BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                   SB 208|
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                                 THIRD READING


          Bill No:  SB 208
          Author:   Steinberg (D), et al
          Amended:  As introduced
          Vote:     27 - Urgency

           
           SENATE HEALTH COMMITTEE  :  11-0, 4/22/09
          AYES:  Alquist, Strickland, Aanestad, Cedillo, Cox,  
            DeSaulnier, Leno, Maldonado, Negrete McLeod, Pavley, Wolk

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8 


           SUBJECT  :    Medi-Cal:  demonstration project waiver

           SOURCE  :     Author


           DIGEST  :    This bill directs the Department of Health Care  
          Services (DHCS) to develop a Medicaid waiver for the states  
          Medi-Cal program and submit the waiver for federal approval  
          by September 1, 2010.

           ANALYSIS  :    Existing federal law establishes the Medicaid  
          program to provide comprehensive health benefits to  
          low-income persons.  Existing law establishes the federal  
          Medicaid Disproportionate Share Hospital program to provide  
          financial assistance to hospitals that serve large numbers  
          of Medicaid and uninsured patients.  Existing law also  
          provides that states may be granted waivers of federal law  
          to implement their Medicaid programs.

          Existing state law establishes the Medi-Cal program, the  
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          state's Medicaid program, administered by 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.  Existing law creates a hospital  
          demonstration project to implement a five-year federal  
          Medicaid waiver for support of public hospitals that serve  
          uninsured patients and patients whose health care services  
          are covered by Medi-Cal (California's Medicaid program).   
          Existing law also creates the Safety Net Care Pool as the  
          federal funds available under the demonstration project to  
          ensure continued government support for the provision of  
          health care services to uninsured populations.  Existing  
          law defines a designated public hospital to be one of  
          twenty-two hospitals specifically named in the statute  
          implementing the federal waiver.

          Existing law requires counties to provide medical services  
          for the medically indigent. 

          This bill:

          1.Requires DHCS to submit an application to the federal  
            Centers for Medicare and Medicaid Services (CMS) for a  
            waiver to implement a demonstration project that does the  
            following: strengthen California's health care safety  
            net, maximize opportunities to expand coverage to the  
            eligible but uninsured populations, optimize  
            opportunities to increase federal financial  
            participation, promotes effective use of state and local  
            funds and improves health outcomes.  

          2.Requires DHCS to consult with interested stakeholders and  
            the Legislature in developing the waiver application.

          3.Requires DHCS to submit the waiver application to CMS by  
            a date that ensures its approval by September 1, 2010.

          4.States that the demonstration project be implemented only  
            upon enactment of subsequent authorizing legislation  
            after CMS approval is obtained.

           Background
           







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          Since 1982, California has had a federal waiver to  
          establish a selective provider contracting program.  Under  
          this program, the California Medical Assistance Commission  
          negotiates daily rates for general acute care hospital  
          inpatient services on behalf of Medi-Cal.  By choosing the  
          hospitals that serves large numbers of Medi-Cal patients,  
          and bargaining with them for the best rates, the state has  
          been generally able to negotiate lower rates for hospital  
          services than if it simply allowed all hospitals to serve  
          Medi-Cal patients and bill the state for services.  Prior  
          to the inception of the program, California hospitals  
          served the Medi-Cal population under a cost-based  
          reimbursement system.  

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

          CTW:nl  5/5/09   Senate Floor Analyses 

                       SUPPORT/OPPOSITION:  NONE RECEIVED

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