BILL ANALYSIS
AB 1098
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1098 (Romero)
As Amended August 25, 2000
Majority vote
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|ASSEMBLY: |74-0 |(January 26, |SENATE: |40-0 |(August 31, 2000) |
| | |2000) | | | |
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|COMMITTEE VOTE: |6-0 |(August 31, 2000) |RECOMMENDATION: |Concur |
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Original Committee Reference: PUB. S.
SUMMARY : Increases the penalties for Medi-Cal fraud, expands the
use of grand juries to investigate Medi-Cal fraud, and creates new
regulations and crimes for clinical laboratory practices.
The Senate amendments substantially amend the Assembly version of
this bill as follows:
1)Increase the penalty for Medi-Cal fraud to two, three, or five
years in the state prison, or by up to one year in the county
jail, by a fine not to exceed three tines the amount of the
fraud, or by both a fine and imprisonment.
2)Increase the penalty for specified offenses related to blood and
biological specimens to up to one year in the county jail.
3)Create an alternate felony/misdemeanor punishable by 16 months,
two, or three years, by a fine not to exceed $50,000, or by both
a fine and imprisonment for the reckless collection, handling, or
storage of biological specimens which creates a substantial risk
of great bodily injury.
4)Make a second or subsequent violation for the reckless handling
of biological specimens punishable by two, four, or six years in
the state prison, by a fine not to exceed $50,000, or by both a
fine and imprisonment.
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5)Create an enhancement of four years in the state prison if a
fraudulent Medi-Cal scheme is likely to cause or causes great
bodily injury to two or more persons.
6)Add specified Medi-Cal fraud offenses to the list of crimes
subject to criminal profiteering asset forfeiture.
7)Allow the Attorney General (AG), with or without the concurrence
of the county district attorney, to petition the court to impanel
a special grand jury to investigate, consider, or issue
indictments for Medi-Cal fraud.
8)Allow a special grand jury convened by the AG in one county to
investigate Medi-Cal fraud, to share confidential information
with a second grand jury convened by the AG in another county
under specified conditions.
9)Provide additional grounds for the denial, suspension, or
revocation of licensure of clinical laboratory operators.
10)Create new licensing requirements for Medi-Cal billing companies
as specified.
11)Allow the Director to the Department of Health Services (DHS) to
suspend or revoke the registration of a billing agent under
investigation for fraud or abuse, or where there are violations
of applicable regulations, or the submission of false
information.
12)Allow DHS three years from the date of a violation to file a
civil or administrative action for the violation of clinical
laboratory laws and regulations.
13)Require DHS and the Department of Justice (DOJ) to administer
the newly formed Medi-Cal fraud programs.
EXISTING LAW:
1)Establishes the Medi-Cal program administered by DHS, to provide
comprehensive health care services to qualified low-income, aged,
blind, and disabled individuals.
2)Provides that Medi-Cal fraud is punishable by up to one year in
the county jail, or by 16 months, two, or three years in the
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state prison, by a fine not exceeding $5,000, or by both a fine
and imprisonment.
3)Makes any violation of law related to the operation of clinical
laboratories a misdemeanor punishable by up to six months in the
county jail or by a fine not to exceed $1,000, or by both.
AS PASSED BY THE ASSEMBLY , this bill conformed the definition of
"provider" to recently enacted legislation related to the Medi-Cal
program.
COMMENTS : According to the author, "AB 1098 is an aggressive
measure designed to curb Medi-Cal fraud which is costing taxpayers
hundreds of millions of dollars annually. Medi-Cal fraud is
perpetrated by unscrupulous medical providers that file false
reimbursement claims."
"Recently Medi-Cal fraud scams have taken on a new form. Medi-Cal
providers are paying small amounts of money to any child or adult,
living usually in low-income neighborhoods, who will come in for a
medical visit. A Medi-Cal reimbursement claim is then submitted to
the State of California. The "patient" may receive $30, but the
fraudulent medical provider can receive hundreds, or thousands of
dollars of taxpayer's money."
"The medical providers are administering fraudulent and unnecessary
procedures without regard to potential injury to the patient. AB
1098 places a high price on those who choose to commit these crimes
and even a higher price on those who choose to use our children for
the sole purpose of financial gain."
Analysis Prepared by: Gregory Pagan / PUB. S. / (916) 319-3744
FN: 0007279