BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           1142 (Price)
          
          Hearing Date:  8/24/2009        Amended: 8/17/2009
          Consultant: Katie Johnson       Policy Vote: Health 8-3
          _________________________________________________________________ 
          ____
          BILL SUMMARY:  AB 1142 would place responsibility of providing  
          all information regarding a patient's Medi-Cal eligibility to  
          all hospital-based providers on the hospital treating the  
          patient. The bill would impose a fine not to exceed three times  
          the amount a provider could otherwise have obtained had he or  
          she billed the Medi-Cal program on a provider who attempts to  
          seek payment from or fails to cease collection efforts against a  
          patient the provider knows to be a Medi-Cal beneficiary. The  
          bill would also require a provider or a collection agency to  
          cease collection efforts against a patient if he or she provides  
          proof of Medi-Cal eligibility.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2009-10      2010-11       2011-12     Fund
                                                                  
          DHCS administration      minor and absorbable          General/*
          to fine violators                                      Federal

          Potential costs to CA hospitals unknown, potentially in the  
          hundreds      Local
          to increase staff capacity      of thousands per health facility

          *50% General Fund, 50% Federal Fund
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: 
          
          Existing law establishes the Medi-Cal program, California's  
          version of the federal Medicaid program, which provides health  
          care services to eligible low-income Californians, including the  
          aged, blind, disabled, children, and pregnant women. The  
          Department of Health Care Services (DHCS) administers Medi-Cal.  
          Existing law makes it the responsibility of a Medi-Cal  
          beneficiary to provide evidence of Medi-Cal eligibility to his  










          or her health care provider if that information is requested.  
          Existing law also states that it is the responsibility of a  
          provider to make a good faith effort to verify a person  
          presenting a Medi-Cal card's identity.

          This bill would require a hospital to assume the responsibility  
          of providing a Medi-Cal beneficiary's information to all  
          hospital-based providers, including anesthesiologists,  
          radiologists, pathologists, and emergency room physicians,  
          ambulance transportation services providers, and providers that  
          provide ambulance transportation services through the "911"  
          system, among others, once the hospital receives proof of a  
          person's Medi-Cal eligibility. In current practice, hospitals  
          provide this information upon the request of any hospital-based  
          provider. Additionally, hospital-based providers have access to  
          patient Medi-Cal information through the Medi-Cal Eligibility  
          Data System (MEDS).

          Page 2
          AB 1142 (Price)

          This bill would provide that a provider of health care services  
          who obtains proof of an individual's Medi-Cal eligibility and  
          who subsequently attempts to seek payment for the cost of  
          covered services from or fails to cease collection efforts  
          against the individual may be subject to a fine not to exceed  
          three times the amount the provider could otherwise have  
          obtained had the provider billed Medi-Cal.

          This bill would provide that if a Medi-Cal provider receives  
          proof of a patient's Medi-Cal eligibility and that provider has  
          referred an unpaid bill to a debt collector, the provider must  
          cease collection efforts against the patient by a debt collector  
          and notify the patient.

          This bill would provide that if a patient provides proof of  
          Medi-Cal eligibility to a collection agency or debt collector,  
          and the debt collector fails to notify the provider of this  
          proof, the provider would not be responsible for ensuring the  
          cessation of collection efforts until the provider is provided  
          with proof of a patient's Medi-Cal eligibility.

          Existing law prohibits a person from furnishing information on a  
          specific transaction to any consumer credit reporting agency if  
          the person knows that the information is incomplete or  
          inaccurate.











          This bill would deem a provider or debt collector in violation  
          of existing law if, after more than 30 days of receiving proof  
          of a person's Medi-Cal coverage, he or she 1) furnishes  
          information regarding the rendering of the Medi-Cal covered  
          services to a consumer credit reporting agency, and 2) fails to  
          notify a consumer credit reporting agency of corrections to  
          information previously furnished by that provider or debt  
          collector.

          Any administrative impact on DHCS to assess and collect fines  
          would be minor and absorbable. Due to the high rate of treatment  
          of Medi-Cal beneficiaries at some of the California's 400  
          hospitals, this bill could necessitate the hiring of additional  
          staff at an estimated cost in the hundreds of thousands of  
          dollars and could place cost pressure on the state's health  
          system.