BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                  AB 1783|
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                                    CONSENT


          Bill No:  AB 1783
          Author:   Hayashi (D)
          Amended:  6/14/10 in Assembly
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  8-0, 6/16/10
          AYES:  Alquist, Strickland, Aanestad, Cedillo, Leno,  
            Negrete McLeod, Pavley, Romero
          NO VOTE RECORDED:  Cox

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8
           
          ASSEMBLY FLOOR  :  74-0, 4/22/10 (Consent) - See last page  
            for vote


           SUBJECT  :    Licensed dentist:  change of location form

           SOURCE  :     California Dental Association 


           DIGEST  :    This bill permits a dentist licensed by the  
          Dental Board of  California, practicing in an individual  
          dental practice, who is enrolled and in good standing in  
          the Medi-Cal program, and who is changing locations of that  
          individual dental practice within the same county, to be  
          eligible to continue enrollment at the new location by  
          filing a change of location form to be developed by the  
          Department of Health Care Services (DHCS), requires that  
          the form developed by DHCS complies with all minimum  
          federal requirements related to Medicaid provider  
          enrollment, and defines individual dental practice for the  
                                                           CONTINUED





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          purposes of this bill.

           ANALYSIS  :    

          Existing law: 

          1. Establishes the Medi-Cal Program, administered by the  
             Department of Health Care Services (DHCS), which  
             provides comprehensive health benefits to low-income  
             children, their parents or caretaker relatives, pregnant  
             women, elderly, blind or disabled persons, nursing home  
             residents, and refugees who meet specified eligibility  
             criteria. 

          2. Requires new Medi-Cal provider applicants, applicants  
             for continued provider participation, and providers  
             moving to a new address to submit a complete application  
             package to DHCS. 

          3. Provides an exemption from #2 above for a Medi-Cal  
             physician provider in good standing in the Medi-Cal  
             program who changes locations within the same county by  
             allowing the provider to continue enrollment at the new  
             location by filing a change of location form. 

          4. Requires DHCS, within 180 days of receiving an  
             application package, or from the date of notice to an  
             applicant that the applicant does not qualify as a  
             preferred provider to give written notice to the  
             applicant that any of the following applies, or on the  
             181st day grant the applicant provisional provider  
             status for a period no longer than 12 months, effective  
             from the 181st day: 

             A.    The applicant is being granted provisional  
                provider status for a period of 12 months, effective  
                from the date on the notice.

             B.    The application package is incomplete. Requires  
                the notice to identify any additional information or  
                documentation that is needed to complete the  
                application package.

             C.    DHCS is exercising its authority as specified to  







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                conduct background checks, preenrollment inspections,  
                or unannounced visits.
              
             D.    The application package is denied for other  
                specified reasons. 

          5. Reduces the time period in #4 above to 90 days for an  
             individual physician who files a change of location  
             form. 

          This bill:

          1. Permits a dentist licensed by the Dental Board of  
             California practicing in a dental practice and who is  
             enrolled in good standing in the Medi-Cal Program to  
             continue enrollment at the new location by filing a  
             change of location form to be developed by DHCS.   
             Requires the form to comply with all minimum federal  
             requirements related to Medicaid provider enrollment. 

          2. Requires DHCS, within 15 days after receiving the change  
             of location form, to provide notice that the form has  
             been received. 

          3. Reduces the time, from 180 days to 90 days, DHCS has to  
             notify a dentist who files a change of location form:   
             if the provider is granted provisional provider status;  
             if the application package is incomplete; if DHCS is  
             conducting additional background investigation; or if  
             the application is being denied for specified reasons. 

          4. Applies these provisions to a dentist practicing as an  
             individual dentist practice, and defines "individual  
             dentist practice" as a dentist licensed by the Dental  
             Board of California enrolled or enrolling in Medi-Cal as  
             an individual provider who is a sole proprietor of  
             his/her practice or is a corporation owned solely by the  
             individual dentist and the only dentist practitioner is  
             the owner.

           Background  

          In 2003, the Senate Select Committee on Government  
          Oversight, conducted hearings on Medi-Cal Fraud and over  







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          utilization.  The Committee received testimony that the  
          vast majority of monetary losses from health care fraud are  
          due to provider fraud, rather than beneficiary fraud.  The  
          2003 May Revision to the Governor's budget included a major  
          DHCS (previously the Department of Health Services)  
          proposal that addressed these issues such as new staff and  
          a number of statutory changes.  SB 857 (Speier), Chapter  
          601, Statutes of 2003, included the statutory changes such  
          as provisional provider status intended to more easily  
          remove problem providers from the Medi-Cal Program, and  
          timelines for DHCS to respond to applications and for  
          providers to answer any questions raised by DHCS.  Until  
          the implementation of AB 1107 (Cedillo), Chapter 146,  
          Statutes of 1999, DHCS issued Medi-Cal provider numbers to  
          essentially any provider requesting one.  As proposed in  
          the Governor's 2000, May Revision, AB 1107 authorizes DHCS,  
          upon reliable evidence of fraud or willful  
          misrepresentation by a provider, to collect any  
          overpayments identified through an audit or examination  
          from any provider or withhold payment for any goods or  
          services owing to the provider.  AB 1107 also provides for  
          disenrollment, in accordance with specified limitations,  
          for providers and prohibited enrollment for provider  
          applicants found to have committed fraud or abuse.  As a  
          result there were approximately 70,000 Medi-Cal providers  
          for whom a systematic review had never been conducted.  In  
          2000, DHCS began reenrolling providers.  These efforts to  
          reduce provider fraud have resulted in more cumbersome  
          enrollment and reenrollment procedures. 

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

           SUPPORT  :   (Verified  6/28/10)

          California Dental Association (source)
          California Society of Pediatric Dentistry 


           ARGUMENTS IN SUPPORT  :    The bill's sponsor, the California  
          Dental Association, states that when a dentist who is  
          participating as a provider within Denti-Cal changes the  
          location of their practice they must fill out and submit an  
          entire provider application form, rather than simply notify  







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          DHCS of change of address.  The sponsor goes on to argue  
          that for an existing provider, the information on the form  
          is redundant and irrelevant in regard to the need to inform  
          the department of an address change.  In support, the  
          California Society of Pediatric Dentistry adds that when  
          the change is within the same county, the dentist has the  
          ability, and usually the intent, to provide a continuum of  
          service to existing patients.  Any interruption in  
          Denti-Cal enrollment that occurs as the result of the new  
          enrollment application process can disrupt the existing  
          treatment plans, suspend or delay needed services and, if  
          prolonged, disturb or even sever the dentist-patient  
          relationship. 


           ASSEMBLY FLOOR  : 
          AYES:  Adams, Ammiano, Anderson, Arambula, Bass, Beall,  
            Bill Berryhill, Tom Berryhill, Blakeslee, Block,  
            Bradford, Brownley, Buchanan, Charles Calderon, Carter,  
            Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,  
            DeVore, Emmerson, Eng, Evans, Feuer, Fletcher, Fong,  
            Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick,  
            Gilmore, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill,  
            Jeffries, Jones, Knight, Lieu, Logue, Bonnie Lowenthal,  
            Ma, Mendoza, Miller, Monning, Nava, Nestande, Niello,  
            Nielsen, V. Manuel Perez, Portantino, Ruskin, Salas,  
            Saldana, Silva, Skinner, Smyth, Solorio, Audra  
            Strickland, Swanson, Torlakson, Torres, Torrico, Tran,  
            Villines, Yamada, John A. Perez
          NO VOTE RECORDED:  Blumenfield, Caballero, Huber, Huffman,  
            Norby, Vacancy


          CTW:mw  6/29/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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