AB 1805, as amended, Skinner. Medi-Cal: reimbursement: provider payments.
Existing law establishes the Medi-Cal program, 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 Program provisions. Existing law requires, except as otherwise provided, Medi-Cal provider payments to be reduced by 1% or 5%, and provider payments for specified non-Medi-Cal programs to be reduced by 1%, for dates of service on and after March 1, 2009, and until June 1, 2011. Existing law requires, except as otherwise provided, Medi-Cal provider payments and payments for specified non-Medi-Cal programs to be reduced by 10% for dates of service on and after June 1, 2011.
This bill would, instead, prohibit the application of those reductions for payments to providers for dates of service on or after June 1, 2011.begin insert The bill would also require payments for managed care health plans for dates of service following the effective date of the bill to be determined without application of some of those reductions.end insert The bill would require the Director of Health Care Services to implement this provision to the maximum extent permitted by federal law and for the maximum time period for which the director obtains federal approval for federal financial participation for those payments.
This bill would declare that it is to take effect immediately as an urgency statute.
Vote: 2⁄3. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 14105.194 is added to the Welfare and
2Institutions Code, to read:
(a) Notwithstanding Sections 14105.07, 14105.191,
414105.192, and 14105.193, payments to providers for dates of
5service on or after June 1, 2011, shall be determined without
6application of the reductions in Sections 14105.07, 14105.191,
714105.192, and 14105.193, except as otherwise provided in this
8section.
9(b) Notwithstanding Sections 14105.07 and 14105.192, and
10except as otherwise provided in this section, for managed care
11health plans that contract with the department pursuant to this
12chapter or Chapter 8 (commencing with Section 14200), payments
13for dates of service following the effective date of the act adding
14this section
shall be determined without application of the
15reductions, limitations, and adjustments in Sections 14105.07 and
1614105.192.
17(b)
end delete
18begin insert(c)end insert The director shall implementbegin delete subdivision (a)end deletebegin insert this sectionend insert to
19the maximum extent permitted by federal law and for the maximum
20time period for which the director obtains federal approval for
21federal financial participation for the payments provided for in
22this section.
P3 1(c)
end delete
2begin insert(d)end insert The director shall promptly seek all necessary federal
3approvals to implement this section.
This act is an urgency statute necessary for the
5immediate preservation of the public peace, health, or safety within
6the meaning of Article IV of the Constitution and shall go into
7immediate effect. The facts constituting the necessity are:
8In order to ensure access to medically necessary care for
9Medi-Cal beneficiaries, it is necessary that this act take effect
10immediately.
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