BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1457
                                                                  Page  1

          Date of Hearing:   August 6, 2014

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                    SB 1457 (Evans) - As Amended:  June 30, 2014 

          Policy Committee:                             HealthVote:17-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill requires treatment authorization requests (TARs) in  
          the Medi-Cal, California Children's Services (CCS), and  
          Genetically Handicapped Person's Program (GHPP) to be submitted  
          in an electronic format.  This bill also:

          1)Requires implementation by July 1, 2016, or a subsequent date  
            determined by the Department of Health Care Services (DHCS). 

          2)Requires DHCS to consult with stakeholders and address  
            challenges of independent sole practitioners, small  
            independent provider-owned clinics, and rural providers in  
            complying, as specified. 

          FISCAL EFFECT  

          1)One-time costs to DHCS of less than $100,000 to develop and  
            adopt policies and regulations (25% GF/75% federal).  The  
            Department indicates that the existing contract with their  
            fiscal intermediary requires it to be able to process  
            additional electronic submissions and provide any training or  
            customer service needed by health care providers during the  
            transition to electronic requests, so no additional  
            administrative or information technology costs are expected.

          2)Unknown, likely significant ongoing cost savings by reducing  
            administrative workload to process paper requests for  
            treatment authorizations in Medi-Cal (GF/federal).  
           
          COMMENTS  

           Purpose  . According to the author, streamlining the current  








                                                                  SB 1457
                                                                  Page  2

          approval processes to an electronic submission system would  
          ensure that Medi-Cal patients receive necessary treatment and  
          services in a timely manner by reducing the risk of processing  
          errors, unauthorized disclosure of confidential health  
          information and a potential backlog of paperwork.  The author  
          states that the majority of pharmacy and medical TARs are  
          already submitted electronically to DHCS through a secure  
          internet system.  One uniform submission process would allow  
          DHCS to increase efficiency, reduce administrative costs and  
          align procedures to the direction received from the federal  
          government. The bill is sponsored by DHCS and has no opposition.

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081