BILL NUMBER: SB 296	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  JULY 2, 2015
	AMENDED IN SENATE  APRIL 20, 2015
	AMENDED IN SENATE  APRIL 7, 2015

INTRODUCED BY   Senator Cannella

                        FEBRUARY 23, 2015

   An act to add Section  14727   14728  to
the Welfare and Institutions Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 296, as amended, 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 billing
documentation requirements for the provision of specialty mental
health services by January 1, 2017, for use commencing July 1, 2017,
and would require the department to update the billing documentation
requirements no less than every 2 years. The bill would generally
prohibit counties from requiring additional billing documentation
requirements for Medi-Cal specialty mental health services that go
beyond the billing 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   14728  is added
to the Welfare and Institutions Code  , 
immediately following Section 14726, to read:
    14727.   14728.   (a) The State
Department of Health Care Services shall consult with counties,
providers, and other stakeholders to develop a single set of service
billing documentation requirements for the provision of specialty
mental health services.
   (b) The billing documentation requirements developed pursuant to
this section shall do both of the following:
   (1) Minimize time and paperwork required of counties and
providers, consistent with federal standards.
   (2) Eliminate duplicative or outdated requirements.
   (c) The billing documentation requirements shall be completed by
January 1, 2017, for use commencing on July 1, 2017, and shall
thereafter be updated no less than every two years through a
stakeholder process, unless changes in the Medicaid state plan or
other federal rules require that the billing requirements be updated
more often.
   (d) After adoption of the standard billing requirements by the
department, a county may not require additional billing 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, or for purposes other
than documentation for billing.