BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de Le�n, Chair


          AB 1868 (Gomez) - Medi-Cal: optional benefits: podiatric  
          medicine.
          
          Amended: June 10, 2014          Policy Vote: Health 8-0
          Urgency: No                     Mandate: No
          Hearing Date: August 4, 2014                            
          Consultant: Brendan McCarthy    
          
          This bill meets the criteria for referral to the Suspense File.
          
          
          Bill Summary: AB 1868 would reinstate podiatric benefits to the  
          Medi-Cal program when the services are provided by a podiatrist  
          and the service is currently covered by Medi-Cal as a physician  
          service.

          Fiscal Impact: 
              Estimated annual costs of about $2 million per year to  
              provide coverage for services provided by podiatrists in the  
              Medi-Cal program (General Fund and federal funds). Medi-Cal  
              currently covers some podiatric services if they are billed  
              as physician services. However, by authorizing those  
              services to be provided by podiatrists, the bill will  
              increase the number of providers of those services and  
              therefore increase utilization of those services.

          Background: Under state and federal law, the Department of  
          Health Care Services operates the Medi-Cal program, which  
          provides health care coverage to pregnant women, children and  
          their parents with low incomes, as well as blind, disabled, and  
          certain other populations. Generally, the federal government  
          provides a 50 percent federal match for expenditures. Pursuant  
          to the federal Affordable Care Act, California has opted to  
          expand eligibility for Medi-Cal up to 138 percent of the federal  
          poverty level and to include childless adults.  The Affordable  
          Care Act provides a significantly enhanced federal match for the  
          Medi-Cal expansion. Under the law, the federal government will  
          pay for 100 percent of the cost of the Medi-Cal expansion in  
          2013-14, declining to a 90 percent federal match in the 2020  
          federal fiscal year and thereafter.

          Federal law requires states to provide coverage for certain  








          AB 1868 (Gomez)
          Page 1


          services in their Medicaid programs (Medi-Cal in California),  
          such as inpatient hospital services, physician services, and  
          others. Federal law allows, but does not require, states to  
          cover other, optional services, such as prescription drugs,  
          podiatry services, dental services and others. As part of the  
          2009 Budget Act, several optional Medi-Cal services were  
          generally eliminated from the program, including podiatric  
          services. However, certain services that are considered  
          podiatric services can still be provided by physicians, as long  
          as they are billed to Medi-Cal as physician services.

          Proposed Law: AB 1868 would reinstate podiatric benefits to the  
          Medi-Cal program when the services are provided by a podiatrist  
          acting within his or her scope of practice and the service is  
          currently covered by Medi-Cal as a physician service.

          Related Legislation: AB 82 (Committee on Budget, Statutes of  
          2013) reinstated adult dental benefits in the Medi-Cal program.