BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 342
                                                                  Page  1

          Date of Hearing:   May 6, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                     AB 342 (Bass) - As Amended:  April 13, 2009 

          Policy Committee:                              Health Vote:18-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill requires the California Department of Health Care  
          Services (DHCS) to establish a new Medi-Cal hospital financing  
          waiver, under Section 1115 of the federal Social Security Act.  
          This new waiver will replace hospital financing provisions  
          established by SB 1100 (Perata), Chapter 560, Statutes of 2005.  
          Specifically, this bill: 

          1)Requires DHCS to submit a waiver application to the federal  
            Centers for Medicare and Medicaid Services (CMS). Establishes  
            the requirements of the waiver to:

             a)   Strengthen California's health care safety net
             b)   Maximize opportunities to expand coverage to the  
               uninsured
             c)   Increase federal financial participation 
             d)   Promote effective use of state and local funds
             e)   Improve health outcomes 

          2)Requires DHCS to consult with the Legislature and stakeholders  
            and to submit the waiver to CMS to allow for approval by  
            September 1, 2010. 

           FISCAL EFFECT  

          Unknown staffing costs, unlikely less than $50,000 to DHCS to  
          consult with the Legislature and stakeholders, establish  
          parameters of the new waiver, and garner final CMS approval. 

           COMMENTS  

           1)Rationale  . This bill requires DHCS to submit an application to  








                                                                  AB 342
                                                                  Page  2

            CMS to renew California's hospital financing waiver  
            established by SB 1100. In the current session, SB 208  
            (Steinberg) is similar to AB 342 to allow for substantial  
            changes in hospital financing under the new waiver agreement  
            with the new federal administration. 
           
          2)Current Medi-Cal Hospital Financing Waiver  . In 2005, a  
            California waiver agreement with the federal government  
            restructured the way Medi-Cal funding is used to fund  
            inpatient hospital services. SB 1100 implemented the related  
            waiver changes to increase overall funding levels while  
            ensuring that no hospital lost funding as a result of the  
            waiver. The waiver also sought to greatly reduce the use of  
            intergovernmental transfers (IGTs), which resulted in  
            "recycling", or establishing IGTs for the purposes of reducing  
            or eliminating state or local contributions used to draw down  
            federal funding. Annual funding to approximately 100 private  
            not-for-profit hospitals participating in the waiver and  
            caring for low-income and indigent patients is approximately  
            $2 billion. Annual funding to 22 public hospitals statewide  
            under the waiver totals $2.3 billion.

           3)Federal Section 1115 Waivers  . California's current and future  
            hospital waiver will be negotiated with the federal government  
            per requirements of Section 1115 of the federal Social  
            Security Act. Section 1115 provides broad authority to  
            authorize experimental, pilot, or demonstration projects to  
            allow states to expand eligibility to individuals not  
            otherwise eligible under the Medicaid program, provide  
            services that are not typically covered, or use innovative  
            service delivery systems. Section 1115 waiver projects are  
            approved for a five-year period and must be budget neutral  
            over the life of the project. Demonstrated cost neutrality  
            means states must show the federal government no more will be  
            spent on demonstration projects than would be spent under  
            traditional programming. 

           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081