BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           152 (Cox)
          
          Hearing Date:  04/27/09         Amended: 04/14/09
          Consultant:  Dan Troy           Policy Vote: Health 11-0
          _________________________________________________________________ 
          ____
          BILL SUMMARY:   SB 152 would, commencing March 1, 2010, require  
          the Department of Mental Health to send a reimbursement claim to  
          the State Controller within 90 days after the receipt of a  
          mental health service claim from county contractors, with  
          specified exceptions.  The bill would further provide that  
          interest would accrue on the claim beginning on the 91st day  
          after submission, to be paid in equal parts from the budgets of  
          DMH, the Department of Health Care Services, and the California  
          Health and Human Services.
          _________________________________________________________________ 
          ___
                            Fiscal Impact (in thousands)

           Major Provisions         2009-10      2010-11       2011-12     Fund
                                                                  
          Interest Payments                           Unknown, depending  
          on number and    General
                                           extent of future late  
          reimbursements, if any   
                        
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: This bill may meet the criteria for referral to  
          the Suspense File.
          
          DMH provides mental health services to Medi-Cal beneficiaries  
          through contracts with local counties and other agencies.   
          Current law requiring reimbursement of claims within 45 days of  
          receipt does not apply to the Medi-Cal program.  As of March 1,  
          2010, this bill would establish a 90-day repayment requirement  
          and apply interest at the daily Pooled Money Investment Account  
          rate for payments not meeting that timeframe.  The bill also  
          requires DMH to request the Director of Finance to include  
          amounts necessary to satisfy claims in a request for a  
          deficiency appropriation should sufficient funding be  
          unavailable.  Interest would not accrue in the event of  










          insufficient fund availability.  The bill exempts claims from  
          the 90-day requirement that are in the dispute resolution  
          process or that have been returned to the claiming entity for  
          additional information or necessary changes.

          In 2007, the Department of Finance's Office of State Audits and  
          Evaluations (OSAE) released a report on the fiscal processes DMH  
          uses in the payment of local assistance claims.  The report  
          confirmed that payments were no being made in a timely manner.   
          Problems identified in the report included ineffective and  
          decentralized program governance between DMH and the Department  
          of Health Care Services and information systems that are  
          defective and outdated. 

          Among the steps DMH has undertaken to address the OSAE report is  
          the development of a new claims system, which will begin being  
          utilized in July of 2009 and will be fully in place by February  
          of 2010.  Under this new system, claims are expected to be paid 
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          SB 152 (Cox)

          within 30 days, adjustments will be automated, and data will be  
          standardized for reporting purposes.  

          DMH processes approximately 1.5 million claims per month  
          totaling about $1 billion, annually.  Imposing payment of  
          interest on late reimbursements could result in significant  
          General Fund costs.  DMH reports that a total of $3.5 million in  
          interest would have been owed had this bill been in effect  
          during the 2006-07 fiscal year.  However, it may be that the new  
          systems scheduled to be fully in effect just prior to the  
          operational date of this bill will result in an end to late  
          payments.  

          Similar legislation, SB 1349 (Cox), was held in submission by  
          the Assembly Appropriations Committee.