BILL NUMBER: AB 2002	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 17, 2012
	AMENDED IN ASSEMBLY  MARCH 29, 2012

INTRODUCED BY   Assembly Member Cedillo
   (Principal coauthor: Assembly Member Bonnie Lowenthal)

                        FEBRUARY 23, 2012

   An act to add Section 14093.12  of   to 
the Welfare and Institutions Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2002, as amended, Cedillo. Medi-Cal: managed care plan
assignment: safety net provider.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. One of the methods by which these
services are provided is pursuant to contracts with various types of
managed care plans. Existing law requires, with certain exceptions,
that under certain models of Medi-Cal managed care, a Medi-Cal
beneficiary be assigned to, and enrolled in, an appropriate health
care plan providing services within the area in which the beneficiary
resides if the beneficiary does not make a choice of managed care
plans. Existing regulations define  the term  safety net
provider for the purposes of the 2-plan model of Medi-Cal managed
care.
   This bill, for the purposes of assigning an eligible Medi-Cal
beneficiary to a managed care plan when the beneficiary fails to
select a plan, would provide that the term safety net provider
includes specified types of clinics and medical care providers.
   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 14093.12 is added to the Welfare and
Institutions Code, to read:
   14093.12.  For the purposes of assigning an eligible Medi-Cal
beneficiary to a managed care plan when the beneficiary fails to
select a plan, "safety net provider" shall include any of the
following:
   (a) A federally qualified health center.
   (b) A federally designated rural health clinic.
   (c) A nonprofit community or free clinic that is licensed pursuant
to subdivision (a) of Section 1204 of the Health and Safety Code.
   (d) A satellite or intermittent site of a nonprofit community or
free clinic licensed pursuant to subdivision (a) of Section 1204 of
the Health and Safety Code.
   (e) An Indian or tribal clinic exempt from licensure pursuant to
subdivision (c) of Section 1206 of the Health and Safety Code.
   (f) A freestanding county clinic or clinic associated with a
 publicly owned  disproportionate share hospital
 , as defined in paragraph (3) of subdivision (a) of Section
14163 and as described in Section 14105.98  .
   (g) A medical group, independent practice association, physician
office, or clinic with more than 10 physicians that has a Medi-Cal or
medically indigent encounter rate of at least 50 percent of total
patients served in a calendar year, based on claims or encounter
data.
   (h) A medical practice of 10 or fewer physicians in which at least
30 percent of patients served in a calendar year are enrolled in
Medi-Cal.