BILL ANALYSIS
AB 175
Page 1
Date of Hearing: May 13, 2009
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Kevin De Leon, Chair
AB 175 (Galgiani) - As Amendeed: April 21, 2009
Policy Committee: Health Vote:
19-0
Business & Professions 10-0
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill increases the use of Medi-Cal telemedicine services
for the diagnosis and treatment of diabetic retinopathy, which
leads to blindness. Specifically, this bill adds optometrists to
the providers authorized to use teleopthalmology (digital
retinal screening) and teledermatology (telemedicine for skin
care) store and forward technology which allows providers to
review medical information at a later time and away from the
patient.
FISCAL EFFECT
1)Major savings of $2,500 (GF) per digital retinal screening to
Medi-Cal and other publicly funded health and human services
programs. $1.3 million (GF) will accrue if 500 screenings
prevent blindness. According to data, there are approximately
110,000 Medi-Cal patients who may benefit from increased
screening pursuant to this bill. Savings will be greater to
the extent more screening for diabetic retinopathy reduces
visual impairments, blindness, and associated dependence on
public benefits.
2)This estimate is based on preliminary research which relies on
a combination of caseload, clinical, cost, and modeling
information to identify significant per screening savings due
AB 175
Page 2
to reduced Medi-Cal, Social Security Program (SSP), In-Home
Supportive Services (IHSS), and California Food Assistance
Program (CFAP) benefits. According to the modeling
information, reductions in visual impairments lead to
significant public savings by reducing disability and
dependence.
COMMENTS
Rationale . This bill is sponsored by the California Department
of Health Care Services (DHCS) to increase the use of
telemedicine in the screening of patients at risk of diabetic
blindness. Diabetic retinopathy is the leading cause of
blindness nationally, with 24,000 diabetics losing their sight
each year. This bill addresses store and forward technology, for
which Medi-Cal reimburses for a provider viewing of patient
digital retinal screening images at a later time. The visual
data provided in this manner can be particularly important in
optical and skin treatments in which the patient and provider
are unable to meet in person.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081