Bill Text: CA AB1202 | 2023-2024 | Regular Session | Enrolled
Bill Title: Medi-Cal: health care services data: children and pregnant or postpartum persons.
Spectrum: Bipartisan Bill
Status: (Vetoed) 2024-02-12 - Consideration of Governor's veto stricken from file. [AB1202 Detail]
Download: California-2023-AB1202-Enrolled.html
|
Enrolled
September 18, 2023 |
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Passed
IN
Senate
September 12, 2023 |
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Passed
IN
Assembly
September 13, 2023 |
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Amended
IN
Senate
July 13, 2023 |
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Amended
IN
Assembly
March 29, 2023 |
CALIFORNIA LEGISLATURE—
2023–2024 REGULAR SESSION
Assembly Bill
No. 1202
| Introduced by Assembly Member Lackey (Coauthors: Assembly Members Boerner, Dixon, Schiavo, and Wallis) |
February 16, 2023 |
An act to add and repeal Section 14197.01 of the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 1202, Lackey.
Medi-Cal: health care services data: children and pregnant or postpartum persons.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services through various health care delivery systems, including managed care pursuant to Medi-Cal managed care plan contracts. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Existing law establishes, until January 1, 2026, certain time or distance and appointment time standards for specified Medi-Cal managed care covered services, consistent with federal regulations relating to network adequacy standards, to ensure that those services are available and accessible to enrollees of Medi-Cal managed care plans in a timely manner, as specified. Existing law sets forth various limits on the number of miles or minutes
from the enrollee’s place of residence, depending on the type of service or specialty and, in some cases, on the county.
This bill would require the department, no later than January 1, 2025, to prepare and submit a report to the Legislature that includes certain information, including an analysis of the adequacy of each Medi-Cal managed care plan’s network for pediatric primary care, including the number and geographic distribution of providers and the plan’s compliance with the above-described time or distance and
appointment time standards.
Under the bill, the report would also include data, disaggregated as specified, on the number of children and pregnant or postpartum persons who are Medi-Cal beneficiaries receiving certain health care services during the 2021–22, 2022–23, and 2023–24 fiscal years. The report would also include additional information regarding the department’s efforts to improve access to pediatric preventive care, as specified. The bill would require that the report be made publicly available through its posting on the department’s internet website.
The bill would repeal these reporting provisions on January 1, 2029.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NOBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 14197.01 is added to the Welfare and Institutions Code, immediately following Section 14197, to read:14197.01.
(a) No later than January 1, 2025, the department shall prepare and submit a report to the Legislature that includes all of the following:(1) An analysis of the adequacy of each Medi-Cal managed care plan’s network for pediatric primary care, including the number and geographic distribution of providers and the Medi-Cal managed care plan’s compliance with the time or distance and appointment time standards described in Section 14197. In providing this analysis, the department is encouraged to use reports that are obtained to meet the CalAIM Terms and Conditions specified in paragraph (2) of subdivision (c) of Section 14184.101.
(2) Data on the following populations and
services, broken down by racial or ethnic groups, primary language spoken, county, and relevant age group:
(A) For the 2021–22, 2022–23, and 2023–24 fiscal years, the number of children who are Medi-Cal beneficiaries receiving any of the early childhood preventive or developmental services listed in clauses (i) through (x), disaggregated by age-related cohort and by service type. Unless the age is otherwise specified, the data shall be broken down by children zero to five years of age, inclusive, as one group and by children 6 to 18 years of age, inclusive, as another group.
(i) Six or more well-child visits in the first 15 months of life.
(ii) Well-child visits in the third, fourth, fifth, and sixth years of life.
(iii) Child and adolescent well-care
visits.
(iv) Immunizations.
(v) Developmental screenings in the first three years of life.
(vi) Weight assessment and nutrition and physical activity counseling.
(vii) Lead screening.
(viii) Screening for depression for children 12 to 17 years of age, inclusive.
(ix) Annual dental visit.
(x) Preventive dental services in the last year.
(B) For the 2021–22, 2022–23, and 2023–24 fiscal years, the number of children who are Medi-Cal beneficiaries who accessed primary care practitioners during the
fiscal year, broken down by the following age groups:
(i) 12 to 24 months of age, inclusive.
(ii) 25 months to 6 years of age, inclusive.
(iii) 7 to 11 years of age, inclusive.
(iv) 12 to 19 years of age, inclusive.
(C) For the 2021–22, 2022–23, and 2023–24 fiscal years, the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of the following services, disaggregated by pregnancy or postpartum status and by service type:
(i) Depression or suicide risk screenings. Depression screenings may include maternal depression screenings.
(ii) Tobacco, alcohol, or drug use assessments.
(3) Additional information regarding the department’s efforts to improve access to pediatric preventive care, including all of the following:
(A) Specific steps that the department has taken to hold Medi-Cal managed care plans accountable for improving utilization of children’s preventive services, including, but not limited to, the following:
(i) Monitoring the efficacy of Medi-Cal managed care plan activities through Healthcare Effectiveness Data and Information Set (HEDIS) measures.
(ii) Medi-Cal managed care plan requirements related to the Population Health Management Program, as described in Section 14184.204, as specific to children’s
preventive care.
(B) Evidence of progress in reducing racial and ethnic disparities for well-child visits and immunizations for children served by the Medi-Cal program.
(C) Evidence of Medi-Cal managed care plan compliance with contractual requirements to train providers on Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) requirements, and the number of providers trained.
(D) Level of accuracy of Medi-Cal managed care plan provider directories, based on the most recent available results of provider directory validation.
(b) The report described in subdivision (a) shall be submitted in accordance with Section 9795 of the Government Code and shall be made publicly available through its posting on the department’s internet website.
(c) Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2029, and as of that date is repealed.
