BILL ANALYSIS Ó
AB 1869
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Date of Hearing: April 18, 2012
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 1869 (John A. Pérez) - As Introduced: February 22, 2012
Policy Committee: HealthVote:19-0
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill adds federal veterans' health benefits to a list of
public health care coverage programs about which the Office of
Patient Advocate (OPA) must provide information and assistance.
FISCAL EFFECT
1)This bill is not likely to result in additional workload or
increase state costs. It simply adds specificity to a
requirement in current law that OPA provide information on a
variety of public health care programs.
2)Potential cost savings related to this bill are uncertain, but
are likely negligible. Based on OPA's broad mandate to provide
a variety of information to individuals about health care
coverage programs, it seems likely that information about VA
benefits would be provided to individuals potentially eligible
for such benefits even in absence of this bill.
In addition, there is another mechanism available to more
directly and systematically identify individuals enrolled in
Medi-Cal who are eligible for VA benefits. In 2009, the
Department of Health Care Services (DHCS) implemented a pilot
program that uses an automated matching system called Public
Assistance Reporting Information System (PARIS) to identify
veterans accessing Medi-Cal benefits, for purposes of
enrolling them into VA benefits. A 2007 LAO report estimates
that expanding PARIS matching statewide could result in
significant cost savings in the range of $250 million GF, by
shifting enrollment of an estimated 144,000 veterans from
Medi-Cal to VA benefits. DHCS indicates that at this time, a
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report evaluating the PARIS pilot program is in its final
stages of review.
COMMENTS
1)Rationale . According to the author, the statute governing the
duties of the OPA does not specifically mention providing
information regarding the United States Department of Veterans
Affairs (VA) health care benefits. While it can be assumed
the OPA would try to include information on these benefits for
veterans, it is not currently a requirement. The author also
asserts the state could realize significant cost savings by
shifting enrollment of veterans from Medi-Cal to the VA, since
veterans can access full health benefits through the VA with
no cost to the state.
2)Office of the Patient Advocate . Since its creation in 2000,
the OPA within the Department of Managed Health Care (DMHC)
has provided consumer education and outreach, public reporting
on health plan quality measures, and related services on
behalf of individuals enrolled in health plans regulated by
DMHC. However, many Californians are enrolled in health plans
regulated by government agencies other than DMHC, such as the
California Department of Insurance or the federal Department
of Labor. In order to provide consumers more comprehensive
assistance with health plan questions and grievances in light
of large-scale changes in the health insurance marketplace, AB
922 (Monning), Chapter 552, Statutes of 2011 broadened OPA's
mandate by making OPA a stand-alone office within the
California Health and Human Services Agency (CHHSA) effective
July 1, 2012, and by requiring OPA to essentially develop a
"one-stop shop" health plan consumer assistance portal.
Pursuant to AB 922, OPA will now assist all health plan
consumers in navigating public and private health care
coverage issues, regardless of whether or through what type of
plan individuals are covered. AB 922 specifically required the
OPA to provide information and assistance on a variety of
public programs, including Medi-Cal, Healthy Families, and
Medicare.
3)Related Legislation .
a) AB 2315 (Monning), also pending in the Assembly Health
Committee, would make a technical clean up in Government
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Code sections related to Senate confirmation of a
governor's appointee to OPA, consistent with AB 922
(Monning), Chapter 552, Statutes of 2011.
b) AB 1223 (Committee on Veterans Affairs, 2011) requires
the Department of Health Care Services (DHCS) to use the
federal Public Assistance and Reporting Information System
(PARIS) to identify veterans and their dependents or
survivors who are enrolled in the Medi-Cal Program, and
assist them in obtaining federal veterans' health care
benefits. It also deletes the previous authorization for a
similar two-year pilot project. AB 1223 is currently
pending in the Senate Committee on Veteran's Affairs.
4)Previous Legislation . AB 922 transferred the DMHC from the
Business, Transportation and Housing Agency to the CHHSA,
transferred the OPA from DMHC to CHHSA effective July 1, 2012
and required OPA to assist all health insurance consumers
navigate public and private health care coverage issues.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081