BILL NUMBER: SB 145	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  SEPTEMBER 10, 2015
	AMENDED IN ASSEMBLY  AUGUST 31, 2015
	AMENDED IN SENATE  MAY 5, 2015
	AMENDED IN SENATE  APRIL 23, 2015

INTRODUCED BY   Senator Pan

                        JANUARY 27, 2015

   An act to add  and repeal  Section 100235  to
  of  the Health and Safety Code, relating to
health care.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 145, as amended, Pan. Robert F. Kennedy Farm Workers Medical
Plan.
    Existing state law requires, for the 2015-16 fiscal year, the
State Department of Health Care Services to provide a grant to a
health benefit plan that is funded by contributions from agricultural
employers, as specified, upon an appropriation of funds for this
purpose. Under existing federal law, the Robert F. Kennedy Farm
Workers Medical Plan is a nonprofit voluntary employees beneficiary
association that provides payments for health care and other benefits
to its members.
   This bill would  require   require, until
January 1, 2021,  the department to annually reimburse the
Robert F. Kennedy Farm Workers Medical Plan up to $3,000,000 per year
for claim payments that exceed $70,000 made by the plan on behalf of
an eligible employee or dependent for a single episode of care on or
after September 1, 2016. The bill would require the department to
make the reimbursement payment within 60 days after it receives
specified claims data from the plan.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) The Robert F. Kennedy Farm Workers Medical Plan is a joint
labor-management health plan for farm workers organized under Section
302(c)(5) of the federal Labor Management Relations Act of 1947.
   (b) This plan has been in existence for more than 45 years and has
provided vital health services to farm workers and their families,
enabling them to lead healthier lives, make better use of their
available income, and achieve self-sufficiency.
   (c) The plan has focused on primary and preventive care and has
significantly alleviated the burden on publicly funded health
resources in the plan's coverage areas.
   (d) The plan has saved the state significant sums of money that
would have otherwise been expended to provide health care.
   (e) The Legislature has determined that the plan is  the
most   an  efficient and  least expensive
  cost-effective  means to deliver health care
services to farm workers and their families within the plan's
coverage areas. Thus, it is in the state's interest to 
expand   maintain  the range of health care
services provided by the plan without threatening the plan's
financial viability.
  SEC. 2.  Section 100235 is added to the Health and Safety Code, to
read:
   100235.  (a) The department shall annually reimburse the Robert F.
Kennedy Farm Workers Medical Plan for claim payments that exceed
seventy thousand dollars ($70,000) made by the plan on behalf of an
eligible employee or dependent for a single episode of care on or
after September 1, 2016. This reimbursement shall not exceed three
million dollars ($3,000,000) per year.
   (b) To seek reimbursement, commencing after September 1, 2017, and
annually thereafter, the plan shall submit to the department
completed data, verified by an independent certified public
accountant, for claims paid by the plan for services during the
preceding year from September 1 to August 31, inclusive.
   (c) (1) If the department receives claims data from the plan
pursuant to subdivision (b), the department shall analyze that data
to determine the aggregate amount of claims that exceed seventy
thousand dollars ($70,000) paid by the plan on behalf of an eligible
employee or dependent for any  separate   singl
  e  episode of care.
   (2) No later than 60 days after the department receives claims
data submitted by the plan, the department shall reimburse the plan
the amount determined pursuant to paragraph (1), up to the amount of
three million dollars ($3,000,000) per year. 
   (d) This section shall remain in effect only until January 1,
2021, and as of that date is repealed, unless a later enacted statute
that is enacted before January 1, 2021, deletes or extends that
date.