BILL NUMBER: AB 2608 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MARCH 29, 2012
INTRODUCED BY Assembly Member Bonilla
FEBRUARY 24, 2012
An act to amend Section 10721 14115.8
of the Welfare and Institutions Code, relating to
health care Medi-Cal .
LEGISLATIVE COUNSEL'S DIGEST
AB 2608, as amended, Bonilla. State Department of Health
Care Services: administration. Medi-Cal: local
educational agency billing option.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services and
under which qualified low-income persons receive health care
benefits. Existing law requires the Director of Health Care
Services to administer various programs relating to the delivery of
health care services and medical assistance, including the Medi-Cal
program. The Medi-Cal program is, in part, governed
and funded by federal Medicaid Program provisions. Existing law
provides that specified services provided by local educational
agencies (LEAs) are covered Medi-Cal benefits, and requires the
department to perform various activities with respect to the billing
option for services provided by LEAs. Existing law
establishes the Local Educational Agency Medi-Cal Recovery Fund,
which consists of proportionately reduced federal Medicaid funds
allocable to LEAs, to be used, upon appropriation by the Legislature,
only to support the department, until January 1, 2013, to meet the
requirements relating to the LEA billing option, the annual amount of
which may not exceed $1,500,000. Existing law requires, as of
January 1, 2013, that all moneys in the fund be returned
proportionally to all LEAs whose federal Medicaid funds were used to
create the fund.
This bill would make technical, nonsubstantive changes to that
provision.
This bill would delete the repeal of these provisions and would
require the department to amend the Medicaid state plan and
regulatory requirements pertaining to the provision of medical
transportation services by LEAs to be no more restrictive than
federal requirements. This bill would provide that the payments
allocable to LEAs that are reduced pursuant to these provisions shall
be reduced no more than as specified and would require that the
department provide an accounting of funds collected as a result of
those reductions in its annual report submitted to the Legislature.
It would also require the department to collaborate with the State
Department of Education to help ensure LEA compliance with state and
federal Medicaid requirements.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14115.8 of the
Welfare and Institutions Code is amended to read:
14115.8. (a) (1) The department shall amend the Medicaid state
plan with respect to the billing option for services by local
educational agencies (LEAs) , to ensure that schools shall
be reimbursed for all eligible services that they provide that are
not precluded by federal requirements.
(2) The department shall examine methodologies for increasing
school participation in the Medi-Cal billing option for
local educational agencies LEAs so that schools
can meet the health care needs of their students.
(3) The department, to the extent possible shall simplify claiming
processes for local educational agency LEA
billing.
(4) The department shall eliminate and modify state plan and
regulatory requirements that exceed federal requirements when they
are unnecessary.
(5) The department shall amend the Medicaid state plan and
regulatory requirements pertaining to the provision of medical
transportation services by LEAs to be no more restrictive than
federal requirements in order to allow LEAs to seek reimbursement for
school transportation services that are not precluded by federal
requirements.
(b) If a rate study for the LEA Medi-Cal billing option is
completed pursuant to Section 52 of Chapter 171 of the Statutes of
2001, the department, in consultation with the entities named in
subdivision (c), shall implement the recommendations from the study,
to the extent feasible and appropriate.
(c) In order to assist the department in formulating the state
plan amendments required by subdivisions (a) and (b), the department
shall regularly consult with the State Department of Education,
representatives of urban, rural, large and small school districts,
and county offices of education, the local education consortium, and
local educational agencies. It is the intent of the Legislature that
the department also consult with staff from Region IX of the federal
Centers for Medicare and Medicaid Services, experts from the fields
of both health and education, and state legislative staff.
(d) Notwithstanding any other provision of law,
or any other contrary state requirement, the department shall take
whatever action is necessary to ensure that, to the extent there is
capacity in its certified match, a local educational agency
an LEA shall be reimbursed retroactively for the
maximum period allowed by the federal government for any department
change that results in an increase in reimbursement to local
educational agency providers.
(e) The department may undertake all necessary activities to
recoup matching funds from the federal government for reimbursable
services that have already been provided in the state's public
schools. The department shall prepare and take whatever action is
necessary to implement all regulations, policies, state plan
amendments, and other requirements necessary to achieve this purpose.
(f) The department shall file an annual report with the
Legislature that shall include at least all of the following:
(1) A copy of the annual comparison required by subdivision (i).
(2) A state-by-state comparison of school-based Medicaid total and
per eligible child claims and federal revenues. The comparison shall
include a review of the most recent two years for which completed
data is available.
(3) A summary of department activities and an explanation of how
each activity contributed toward narrowing the gap between California'
s per eligible student federal fund recovery and the per student
recovery of the top three states.
(4) A listing of all school-based services, activities, and
providers approved for reimbursement by the federal Centers for
Medicare and Medicaid Services in other state plans that are not yet
approved for reimbursement in California's state plan and the service
unit rates approved for reimbursement.
(5) The official recommendations made to the department by the
entities named in subdivision (c) and the action taken by the
department regarding each recommendation.
(6) A one-year timetable for state plan amendments and other
actions necessary to obtain reimbursement for those items listed in
paragraph (4).
(7) Identify Identification of any
barriers to local educational agency reimbursement, including those
specified by the entities named in subdivision (c), that are not
imposed by federal requirements, and describe
a description of the actions that have been, and will be,
taken to eliminate them.
(8) An accounting of funds collected from federal Medicaid
payments allocable to LEAs pursuant to subdivision (g). The report
shall detail amounts withheld from federal Medicaid payments to each
participating LEA for the year.
(g) (1) These activities shall be funded and staffed by
proportionately reducing federal Medicaid payments allocable to
local educational agencies LEAs for the
provision of benefits funded by the federal Medicaid program under
the billing option for services by local educational
agencies LEAs specified in this section. Moneys
collected as a result of the reduction in federal Medicaid payments
allocable to local educational agencies LEAs
shall be deposited into the Local Educational Agency Medi-Cal
Recovery Fund, which is hereby established in the Special Deposit
Fund established pursuant to Section 16370 of the Government Code.
These funds shall be used, upon appropriation by the Legislature,
only to support the department to meet all the requirements of this
section. As of January 1, 2013, unless the Legislature
enacts a new statute or extends the repeal date in subdivision (j)
If at any time this section is repealed , it
is the intent of the Legislature that all funds in the Local
Educational Agency Medi-Cal Recovery Fund shall be
returned proportionally to all local educational agencies
LEAs whose federal Medicaid funds were used to
create this fund. The
(A) Federal Medicaid payments allocable to LEAs under this section
shall be reduced by no more than 1 percent for the purpose of
funding administrative and processing services costs related to the
management of the LEA Medi-Cal Billing Option Program.
(B) In addition to the amounts
described in subparagraph (A), federal Medicaid payments allocable to
LEAs under this section shall be reduced for the purpose
of supporting the department to meet all of the requirements of this
section. The annual amount funded pursuant to this
subparagraph shall not exceed one million five hundred thousand
dollars ($1,500,000).
(2) Funding received pursuant to paragraph (1) shall derive only
from federal Medicaid funds that exceed the baseline amount of local
educational agency Medicaid billing option revenues for the 2000-01
fiscal year.
(C) In addition to the amounts described in subparagraphs (A) and
(B), federal Medicaid payments allocable to LEAs under this section
shall be reduced by no more than 1 percent for the purpose of funding
the work and related administrative costs associated with audit
requirements to ensure the fiscal accountability of the Medi-Cal
billing option for LEAs and to comply with the Medicaid state plan.
The annual amount funded pursuant to this subparagraph shall not
exceed six hundred fifty thousand dollars ($650,000).
(2) Moneys collected under paragraph (1) shall be proportionately
reduced from federal Medicaid payments to all participating LEAs so
that no one LEA loses a disproportionate share of its federal
Medicaid payments.
(h) (1) The department may enter into a sole source contract to
comply with the requirements of this section.
(2) The level of additional staff to comply with the requirements
of this section, including, but not limited to, staff for which the
department has contracted for pursuant to paragraph (1), shall be
limited to that level that can be funded with revenues derived
pursuant to subdivision (g).
(i) The activities of the department shall include all of the
following:
(1) An annual comparison of the school-based Medicaid systems in
comparable states.
(2) Efforts to improve communications with the federal government,
the State Department of Education, and local educational agencies.
(3) The development and updating of written guidelines to local
educational agencies regarding best practices to avoid audit
exceptions, as needed.
(4) The establishment and maintenance of a local educational
agency user-friendly, interactive Internet Web site.
(j) This section shall remain in effect only until January 1,
2013, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2013, deletes or extends
that date.
(5) Collaboration with the State Department of Education to help
ensure LEA compliance with state and federal Medicaid requirement and
to help improve LEA participation in the Medi-Cal billing option for
LEAs.
SECTION 1. Section 10721 of the Welfare and
Institutions Code is amended to read:
10721. The director shall administer Chapter 7 (commencing with
Section 14000) and Chapter 8 (commencing with Section 14200) of Part
3 and any other law pertaining to the administration of health care
services and medical assistance. He or she shall perform other duties
as may be prescribed by law and shall observe and report to the
Secretary of California Health and Human Services and the Governor on
the condition of health care services and medical assistance
throughout the state.