BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1098
                                                                  Page  1

          Date of Hearing:  January 11, 2000

                            ASSEMBLY COMMITTEE ON HEALTH 
                               Martin Gallegos, Chair
                   AB 1098 (Romero) - As Amended:  January 3, 2000
           
          SUBJECT  :  Medi-Cal.

           SUMMARY  :  Amends existing law to conform the definition of  
          "provider" as established by AB 784 (Romero), Chapter 993,  
          Statutes of 1999, to the definition established in the 1999-2000  
          omnibus health budget trailer bill, AB 1107 (Cedillo), Chapter  
          146, Statutes of 1999.

           EXISTING LAW  :

          1)Establishes the Medi-Cal program, administered by the  
            Department of Health Services (DHS), to provide comprehensive  
            health care services to qualified low-income, aged, blind and  
            disabled individuals.

          2)Defines, pursuant to AB 1107 (Cedillo) Chapter 146, Statutes  
            of 1999, "provider" for the purposes of certain provider  
            certification activities as any individual, partnership,  
            group, association, corporation, institution, or entity, and  
            the officers, directors, employees, or agents thereof, that  
            provides services, goods, supplies, or merchandise, directly  
            or indirectly, to a Medi-Cal beneficiary and that has been  
            enrolled in the Medi-Cal program.

          3)Defines, pursuant to AB 784 (Romero), Chapter 993, Statutes of  
            1999, "provider" for the purposes of certain provider audit  
            and reimbursement requirements as any individual, partnership,  
            clinic, group, association, corporation, institution, or  
            public agency, as specified, which meets applicable standards  
            for participation with the Medi-Cal program, as specified.

           FISCAL EFFECT  :  Unknown

           COMMENTS  :   

           1)PURPOSE OF THIS BILL  .  This bill has been recently amended in  
            response to a request by the Davis Administration for  
            subsequent legislation "conforming" these definitions.  









                                                                  AB 1098
                                                                  Page  2

           2)BACKGROUND  .  AB 784 (Romero), Chapter 993, Statutes of 1999,  
            requires certain Medi-Cal providers to provide DHS with a bond  
            or security, requires certain Medi-Cal suppliers to maintain  
            specified accounting records, and requires certain providers  
            to pay interest charges and penalties under certain  
            circumstances when an audit uncovers improper claims.  AB 1107  
            (Cedillo), Chapter 146, Statutes of 1999, authorizes DHS, upon  
            reliable evidence of fraud or willful misrepresentation by a  
            provider, to collect any overpayment identified through an  
            audit examination from any provider or withhold payment for  
            any goods or services owing to the provider.    



           REGISTERED SUPPORT / OPPOSITION  :   

           Support  

          None on file

           Opposition  

          None on file
           
          Analysis Prepared by  :  Teri Boughton / HEALTH / (916) 319-2097