BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 367
                                                                  Page  1

          Date of Hearing:   May 13, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                AB 367 (Galgiani) - As Introduced:  February 24, 2009 

          Policy Committee:                              Health  Vote:  
          17-0         

          Urgency:     Yes                  State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill deletes a current law cap on a $2 billion (50% GF)  
          continuous appropriation of the Medi-Cal Providers Interim  
          Payment Fund (MPIF) established by AB 561 (Scott), Chapter 993,  
          Statutes of 1998. The MPIF funds are available to Medi-Cal  
          providers in the absence of an enacted state budget. 

          This bill also deletes the current law authority of the  
          California Department of Health Care Services (DHCS) to impose a  
          one-month cash delay on Medi-Cal provider payments. 

           FISCAL EFFECT  

          1)An annual increased continuous appropriation of Medi-Cal funds  
            of more than $2 billion (50% GF). Recent versions of bills  
            addressing the MPIF have proposed doubling the current cap to  
            add another $2 billion (50% GF) to the fund. AB 367, which  
            deletes the MPIF cap, could have an ever greater fiscal  
            impact, depending on the length of the budget delay and the  
            payment needs of providers during the delay. 
           
          2)Potential GF revenue losses of more than $2 million from  
            forgone Pooled Money Investment Account (PMIA) interest  
            earnings. This estimate assumes a five percent annual yield on  
            PMIA investments and disbursement of an additional $500  
            million during a month long budget delay. 

          3)This bill eliminates DHCS authority established in the 2009-10  
            budget act to delay one month of payments to Medi-Cal  
            institutional providers and managed care plans during any  
            month prior to June 2009. According to estimates, a delay of  








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            $440 million GF was planned to reduce California's cash needs  
            prior to the receipt of April tax revenues.  However, the  
            delay did not occur because cash receipts improved enough to  
            reduce the scope of the delay. 

          4)This bill and its urgency clause would have minimal impact on  
            the budget year. Due to recent budget actions, California  
            enacted a state budget for 2009-10. In addition, and due to  
            the federal American Recovery and Reinvestment Act (ARRA),  
            many Medi-Cal providers will be held harmless with respect to  
            non-payment, late payment, or cash deferrals due to ARRA  
            prompt pay requirements and related to California's enhanced  
            Federal Medical Assistance Percentage (FMAP). California, due  
            to enhanced FMAP, is currently enjoying a 12% federal funding  
            participation (FFP) increase in addition to the customary 50%  
            FFP until December 2010. 

           COMMENTS  

           1)Purpose  . This bill is sponsored by the California Association  
            of Health Facilities (CAHF). CAHF represents long-term care  
            providers such as skilled nursing facilities (SNFs) and  
            intermediate care facilities (ICFs) who receive Medi-Cal  
            payments for the care of elderly and disabled patients. This  
            bill increases the amount of emergency funding available to a  
            range of Medi-Cal providers during months when the state  
            budget passage is delayed. This bill has been proposed to  
            address the financial predicament of Medi-Cal providers in the  
            days and months following the failure of a budget being signed  
            by the start of the fiscal year. 

            According to the author and sponsor, many CAHF member  
            facilities are still recovering from the lack of Medi-Cal  
            payments during the unprecedented 2008 budget impasse and are  
            unable to cope with another cash flow interruption. CAHF  
            indicates member facilities have few reserves and are unable  
            to secure short-term loans in the current tight credit market.  
            This bill provides a more robust statutory emergency fund to  
            address the funding predicament of providers. 

           2)Medi-Cal Payments in the Absence of a State Budget  . Federal  
            laws and regulations require certain providers to be paid in  
            the event of a late state budget, including most  
            non-institutional providers such as physicians, optometrists,  
            physician groups, occupational therapists, physical  








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            therapists, podiatrists, pharmacies, and psychologists.   
            Providers who draw on the MPIF include SNFs, inpatient and  
            outpatient community hospitals, clinics, and federally  
            qualified health center, adult day health centers, blood  
            banks, clinical labs, optical labs, home health agencies, and  
            managed care plan.

          Data for the 30 years since 1977-78 indicate the state budget  
            has passed prior to July 1st, 30% of the time. For the four  
            most recent years, the continuous appropriation addressed by  
            this bill has had remaining MPIF balances (all funds) of $886  
            million, $1.2 billion, $1.4 billion and $2 billion,  
            respectively, by the time the budget has passed. Such  
            significant balances indicate the proposed removal of the  
            current cap on the $2 billion appropriation may not be  
            justified. 

           3)Related Legislation  . Numerous legislative efforts to establish  
            or expand continuous appropriations in Medi-Cal have been  
            pursued in recent years. Most recently, AB 308 (Galgiani) in  
            2008 and AB 237 (Strickland) in 2007 addressed MPIF. AB 308  
            was never heard in Assembly Health Committee and AB 237 was  
            held on the Suspense File of this committee. 

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