BILL NUMBER: SB 296	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Cannella

                        FEBRUARY 23, 2015

   An act to add Section 14727 to the Welfare and Institutions Code,
relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 296, as introduced, Cannella. Medi-Cal: specialty mental health
services: documentation requirements.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services,
including specialty mental health services. The Medi-Cal program is,
in part, governed and funded by federal Medicaid Program provisions.
In order to facilitate the receipt of medically necessary specialty
mental health services by a foster child who is placed outside of his
or her county of original jurisdiction, existing law requires the
department to create a standardized set of documentation standards
and forms.
   This bill would require the department, in consultation with
specified stakeholders, to develop a single set of service
documentation requirements for the provision of specialty mental
health services by March 31, 2016, for use commencing July 1, 2016,
and would require the department to update the documentation
requirements no less than every 2 years. The bill would generally
prohibit counties from requiring additional documentation
requirements for Medi-Cal specialty mental health services that go
beyond the documentation requirements developed by the department.
   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) Counties and private providers that contract for service
delivery estimate that over 40 cents out of every dollar spent on
Medi-Cal mental health services goes to paperwork to document that
the services meet federal billing standards and to avoid potential
state audit disallowances.
   (b) A national expert reviewed what counties in California were
requiring of providers and noted that it took 20 minutes of
documentation to prepare progress notes for a single session of
psychotherapy, as compared to an estimated five minutes in other
states.
   (c) State guidelines on billing are not significantly different
from the requirements of other states, however, counties have added
other documentation requirements based on the fear that
interpretations of the guidelines during audits may result in some
services being disallowed if the additional documentation is not
included.
   (d) In order to eliminate this pattern, it is necessary for the
State Department of Health Care Services to develop a single set of
documentation requirements, in consultation with counties and
providers, that limits audit disallowances to circumstances clearly
spelled out in the requirements.
  SEC. 2.  Section 14727 is added to the Welfare and Institutions
Code, immediately following Section 14726, to read:
   14727.  (a) The State Department of Health Care Services shall
consult with counties, providers, national experts, other states, and
other stakeholders to develop a single set of service documentation
requirements for the provision of specialty mental health services.
   (b) The documentation requirements developed pursuant to this
section shall do all of the following:
   (1) Minimize time and paperwork required of counties and
providers, consistent with federal standards and practices of other
states.
   (2) Eliminate duplicative or outdated requirements.
   (3) Reflect outcome reporting requirements developed pursuant to
the performance outcome system for Early and Periodic Screening,
Diagnosis, and Treatment mental health services developed pursuant to
Section 14707.5.
   (c) The documentation requirements shall be completed by March 31,
2016, for use commencing on July 1, 2016, and shall thereafter be
updated no less than every two years through a stakeholder process,
unless changes in the state Medi-Cal plan or other federal rules
require that the requirements be updated more often.
   (d) After adoption of the standard requirements by the department,
a county may not require additional documentation for Medi-Cal
specialty mental health services that go beyond these requirements
unless necessary for funding from other funding sources that are also
used to pay for the services.