BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                          SB 136 (Yee)
          
          Hearing Date: 5/16/2011         Amended: 4/28/2011
          Consultant: Katie Johnson       Policy Vote: Health 6-2
          _________________________________________________________________
          ____
          BILL SUMMARY: SB 136 would extend the sunset date from January 
          1, 2013, to January 1, 2018, on provisions permitting the use of 
          store-and-forward technology for teledermatology and 
          teleophthalmology services. 
          _________________________________________________________________
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2011-12      2012-13       2013-14     Fund
           
          Increased Medi-Cal     unknown, potentially significant 
          General/*
          services                                                Federal
          *Medi-Cal costs reimbursed with 50 percent General Fund, 50 
          percent federal funds.
          _________________________________________________________________
          ____

          STAFF COMMENTS: This bill may meet the criteria for referral to 
          the Suspense File.
          
          Since July 1, 2006, existing law has not required face-to-face 
          contact between a health care provider of teledermatology and 
          teleophthalmology services by store-and-forward technology and a 
          patient. These provisions sunset January 1, 2013. This bill 
          would extend the sunset from January 1, 2013, to January 1, 
          2018. 

          It is unclear whether or not the extension of this program would 
          decrease barriers to teledermatology and teleophthalmology 
          services; in February 2009, the Department of Health Care 
          Services (DHCS) submitted a report to the Legislature entitled, 
          "Medi-Cal Telemedicine Benefits: Store and Forward 
          Teleophthalmology and Teledermatology," in response to statutory 
          reporting requirements of the 2006 implementing legislation. 
          This bill would delete the reporting requirement since it is no 
          longer necessary.








          SB 136 (Yee)
          Page 1



          According to the report, since July 1, 2006, only one provider 
          has submitted claims under the store-and-forward billing code. 
          He submitted 30 claims for teledermatology services over the 
          period July 1, 2006, through November 19, 2007, at a total cost 
          of $1,786. DHCS notes that it is possible that other providers 
          are using store-and-forward technology, but that since the 
          reimbursement rates are identical, they could have failed to use 
          the billing code modifier that denotes the use of 
          store-and-forward. 

          Therefore, it is unknown whether or not providers in California 
          utilize this statutory authority. Since current data is 
          insufficient to recommend to the Legislature whether or not this 
          program increases access to these services and this bill deletes 
          the now obsolete 2008 reporting requirement, staff recommends 
          that the bill be amended to: 
             1)   Include a requirement that DHCS report to the 
               appropriate policy and fiscal committees of the Legislature 
               no later than January 1, 2015, and again no later than 
               January 1, 2017, the following:
                  a.        the number and dollar amount of claims billed 
                    under this program for all years it has been active 
                    (prior to and including this bill up to January 1, 
                    2017), and, 
                  b.        the number and dollar amount of all 
                    ophthalmology and dermatology claims for all years 
                    that this telemedicine program has been active, as 
                    well as the number and dollar amount of all 
                    ophthalmology and dermatology claims for 3 years prior 
                    to the authorization of store-and-forward; and,

             2)   Require DHCS to specify that providers billing for 
               store-and-forward teledermatology and teleophthalmology 
               services must use the appropriate billing code in the next 
               available general provider bulletin after the effective 
               date of this bill.

          Any costs related to these reporting requirements and an 
          addendum to a regularly scheduled provider bulletin would be 
          minor and absorbable.











          SB 136 (Yee)
          Page 2