCMC standards
are met in implementing this bill.
5)Requires DHCS to establish capitation rates for services
provided pursuant to this bill. Specifies that capitation
rates may not exceed 95% of the Medi-Cal fee-for-service costs
for individuals with CHBV.
6)Requires DHCS to meet federal revenue neutrality requirements
through savings generated by the voluntary enrollment of
Medi-Cal beneficiaries, who are disabled as a result of CHBV,
into MCMC, and requires DHCS to engage in specified outreach
activities to encourage this enrollment. States that DHCS is
not precluded from implementing other means of meeting federal
neutrality requirements. Prohibits DHCS from enrolling any
individuals in the program established pursuant to #1) above
until DHCS can ensure sufficient savings to meet the federal
neutrality requirement.
7)Requires DHCS to do all of the following:
a) Implement this bill by means of an all-county letter or
similar instruction;
b) Seek the appropriate federal waiver, as specified; and,
c) Implement this bill only if, and to the extent that, FFP
is available.
8)Permits DHCS to seek federal reimbursement for its initial
costs in developing and implementing the expansion of
eligibility provided for in this bill.
9)States legislative intent regarding the purpose of this bill.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Increased annual costs of at least $1 million (50% General
Fund) if 200 individuals with CHBV become eligible for
Medi-Cal pursuant to this bill. This estimate reflects
information about CHBV infection rates, family and size, and
take-up rates when public program coverage is offered to new
beneficiaries. Unknown likely minor federal support to the
AB 158
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extent DHCS is able to collect administrative costs pursuant
to recent amendments.
2)Unknown offsetting savings to the extent newly eligible or
current enrollees elect Medi-Cal managed care, which is only
available in certain counties. This bill requires DHCS to meet
federal revenue neutrality requirements through savings
generated by voluntary enrollment of CHBV beneficiaries into
Medi-Cal Managed Care from existing fee-for-service or when
beneficiaries newly enroll.
3)The Medi-Cal benefit created by this bill, as well as the
revenue neutrality provision is modeled on AB 2197 (Koretz),
Chapter 687, Statutes of 2002. AB 2197 requires Medi-Cal
eligibility to be extended to HIV-positive individuals who are
not disabled by the infection, but who would qualify for
benefits once disabled. AB 2197 has not been funded or
implemented and is now the subject of litigation brought by
the AIDS Healthcare Foundation, one of the country's largest
providers of HIV/AIDS medical care.
COMMENTS : According to the author, this bill is necessary to
help individuals with CHBV receive necessary care before they
become disabled, because early disease management and treatment
are the keys to saving lives and saving limited health care
dollars. By expanding Medi-Cal eligibility to nondisabled
individuals with CHBV, the state avoids the high costs of
treating advanced liver disease, including the expense of liver
transplantation.
Analysis Prepared by : John Gilman / HEALTH / (916) 319-2097
FN: 0003889