BILL ANALYSIS
AB 1985
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1985 (Galgiani)
As Amended July 15, 2010
Majority vote
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|ASSEMBLY: |52-22|(June 1, 2010) |SENATE: |34-0 |(August 19, |
| | | | | |2010) |
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Original Committee Reference: HEALTH
SUMMARY : 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. The bill would authorize CDCR to adopt
policies and procedures for 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 (APA).
The Senate amendments :
1)Delete the provisions of this bill related to durable medical
equipment (DME).
2)Makes specified legislative findings and declarations
regarding contractors providing specified medical care to CDCR
inmates.
3)Require CDCR to do all of the following by January 1, 2011:
a) Adopt industry standard claim forms for use by contract
health care service providers;
b) Be able to accept secure electronic submission of claims
from contract health care service providers;
c) Perform periodic audits of claims paid to contract
health care providers; and,
AB 1985
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d) Provide secure, remote electronic access to claim status
information to those contract health care service providers
submitting claims electronically in the manner required by
the department.
4)Authorizes CDCR to adopt policies and procedures for the
purpose of 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 APA.
AS PASSED BY THE ASSEMBLY , this bill permitted CDCR to use
Medi-Cal's methodology for determining maximum allowable
reimbursement rates for DME, if approved by the federal receiver
or when CDCR is no longer under the authority of the federal
receiver. Exempted the provisions of this bill from APA.
FISCAL EFFECT : 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
endsGeneral
APA exemption Potentially significant future state
savingsGeneral
COMMENTS : The Federal Receiver has already directed staff to
begin the activities specified in this bill, and they are in
process under his authority (and in the absence of statute).
When the receivership ends, the bill will serve to continue
these policies, which have already been demonstrated to achieve
ongoing cost avoidance. Additionally, this bill would permit
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 APA. This exemption would allow CDCR, after
the federal receivership has ended, to make changes to these
AB 1985
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policies without going through a lengthier APA process.
Presumably, this would allow the department to respond more
quickly to changing circumstances and achieve greater
efficiencies.
Analysis Prepared by : Martin Radosevich / HEALTH / (916)
319-2097
FN: 0005584