BILL ANALYSIS                                                                                                                                                                                                    



                                                                    AB 1098
                                                                    Page  1


          ASSEMBLY THIRD READING
          AB 1098 (Romero)
          As Amended January 3, 2000
          Majority vote 

           HEALTH              14-0        APPROPRIATIONS      21-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Gallegos, Strickland,     |Ayes:|Migden, Campbell,         |
          |     |Aanestad, Bates, Corbett, |     |Ackerman, Ashburn,        |
          |     |Firebaugh, Kuehl, Runner, |     |Leonard, Cedillo, Davis,  |
          |     |Steinberg, Thomson,       |     |Hertzberg, Kuehl,         |
          |     |Honda, Wayne, Wildman,    |     |Maldonado, Papan, Romero, |
          |     |Zettel                    |     |Runner, Shelley,          |
          |     |                          |     |Steinberg, Thomson,       |
          |     |                          |     |Wesson, Wiggins, Wright,  |
          |     |                          |     |Zettel, Aroner            |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           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 Chapter 146, "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 Chapter 993, "provider" for the purposes  
            of certain provider audit and reimbursement requirements as  








                                                                    AB 1098
                                                                    Page  2


            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  :  According to the Assembly Appropriations  
          Committee analyses, negligible fiscal effect.
           
           COMMENTS  :  This bill has been recently amended in response to a  
          request by the Davis Administration for subsequent legislation  
          "conforming" these definitions.  

          Chapter 993 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.  Chapter  
          146 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.    


           Analysis Prepared by  :  Teri Boughton / HEALTH / (916) 319-2097 


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