BILL ANALYSIS
AB 998
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Date of Hearing: May 6, 2009
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Kevin De Leon, Chair
AB 998 (John A. Perez) - As Introduced: February 27, 2009
Policy Committee: Health Vote:14-1
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill establishes a state-only program to ensure
dialysis-only Medi-Cal beneficiaries remain eligible for
anti-rejection medication following a kidney transplant for up
to three years, unless the beneficiary becomes eligible for
Medicare or private health insurance that covers the medication.
FISCAL EFFECT
1)Annual costs of $700,000 (100% GF) to provide post-transplant
anti-rejection medication to Medi-Cal beneficiaries who had
formerly been on dialysis-only Medi-Cal and who would either
return to that program or require a new kidney transplant.
This estimate assumes beneficiaries would only require two of
the three years of the post-transplant medication support.
Under current law, Medi-Cal pays during the first year after
transplantation due to a continued disability status. As a
patient recovers, this disability status is lost and the
patient loses payment for the medications. Actual costs may be
lower to the extent that individuals benefiting from this bill
need to be in specific eligibility circumstances: (a)
initially dialysis-only Medi-Cal, (b) in need of a kidney
transplant, (c) be matched and receive a kidney transplant,
and (d) have no other payer (private health insurance or
Medicare) available to support post-transplantation
medications. This estimate reflects the small number of people
who may meet these requirements. Under current law, only 80
beneficiaries per month are enrolled in dialysis-only
Medi-Cal.
2)Reduced Medi-Cal costs to the extent this bill reduces the
need for a return to dialysis-only Medi-cal or a new
transplant. An additional transplant or continuation of
dialysis-only treatment costs between $50,000 and $100,000 per
year.
AB 998
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COMMENTS
Rationale . This bill creates continuity of treatment for
patients who are initially on a specific dialysis-only Medi-Cal
program which serves beneficiaries with chronic kidney disease
and who require dialysis. Dialysis is a substitute for the
normal functioning of the kidneys. It filters waste products
from the blood. Following a kidney transplant, these patients no
longer require dialysis and are no longer deemed disabled for
the purposes of their very narrow Medi-Cal coverage. If a
patient has no Medi-Cal, private insurance, or Medicare
coverage, they are at risk for organ failure, a return to
dialysis, death, or a new transplant. The author indicates a
significant investment has already been made via the transplant
and patients should be afforded continuity of care at a much
lower costs than alternatives.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081