BILL ANALYSIS �
SB 1019
Page 1
SENATE THIRD READING
SB 1019 (Budget and Fiscal Review Committee)
As Amended August 23, 2012
Majority vote. Budget Bill Appropriation Takes Effect
Immediately
SENATE VOTE :Vote not relevant
SUMMARY : Makes technical statutory revisions affecting health
programs necessary to implement the Budget Act of 2012.
Specifically, this bill :
1)Makes technical corrections and clarifications to the duals
demonstration project that was adopted through SB 1008 (Budget
and Fiscal Review Committee), Chapter 33, Statutes of 2012.
In addition, it:
a) Requires persons enrolled in a Medi-Cal home and
community-based waiver program to be mandatorily enrolled
in Medi-Cal managed care (for medical services and
long-term supports and services). This change is
consistent with how Seniors and Persons with Disabilities,
who are enrolled in a Medi-Cal home and community-based
waiver program, are mandatorily enrolled in Medi-Cal
managed care. These individuals would still receive their
home and community-based wavier program services through
the waiver program/provider.
b) Eliminates the requirement that the Department of
Managed Health Care (DMHC) monitor health plans
participating in the duals demonstration project on a
quarterly basis to determine whether the beneficiaries are
able to receive timely access to primary and specialty care
services as federal law (42 Code of Federal Regulations
(C.F.R.) Section 422.402) preempts DMHC from performing
this activity on Medicare plans.
2)Makes technical corrections to the eligibility language for
various hospital supplemental funds , as contained in AB 1467
(Budget Committee), Chapter 23, Statutes of 2012, which
amended Welfare and Institutions Code Sections 14166.12 and
14166.17 to include the eligibility requirements for various
hospital supplemental funds. These sections should reference
the Selective Provider Contract program's statute.
SB 1019
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3)Makes technical corrections to ensure that Medi-Cal primary
care provider payment increases (as required by federal health
care reform and implemented by AB 1467) do not apply to
state-only programs. Federal health care reform requires that
specified primary care services be reimbursed at no less than
the Medicare rate from January 1, 2013, through December 31,
2014. The marginal rate increase is fully funded by the
federal government for services provided in the Medi-Cal
program. This change is necessary to clarify that no
increases will be provided in state-only programs.
4)Makes various technical corrections to the statute that
transfers the Healthy Families Program to Medi-Cal, contained
in AB 1494 (Budget Committee), Chapter 28, Statutes of 2012.
5)Exempts the Department of Health Care Services (DHCS) from
competitive bidding rules for the purposes of contracting with
the Healthy Families Program administrative vendor for
implementing and maintaining the necessary systems and
activities for providing health care coverage to optional
targeted low-income children in the Medi-Cal Program for
purposes of Accelerated Enrollment application processing by
Single Point of Entry, non-eligibility-related case
maintenance and premium collection, maintenance of the
Health-E-App web portal, call center staffing and operations,
Certified Application Assistant services, and reporting
capabilities. This bill also permits DHCS to enter into a
contract with the Health Care Options Broker of the department
for purposes of managed care enrollment activities. These
specified contracts may be initially completed on a
noncompetitive bid basis and are exempt from the Public
Contract Code. Subsequent contracts for these purposes shall
use a competitive bid basis and shall be subject to the Public
Contract Code.
6)Restores sections of AB 1467, which were inadvertently
chaptered out by subsequent bills. The chaptered out sections
relate to the rural expansion of Medi-Cal managed care and the
consideration of safety net providers when factoring managed
care plan costs in the default managed care assignment
algorithm. This bill restores the AB 1467 changes.
7)Changes references to the Department of Mental Health (DMH) to
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the appropriate state departments, as DMH was eliminated in
the Budget Act of 2012.
8)Contains an appropriation allowing this bill take effect
immediately upon enactment.
Analysis Prepared by : Andrea Margolis / BUDGET / (916)
319-2099
FN: 0005706