BILL ANALYSIS
AB 2352
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 2352 (John A. Perez)
As Amended July 15, 2010
Majority vote
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|ASSEMBLY: |62-12|(June 1, 2010) |SENATE: |31-4 |(August 24, |
| | | | | |2010) |
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Original Committee Reference: HEALTH
SUMMARY : Requires Medi-Cal beneficiaries to remain eligible to
receive Medi-Cal coverage for anti-rejection medication for up
to two years following an organ transplant unless during that
time the beneficiary becomes eligible for Medicare or private
health insurance that would cover the medication.
The Senate amendments authorize the Department of Health Care
Services (DHCS) to implement, by means of all-county letters,
provider bulletins, or similar instructions, without taking any
further regulatory action.
AS PASSED BY THE ASSEMBLY , this bill was substantially similar
to the bill as passed by the Senate.
FISCAL EFFECT : According to the Senate Appropriations
Committee:
Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
Medication costs $190
$400$400General
COMMENTS : According to the author, there are currently some
patients that qualify for Medi-Cal under a federal rule allowing
coverage for patients with end-stage renal disease (on
dialysis). Those patients, if they are able to receive a kidney
and have an organ transplant, will only receive coverage for
their immunosuppressive medication for one year post-transplant
as the person's Medi-Cal eligibility ends when he or she no
longer meets the eligibility requirement of end-stage renal
disease.
AB 2352
Page 2
Patients in this particular group may not be eligible for
Medi-Cal under any other eligibility criteria, and they may also
be ineligible for Medicare, either because they have not paid
into Social Security for a sufficient time or because of their
immigration status. The author states that if these patients
were dual-eligible for Medicare and Medi-Cal, Medicare would pay
for immunosuppressive coverage for an additional two years, so
the patient would have immunosuppressive drugs for a total of
three years post-transplant. Because patients who have had a
kidney transplant must have immunosuppressive drugs or their
body will naturally reject the organ, they have a medical need
for the anti-rejection medication to prevent kidney failure,
being placed back on dialysis or, in a worst-case scenario,
death. The author argues the state has already paid for the
organ transplant surgery (the cost of transplant surgery is
$50,000 to $100,000 according to the author) and it makes no
sense to drop Medi-Cal coverage for these patients after only a
year when many organ transplant patients are not yet stable or
ready to enter the workforce.
The Patient Protection and Affordable Care Act (Public Law
111-148), among other provisions, requires states, as of January
2014 to include all adults with income up to 133% of the Federal
Poverty Level (FPL) in its Medicaid Program and provides
enhanced federal matching assistance funds. States have the
option to begin providing medical assistance to individuals
eligible under this new group as of April 1, 2010. Transplant
patients who have income under 133% of FPL will have full-scope
Medi-Cal once this is implemented.
Analysis Prepared by : Marjorie Swartz / HEALTH / (916)
319-2097
FN: 0006009