BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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                                 THIRD READING


          Bill No:  AB 1985
          Author:   Galgiani (D)
          Amended:  7/15/10 in Senate
          Vote:     21

           
           SENATE PUBLIC SAFETY COMMITTEE  :  5-0, 6/29/10
          AYES:  Leno, Cedillo, Huff, Steinberg, Wright
          NO VOTE RECORDED:  Cogdill, Hancock

           SENATE APPROPRIATIONS COMMITTEE  :  10-0, 8/2/10
          AYES:  Kehoe, Alquist, Ashburn, Corbett, Emmerson, Leno,  
            Price, Wolk, Wyland, Yee
          NO VOTE RECORDED:  Walters
           
          ASSEMBLY FLOOR  :  52-22, 6/1/10 - See last page for vote


           SUBJECT  :    Corrections: contract health care providers

           SOURCE  :     California Prison Health Care Services (Federal  
          Receiver)


           DIGEST  :    This bill requires the Department of Corrections  
          and Rehabilitation (CDCR), by January 1, 2011, to adopt  
          industry standard claim forms for use by contract health  
          care providers, to be able to accept electronic submissions  
          of claims from contract health care providers, to perform  
          periodic audits of claims paid to contract health care  
          providers, and to provide remote electronic access to claim  
          status information to contract health care providers.  This  
          bill authorizes CDCR to adopt policies and procedures for  
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          enabling electronic health care claims management and  
          processing, and would exempt the adoption, amendment, and  
          repeal of policies and procedures for this limited purpose  
          from the rulemaking provisions of the Administrative  
          Procedures Act. 

           ANALYSIS  :    Current law establishes the following durable  
          medical goods (DME) reimbursement rules for Medi-Cal:

          1. Requires the Department of Health Care Services (DHCS)  
             to establish a list of covered services and maximum  
             allowable reimbursement rates for DME, as defined, and  
             requires the list to specify utilization controls to be  
             applied to each type of DME.

          2. Requires reimbursement for DME, except wheelchairs and  
             speech-generating devices to be the lesser of:

             A.    The amount billed pursuant to DHCS regulations.

             B.    An amount that does not exceed 80 percent Medicare  
                allowance.

             C.    Or, the guaranteed negotiated acquisition cost by  
                means of exclusive or nonexclusive contracts on a bid  
                plus a specified percentage markup.

          3. Requires reimbursement for wheelchairs and  
             speech-generating devices and their related accessories  
             to be the lesser of:

             A.    The amount billed pursuant to DHCS regulations.

             B.    An amount that does not exceed 100 percent of  
                Medicare allowance.

             C.    Or, the guaranteed negotiated acquisition cost by  
                means of exclusive or nonexclusive contracts on a bid  
                plus a specified percentage markup. 

          4. Requires reimbursement for all DME utilizing codes with  
             no specified maximum allowable rate to be the lesser of:

             A.    The amount billed pursuant to DHCS regulations.







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             B.    The guaranteed negotiated acquisition cost  
                negotiated by means of exclusive or nonexclusive  
                contracts on a bid plus a specified percentage  
                markup.

             C.    The actual acquisition cost plus a markup  
                established by DHCS.

             D.    A specified percentage of the manufacturer's  
                suggested retail purchase price on June 1, 2006, as  
                specified, not to exceed 15 percent for wheelchairs  
                and wheelchair accessories if the provider employs or  
                contracts with a qualified rehabilitation  
                professional.

             E.    Or, a price established through targeted  
                product-specific cost containment provisions  
                developed with providers.

          5. Requires reimbursement for all DME supplies and  
             accessories billed to the Medi-Cal Program to be the  
             lesser of the amount billed pursuant to pursuant to DHCS  
             regulations or the acquisition cost plus a 23 percent  
             markup.  (Section 14105.48 of the Welfare and  
             Institutions Code)
           
           This bill requires CDCR, by January 1, 2011, to do the  
          following: 

          1. Adopt industry standard claims forms for use by contract  
             healthcare service providers. 

          2. Be able to accept secure electronic submission of claims  
             from contract healthcare service providers.

          3. Perform periodic audits of claims paid to contract  
             healthcare providers.

          4. Provide secure, remote electronic access to claim status  
             information to those contract healthcare service  
             providers submitting claims electronically in the manner  
             required by the department.








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          This bill permits CDCR to adopt policies and procedures for  
          the purpose of enabling electronic healthcare claims  
          management and processing and would exempt the adoption,  
          amendment, or repeal of policies and procedures for this  
          limited purpose from the rulemaking provisions of the  
          Administrative Procedure Act, as specified.

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

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions       2010-11    2011-12     2012-13         Fund  

          Codifies existing practice              No new state costs  
          resulting from this bill                General
                               New state savings after receivership  
          ends                 General 

          Administrative Procedures     Potentially significant  
          future state savings          General
            Act exemption

           SUPPORT  :   (Verified  8/3/10)

          California Prison Health Care Services (Federal Receiver)  
          (source)


           ARGUMENTS IN SUPPORT  :    According to the author, "The  
          Department of Corrections and Rehabilitation's medical care  
          system is in a current state of crisis, as evidenced by the  
          fact it was placed in a federal receivership.  Any way the  
          state of California can assist the Receiver in finding ways  
          to cut state costs in the prison medical care system is a  
          plus."


           ASSEMBLY FLOOR  :
          AYES:  Ammiano, Arambula, Bass, Beall, Block, Blumenfield,  
            Bradford, Brownley, Buchanan, Caballero, Charles  
            Calderon, Carter, Chesbro, Conway, Coto, Davis, De La  







                                                               AB 1985
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            Torre, De Leon, Eng, Evans, Feuer, Fong, Fuentes, Fuller,  
            Furutani, Galgiani, Gilmore, Hall, Hayashi, Hernandez,  
            Hill, Huffman, Jones, Lieu, Bonnie Lowenthal, Ma,  
            Mendoza, Monning, Nava, V. Manuel Perez, Portantino,  
            Ruskin, Salas, Saldana, Skinner, Solorio, Swanson,  
            Torlakson, Torres, Torrico, Yamada, John A. Perez
          NOES:  Adams, Anderson, Blakeslee, DeVore, Emmerson,  
            Gaines, Garrick, Hagman, Harkey, Huber, Jeffries, Knight,  
            Logue, Miller, Nestande, Niello, Nielsen, Norby, Silva,  
            Smyth, Tran, Villines
          NO VOTE RECORDED:  Bill Berryhill, Tom Berryhill, Cook,  
            Fletcher, Audra Strickland, Vacancy


          RJG:mw  8/4/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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