BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                  SB 1019|
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                              UNFINISHED BUSINESS


          Bill No:  SB 1019
          Author:   Senate Budget and Fiscal Review Committee
          Amended:  8/23/12
          Vote:     21 - Urgency

           
          PRIOR VOTES NOT RELEVANT

           ASSEMBLY FLOOR  :  Not available


           SUBJECT  :    Budget Trailer Bill

           SOURCE  :     Author


           DIGEST  :    This bill makes technical statutory revisions 
          affecting health programs necessary to implement the Budget 
          Act of 2012.  

           Assembly Amendments  delete the Senate version of the bill, 
          which expressed legislative intent relative to the Budget 
          Act of 2012, and instead add the current language.

           ANALYSIS  :    Under existing law, the Department of Health 
          Care Services is authorized and required to perform various 
          functions relating to the care and treatment of persons 
          with mental disorders.  Under existing law, services for 
          these individuals may be provided in psychiatric hospitals 
          or other types of facilities, as well as in community 
          settings.  Under existing law, psychiatric health 
          facilities are licensed and regulated by the State 
          Department of Social Services.  Existing law provides for 
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          state hospitals for the care, treatment, and education of 
          mentally disordered persons, which are under the 
          jurisdiction of the State Department of State Hospitals.

          Existing law creates the Healthy Families Program, 
          administered by the Managed Risk Medical Insurance Board 
          (MRMIB), to arrange for the provision of health, vision, 
          and dental benefits to eligible children pursuant to the 
          federal Children's Health Insurance Program.  Existing law 
          also provides for the Medi-Cal program, which is 
          administered by the State Department of Health Care 
          Services, under which basic health care services are 
          provided to qualified low-income persons.  The Medi-Cal 
          program is, in part, governed and funded by federal 
          Medicaid provisions.

          Existing law provides for the transition of specified 
          enrollees of the Healthy Families Program to the Medi-Cal 
          program, to the extent that those individuals are otherwise 
          eligible, no sooner than January 1, 2013.  Existing law 
          requires this transition to take place in 4 phases, as 
          prescribed.  Existing law requires the Department of Health 
          Care Services to exercise the option to provide full-scope 
          benefits with no share of cost to children who have 
          attained 6 years of age but have not attained 19 years of 
          age and who are optional targeted low-income children, as 
          specified.

          Existing law requires, to the extent required by federal 
          law, and beginning January 1, 2013, through and including 
          December 31, 2014, that payments for primary care services 
          provided by specified physicians be no less than 100% of 
          the payment rate that applies to those services and 
          physicians as established by the Medicare Program, for both 
          fee-for-service and managed care plans.

          Existing law requires the State Department of Health Care 
          Services to ensure and improve the care coordination and 
          integration of health care services for Medi-Cal 
          beneficiaries residing in counties participating in the 
          demonstration project.

          Existing law requires the department to enter into an 
          interagency agreement with the Department of Managed Health 

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          Care to conduct financial audits, medical surveys, and a 
          review of the provider networks of the managed care plans 
          participating in a certain demonstration project and 
          provide consumer assistance to beneficiaries affected by 
          certain provisions.

          Existing law authorizes, to the extent consistent with 
          federal law, the State Department of Health Care Services 
          to defer payments to Medi-Cal managed care health plans and 
          providers, as applicable, contracting with the department, 
          as specified, which are payable to the plans during the 
          final month of the 2012-13 state fiscal year, if certain 
          conditions are satisfied.

          This bill:

           1. Makes technical corrections and clarifications to the 
             duals demonstration project that was adopted through SB 
             1008 (Senate Budget and Fiscal Review Committee), 
             Chapter 33, Statutes of 2012. 

           2. 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. 

           3. 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.

           4. Makes technical corrections to the eligibility language 
             for various hospital supplemental funds, as contained in 
             AB 1467 (Budget Committee), Chapter 23, Statutes of 

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             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.

           5. 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.

           6. 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. 

           7. 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.


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           8. 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.

           9. Changes references to the Department of Mental Health 
             (DMH) to the appropriate state departments, as DMH was 
             eliminated in the Budget Act of 2012. 

           10.Contains an appropriation allowing this bill take 
             effect immediately upon enactment.

           FISCAL EFFECT  :    Appropriation:  Yes   Fiscal Com.:  Yes   
          Local:  No


          DLW:JJA:d  8/29/12   Senate Floor Analyses 

                       SUPPORT/OPPOSITION:  NONE RECEIVED

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