BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 1869
                                                                  Page  1

          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 








                                                                  AB 1869
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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