BILL NUMBER: SB 1236	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Alquist

                        FEBRUARY 19, 2010

   An act to add and repeal Section 14133.55 of the Welfare and
Institutions Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1236, as introduced, Alquist. Medi-Cal: utilization controls.
   Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which basic health
care services are provided to qualified low-income persons. The
Medi-Cal program is, in part, governed and funded by federal Medicaid
provisions.
   Existing law establishes a program in Alameda County in which
utilization controls shall not be required when, pursuant to federal
law under the Medicare Program, a county hospital based utilization
review committee has been established to determine the level of
authorization for payment under Medi-Cal and a utilization plan has
been filed with the department and approved by it.
   This bill would establish a program, whereby state utilization
controls shall not be required for inpatient hospitalization at
designated public hospitals, as defined, in Santa Clara County. The
bill would require the nonfederal share of expenditures for inpatient
hospitalization at designated public hospitals in Santa Clara County
submitted to the federal Centers for Medicare and Medicaid Services
for purposes of claiming federal financial participation to be
comprised of only those funds that are paid by Santa Clara County and
certified by the county in accordance with applicable state and
federal requirements.
   This bill would provide that the above-described provisions shall
become inoperative on the date the Director of Health Care Services
executes a declaration specifying that the nonfederal share of
expenditures for inpatient hospitalization at designated public
hospitals in Santa Clara County used for purposes of claiming federal
financial participation is not comprised of funds that are paid by
Santa Clara County and certified by the county in accordance with
applicable state and federal requirements.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 14133.55 is added to the Welfare and
Institutions Code, to read:
   14133.55.  (a) There shall be established a program whereby state
utilization controls shall not be required for inpatient
hospitalization at designated public hospitals, as defined in
subdivision (d) of Section 14166.1, in Santa Clara County.
   (b) The nonfederal share of expenditures for inpatient
hospitalization at designated public hospitals in Santa Clara County
submitted to the federal Centers for Medicare and Medicaid Services
for purposes of claiming federal financial participation shall be
comprised of only those funds that are paid by Santa Clara County and
certified by the county in accordance with applicable state and
federal requirements.
   (c) This section shall become inoperative on the date the Director
of Health Care Services executes a declaration specifying that the
nonfederal share of expenditures for inpatient hospitalization at
designated public hospitals in Santa Clara County used for purposes
of claiming federal financial participation is not comprised of funds
that are paid by Santa Clara County and certified by the county in
accordance with applicable state and federal requirements, and as of
that date is repealed.
   (d) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department shall implement this section by means of policy letters or
similar instructions, without taking further regulatory action.