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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