Bill Text: CA AB1540 | 2009-2010 | Regular Session | Introduced
Bill Title: Health.
Spectrum: Strong Partisan Bill (Democrat 12-1)
Status: (Passed) 2009-10-11 - Chaptered by Secretary of State - Chapter 298, Statutes of 2009. [AB1540 Detail]
Download: California-2009-AB1540-Introduced.html
BILL NUMBER: AB 1540 INTRODUCED
BILL TEXT
INTRODUCED BY Committee on Health (Jones (Chair), Adams, Ammiano,
Block, Carter, De La Torre, Hall, Hayashi, Hernandez, Bonnie
Lowenthal, Nava, V. Manuel Perez, and Salas)
MARCH 4, 2009
An act to amend Section 6276.24 of the Government Code, to amend
Sections 1367.46, 116283, 116286, 116380, 116540, 116650, 116725,
127662, 127664, 127665, 128730, and 128745 of the Health and Safety
Code, to amend Section 10123.91 of the Insurance Code, and to amend
Sections 14043.26, 14043.28, 14043.29, and 14115 of the Welfare and
Institutions Code, relating to health.
LEGISLATIVE COUNSEL'S DIGEST
AB 1540, as introduced, Committee on Health. Health.
Existing law, the California Public Records Act, requires certain
public records to be made available for public inspection.
Existing law, the Health Data and Advisory Council Consolidation
Act, requires every organization that operates, conducts, or
maintains a health facility to make and file with the Office of
Statewide Health Planning and Development, specified reports
containing various financial and patient data. Existing law requires
the office to publish risk-adjusted outcome reports for coronary
artery bypass graft surgeries, as specified.
This bill would provide, with respect to the above provisions,
that patient medical record numbers and any other data elements that
the office believes could be used to determine the identity of an
individual patient shall be exempt from the disclosure requirements
of the California Public Records Act.
Existing law, known as the California Safe Drinking Water Act,
requires the State Department of Public Health to administer
provisions relating to the regulation of drinking water to protect
public health.
Existing law requires the department to adopt regulations it
determines to be necessary to carry out the purposes of the
California Safe Drinking Water Act. Existing law requires regulations
adopted by the department to include requirements governing the use
of point-of-entry treatment by public water systems in lieu of
centralized treatment, as specified.
This bill would require regulations adopted by the department to
include requirements governing the use of point-of-entry and
point-of-use treatment by public water systems in lieu of centralized
treatment, as specified.
Existing law provides that the department may issue a citation to
a public water system that violates the California Safe Drinking
Water Act. Existing law provides that for noncontinuing violations of
primary drinking standards, other than turbidity, the department may
assess a civil penalty in the citation, as specified.
This bill would delete the exemption for turbidity.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services and
under which qualified low-income persons receive health care
benefits. Existing law requires that health care providers apply to,
and be certified by, the department prior to their participation in
the Medi-Cal program.
Existing law allows the department to grant provisional provider
status or preferred provisional provider status to an applicant or
provider, and requires the department to terminate that status if any
specified grounds exist.
This bill would correct obsolete references in the above
provisions.
Under existing law, the Medi-Cal program is partially governed and
funded as part of the federal Medicaid Program. Existing law
requires the department to amend the Medicaid state plan with respect
to the billing option for services by local education agencies to
ensure that schools are reimbursed for all eligible services that
they provide that are not precluded by federal requirements. Existing
law would repeal these provisions on January 1, 2010.
This bill would delete the provision repealing these provisions on
January 1, 2010, thereby extending the operation of those
provisions, indefinitely.
Existing law establishes the Local Education Agency Medi-Cal
Recovery Account in the Special Deposit Fund, to be used only to
support the department in meeting the requirements of the above
provisions, and specifies a formula for funding and staffing
activities provided for under these provisions.
Existing law provides that as of January 1, 2010, unless the
Legislature enacts a new statute or extends the date beyond January
1, 2010, all funds in the Local Education Agency Medi-Cal Recovery
Account shall be returned proportionately to all local education
agencies whose federal Medicaid funds were used to create the
account.
This bill would rename the account to be the Local Educational
Agency Medi-Cal Recovery Fund.
This bill would also provide that if the Legislature enacts a new
statute that ends the billing option, all funds in the Local
Educational Agency Medi-Cal Recovery Fund shall be returned
proportionally to all local educational agencies whose federal
Medicaid funds were used to create the account.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975,
provides for the regulation of health care service plans by the
Department of Managed Health Care. Existing law provides that a
willful violation of the act is a crime. Existing law provides for
the regulation of health insurers by the Department of Insurance.
Existing law requires health care service plans and health insurers
to provide human immunodeficiency virus (HIV) testing, regardless of
whether the testing is related to a primary diagnosis.
This bill would provide that the HIV testing requirement does not
apply to specialized health care service plan contracts or
specialized health insurance polices, Medicare supplement contracts
or policies, and other specified insurance policies.
Existing law, until January 1, 2011, requests the University of
California to establish the California Health Benefit Review Program
to assess legislation proposing a mandated health benefit or service,
as defined, to be provided by health care service plans and health
insurers, and to prepare a written analysis in accordance with
specified criteria.
This bill would extend the repeal date of the above provisions to
June 30, 2015.
Existing law requests the University of California to submit a
report to the Governor and the Legislature no later than January 1,
2010, regarding the implementation of the above provisions.
This bill would, instead, request the University of California to
submit a report no later than January 1, 2014.
Existing law, for fiscal years 2006-07 to 2009-10, inclusive,
provides funding for the University of California's implementation of
the above provisions from a fee imposed upon health care service
plans and health insurers, which would not exceed a total of
$2,000,000, and is to be deposited in the Health Care Benefits Fund.
This bill, instead, provides for the imposition of that fee for
fiscal years 2010-11 to 2014-15, inclusive.
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. Section 6276.24 of the Government Code is amended to
read:
6276.24. Harmful matter, distribution, confidentiality of certain
recipients, Section 313.1, Penal Code.
Hazardous substance tax information, prohibition against
disclosure, Section 43651, Revenue and Taxation Code.
Hazardous waste control, business plans, public inspection,
Section 25506, Health and Safety Code.
Hazardous waste control, notice of unlawful hazardous waste
disposal, Section 25180.5, Health and Safety Code.
Hazardous waste control, trade secrets, disclosure of information,
Sections 25511 and 25538, Health and Safety Code.
Hazardous waste control, trade secrets, procedures for release of
information, Section 25358.2, Health and Safety Code.
Hazardous waste generator report, protection of trade secrets,
Sections 25244.21 and 25244.23, Health and Safety Code.
Hazardous waste licenseholder disclosure statement,
confidentiality of, Section 25186.5, Health and Safety Code.
Hazardous waste management facilities on Indian lands,
confidentiality of privileged or trade secret information, Section
25198.4, Health and Safety Code.
Hazardous waste recycling, duties of department, Section 25170,
Health and Safety Code.
Hazardous waste recycling, list of specified hazardous wastes,
trade secrets, Section 25175, Health and Safety Code.
Hazardous waste recycling, trade secrets, confidential nature,
Sections 25173 and 25180.5, Health and Safety Code.
Healing arts licensees, central files, confidentiality, Section
800, Business and Professions Code.
Health authorities, special county, protection of trade secrets,
Sections 14087.35, 14087.36, and 14087.38, Welfare and Institutions
Code.
Health Care Provider Central Files, confidentiality of, Section
800, Business and Professions Code.
Health care provider disciplinary proceeding, confidentiality of
documents, Section 805.1, Business and Professions Code.
Health care service plans, review of quality of care, privileged
communications, Sections 1370 and 1380, Health and Safety Code.
Health commissions, special county, protection of trade secrets,
Section 14087.31, Welfare and Institutions Code.
Health facilities, patient's rights of confidentiality,
subdivision (c) of Section 128745 and Sections 128735,
128736, 128737, 128755, and 128765, Health and Safety Code.
Health facility and clinic, consolidated data and reports,
confidentiality of, Section 128730, Health and Safety Code.
Health personnel, data collection by the Office of Statewide
Health Planning and Development, confidentiality of information on
individual licentiates, Sections 127775 and 127780, Health and Safety
Code.
Health planning and development pilot projects, confidentiality of
data collected, Section 128165, Health and Safety Code.
Hereditary Disorders Act, legislative finding and declaration,
confidential information, Sections 124975 and 124980, Health and
Safety Code.
Hereditary Disorders Act, rules, regulations, and standards,
breach of confidentiality, Section 124980, Health and Safety Code.
Higher Education Employee-Employer Relations, findings of fact and
recommended terms of settlement, Section 3593, Government Code.
Higher Education Employee-Employer Relations, access by Public
Employment Relations Board to employer's or employee organization's
records, Section 3563, Government Code.
HIV, disclosures to blood banks by department or county health
officers, Section 1603.1, Health and Safety Code.
Home address of public employees and officers in Department of
Motor Vehicles, records, confidentiality of, Sections 1808.2 and
1808.4, Vehicle Code.
Horse racing, horses, blood or urine test sample, confidentiality,
Section 19577, Business and Professions Code.
Hospital district and municipal hospital records relating to
contracts with insurers and service plans, subdivision (t), Section
6254, Government Code.
Hospital final accreditation report, subdivision (s), Section
6254, Government Code.
Housing authorities, confidentiality of rosters of tenants,
Section 34283, Health and Safety Code.
Housing authorities, confidentiality of applications by
prospective or current tenants, Section 34332, Health and Safety
Code.
SEC. 2. Section 1367.46 of the Health and Safety Code is amended
to read:
1367.46. (a) Every individual or group
health care service plan contract that is issued, amended, or renewed
on or after January 1, 2009, that covers hospital, medical, or
surgery expenses shall provide coverage for human immunodeficiency
virus (HIV) testing, regardless of whether the testing is related to
a primary diagnosis.
(b) This section shall not apply to specialized health care
service plan contracts or Medicare supplement contracts.
SEC. 3. Section 116283 of the Health and Safety Code, as added by
Section 4 of Chapter 874 of the Statutes of 1996, is amended to read:
116283. This chapter shall apply to a food facility that is
regulated pursuant to the California Uniform
Retail Food Facilities Law Code only if
the human consumption includes drinking of water.
SEC. 4. Section 116283 of the Health and Safety Code, as added by
Section 4 of Chapter 875 of the Statutes of 1996, is amended to read:
116283. This chapter shall apply to a food facility that is
regulated pursuant to the California Uniform
Retail Food Facilities Law Code only if
the human consumption includes drinking of water.
SEC. 5. Section 116286 of the Health and Safety Code is amended to
read:
116286. (a) A water district, as defined in subdivision (b), in
existence prior to May 18, 1994, that provides primarily agricultural
services through a piped water system with only incidental
residential or similar uses shall not be considered to be a public
water system if the department determines that either of the
following applies:
(1) The system or the residential or similar users of the
system certify to the system certifies that
they are it is providing alternative
water for residential or similar uses for drinking water and cooking
to achieve the equivalent level of public health protection provided
by the applicable primary drinking water regulations.
(2) The water provided for residential or similar uses for
drinking, cooking, and bathing is centrally treated or treated at the
point of entry by the provider, a passthrough entity, or the user to
achieve the equivalent level of protection provided by the
applicable primary drinking water regulations.
(b) For purposes of this section, "water district" means any
district or other political subdivision, other than a city or county,
a primary function of which is irrigation, reclamation, or drainage
of land.
SEC. 6. Section 116380 of the Health and Safety Code is amended to
read:
116380. In addition to the requirements set forth in Section
116375, the regulations adopted by the department pursuant to Section
116375 shall include requirements governing the use of
point-of-entry and point-of-use treatment by public water
systems in lieu of centralized treatment where it can be demonstrated
that centralized treatment is not economically feasible.
SEC. 7. Section 116540 of the Health and Safety Code is amended to
read:
116540. Following completion of the investigation and
satisfaction of the requirements of subdivisions (a) and (b), the
department shall issue or deny the permit. The department may impose
permit conditions, requirements for system improvements, and time
schedules as it deems necessary to assure a reliable and adequate
supply of water at all times that is pure, wholesome, potable, and
does not endanger the health of consumers.
(a) No public water system that was not in existence on January 1,
1998, shall be granted a permit unless the system demonstrates to
the department that the water supplier possesses adequate financial,
managerial, and technical capability to assure the delivery of pure,
wholesome, and potable drinking water. This section shall also apply
to any change of ownership of a public water system that occurs after
January 1, 1998.
(b) No permit under this chapter shall be issued to an association
organized under Title 3 (commencing with Section 20000)
18000) of Division 3 of the Corporations Code.
This section shall not apply to unincorporated associations that as
of December 31, 1990, are holders of a permit issued under this
chapter.
SEC. 8. Section 116650 of the Health and Safety Code is amended to
read:
116650. (a) If the department determines that a public water
system is in violation of this chapter or any regulation, permit,
standard, or order issued or adopted thereunder, the department may
issue a citation to the public water system. The citation shall be
served upon the public water system personally or by registered mail.
(b) Each citation shall be in writing and shall describe with
particularity the nature of the violation, including a reference to
the statutory provision, standard, order, or regulation alleged to
have been violated.
(c) For continuing violations, the citation shall fix the earliest
feasible time for elimination or correction of the condition
constituting the violation where appropriate. If the public water
system fails to correct a violation within the time specified in the
citation, the department may assess a civil penalty as specified in
subdivision (e).
(d) For a noncontinuing violation of primary drinking standards
, other than turbidity , the department may assess
in the citation a civil penalty as specified in subdivision (e).
(e) Citations issued pursuant to this section shall be classified
according to the nature of the violation or the failure to comply.
The department shall specify the classification in the citation and
may assess civil penalties for each classification as follows:
(1) For violation of a primary drinking standard , other
than turbidity , an amount not to exceed one thousand
dollars ($1,000) per day for each day that the violation
occurred for noncontinuing violations or for
, including each day that the violation continues beyond the
date specified for correction in the citation.
(2) For failure to comply with any citation or order issued for
failure of the primary drinking water standard for turbidity
or for violation of a secondary drinking water standard
that the director determines may have a direct or immediate
relationship to the welfare of the users, an amount not to exceed one
thousand dollars ($1,000) for each day that the violation continues
beyond the date specified for correction in the citation.
(3) For failure to comply with any citation or order issued for
noncompliance with any department regulation or order, other than a
primary or secondary drinking water standard, an amount not to exceed
two hundred dollars ($200) per day for each day the violation
continues beyond the date specified for correction in the citation.
SEC. 9. Section 116725 of the Health and Safety Code is amended to
read:
116725. (a) Any person who knowingly makes any false statement
or representation in any application, record, report, or other
document submitted, maintained, or used for purposes of compliance
with this chapter, may be liable, as determined by the court, for a
civil penalty not to exceed five thousand dollars ($5,000) for each
separate violation or, for continuing violations, for each day that
violation continues.
(b) Any person who violates a citation schedule of compliance for
a primary drinking water standard , other than turbidity,
or any order regarding a primary drinking water standard
other than turbidity, or the requirement that a
reliable and adequate supply of pure, wholesome, healthful, and
potable water be provided may be liable, as determined by the court,
for a civil penalty not to exceed twenty-five thousand dollars
($25,000) for each separate violation or, for continuing violations,
for each day that violation continues.
(c) Any person who violates any order, other than one specified in
subdivision (b), issued pursuant to this chapter may be liable, as
determined by the court, for a civil penalty not to exceed five
thousand dollars ($5,000) for each separate violation or, for
continuing violations, for each day that violation continues.
(d) Any person who operates a public water system without a permit
issued by the department pursuant to this chapter may be liable, as
determined by the court, for a civil penalty not to exceed
twenty-five thousand dollars ($25,000) for each separate violation
or, for continuing violations, for each day that violation continues.
(e) Each civil penalty imposed for any separate violation pursuant
to this section shall be separate and in addition to any other civil
penalty imposed pursuant to this section or any other provision of
law.
SEC. 10. Section 127662 of the Health and Safety Code is amended
to read:
127662. (a) In order to effectively support the University of
California and its work in implementing this chapter, there is hereby
established in the State Treasury, the Health Care Benefits Fund.
The university's work in providing the bill analyses shall be
supported from the fund.
(b) For fiscal years 2006-07 2010-
11 to 2009-10 2014- 15
, inclusive, each health care service plan, except a
specialized health care service plan, and each health insurer, as
defined in Section 106 of the Insurance Code, shall be assessed an
annual fee in an amount determined through regulation. The amount of
the fee shall be determined by the Department of Managed Health Care
and the Department of Insurance in consultation with the university
and shall be limited to the amount necessary to fund the actual and
necessary expenses of the university and its work in implementing
this chapter. The total annual assessment on health care service
plans and health insurers shall not exceed two million dollars
($2,000,000).
(c) The Department of Managed Health Care and the Department of
Insurance, in coordination with the university, shall assess the
health care service plans and health insurers, respectively, for the
costs required to fund the university's activities pursuant to
subdivision (b).
(1) Health care service plans shall be notified of the assessment
on or before June 15 of each year with the annual assessment notice
issued pursuant to Section 1356. The assessment pursuant to this
section is separate and independent of the assessments in Section
1356.
(2) Health insurers shall be noticed of the assessment in
accordance with the notice for the annual assessment or quarterly
premium tax revenues.
(3) The assessed fees required pursuant to subdivision (b) shall
be paid on an annual basis no later than August 1 of each year. The
Department of Managed Health Care and the Department of Insurance
shall forward the assessed fees to the Controller for deposit in the
Health Care Benefits Fund immediately following their receipt.
(4) "Health insurance," as used in this subdivision, does not
include Medicare supplement, vision-only, dental-only, or CHAMPUS
supplement insurance, or hospital indemnity, accident-only, or
specified disease insurance that does not pay benefits on a fixed
benefit, cash payment only basis.
SEC. 11. Section 127664 of the Health and Safety Code is amended
to read:
127664. The Legislature requests the University of California to
submit a report to the Governor and the Legislature by January 1,
2010 2014 , regarding the
implementation of this chapter.
SEC. 12. Section 127665 of the Health and Safety Code is amended
to read:
127665. This chapter shall remain in effect until
January 1, 2011 June 30, 2015 , and shall be
repealed as of that date, unless a later enacted statute that becomes
operative on or before January 1, 2011 June
30, 2015 , deletes or extends that date.
SEC. 13. Section 128730 of the Health and Safety Code is amended
to read:
128730. (a) Effective January 1, 1986, the office shall be the
single state agency designated to collect the following health
facility or clinic data for use by all state agencies:
(1) That data required by the office pursuant to Section 127285.
(2) That data required in the Medi-Cal cost reports pursuant to
Section 14170 of the Welfare and Institutions Code.
(3) Those data items formerly required by the California Health
Facilities Commission that are listed in Sections 128735 and 128740.
Information collected pursuant to subdivision (g) of Section 128735
and Sections 128736 and 128737 shall be made available to the State
Department of Health Care Services and the State
Department of Public Health . The department
departments shall ensure that the patient's rights to
confidentiality shall not be violated in any manner. The
department departments shall comply with all
applicable policies and requirements involving review and oversight
by the State Committee for the Protection of Human Subjects.
(b) The office shall consolidate any and all of the reports listed
under this section or Sections 128735 and 128740, to the extent
feasible, to minimize the reporting burdens on hospitals. Provided,
however, that the office shall neither add nor delete data items from
the Hospital Discharge Abstract Data Record or the quarterly reports
without prior authorizing legislation, unless specifically required
by federal law or regulation or judicial decision.
SEC. 14. Section 128745 of the Health and Safety Code is amended
to read:
128745. (a) Commencing July 1993, and annually thereafter, the
office shall publish risk-adjusted outcome reports in accordance with
the following schedule:
Procedures and
Publication Period Conditions
Date Covered Covered
July 1993 1988-90 3
July 1994 1989-91 6
July 1995 1990-92 9
Reports for subsequent years shall include conditions and
procedures and cover periods as appropriate.
(b) The procedures and conditions required to be reported under
this chapter shall be divided among medical, surgical and obstetric
conditions or procedures and shall be selected by the office, based
on the recommendations of the commission and the advice of the
technical advisory committee set forth in subdivision (j) of Section
128725. The office shall publish the risk-adjusted outcome reports
for surgical procedures by individual hospital and individual surgeon
unless the office in consultation with the technical advisory
committee and medical specialists in the relevant area of practice
determines that it is not appropriate to report by individual
surgeon. The office, in consultation with the technical advisory
committee and medical specialists in the relevant area of practice,
may decide to report nonsurgical procedures and conditions by
individual physician when it is appropriate. The selections shall be
in accordance with all of the following criteria:
(1) The patient discharge abstract contains sufficient data to
undertake a valid risk adjustment. The risk adjustment report shall
ensure that public hospitals and other hospitals serving primarily
low-income patients are not unfairly discriminated against.
(2) The relative importance of the procedure and condition in
terms of the cost of cases and the number of cases and the
seriousness of the health consequences of the procedure or condition.
(3) Ability to measure outcome and the likelihood that care
influences outcome.
(4) Reliability of the diagnostic and procedure data.
(c) (1) In addition to any other established and pending reports,
on or before July 1, 2002, the office shall publish a risk-adjusted
outcome report for coronary artery bypass graft surgery by hospital
for all hospitals opting to participate in the report. This report
shall be updated on or before July 1, 2003.
(2) In addition to any other established and pending reports,
commencing July 1, 2004, and every year thereafter, the office shall
publish risk-adjusted outcome reports for coronary artery bypass
graft surgery for all coronary artery bypass graft surgeries
performed in the state. In each year, the reports shall compare
risk-adjusted outcomes by hospital, and in every other year, by
hospital and cardiac surgeon. Upon the recommendation of the
technical advisory committee based on statistical and technical
considerations, information on individual hospitals and surgeons may
be excluded from the reports.
(3) Unless otherwise recommended by the clinical panel established
by Section 128748, the office shall collect the same data used for
the most recent risk-adjusted model developed for the California
Coronary Artery Bypass Graft Mortality Reporting Program. Upon
recommendation of the clinical panel, the office may add any clinical
data elements included in the Society of Thoracic Surgeons'
data base database . Prior to any additions
from the Society of Thoracic Surgeons' data base
database , the following factors shall be considered:
(A) Utilization of sampling to the maximum extent possible.
(B) Exchange of data elements as opposed to addition of data
elements.
(4) Upon recommendation of the clinical panel, the office may add,
delete or revise clinical data elements, but shall add no more than
a net of six elements not included in the Society of Thoracic
Surgeons' data base database , to the
data set over any five-year period. Prior to any additions or
deletions, all of the following factors shall be considered:
(A) Utilization of sampling to the maximum extent possible.
(B) Feasibility of collecting data elements.
(C) Costs and benefits of collection and submission of data.
(D) Exchange of data elements as opposed to addition of data
elements.
(5) The office shall collect the minimum data necessary for
purposes of testing or validating a risk-adjusted model for the
coronary artery bypass graft report.
(6) Patient medical record numbers and any other data elements
that the office believes could be used to determine the identity of
an individual patient shall be exempt from the disclosure
requirements of the California Public Records Act (Chapter 3.5
(commencing with Section 6250) of Division 7 of Title 1 of the
Government Code).
(d) The annual reports shall compare the risk-adjusted outcomes
experienced by all patients treated for the selected conditions and
procedures in each California hospital during the period covered by
each report, to the outcomes expected. Outcomes shall be reported in
the five following groupings for each hospital:
(1) "Much higher than average outcomes," for hospitals with
risk-adjusted outcomes much higher than the norm.
(2) "Higher than average outcomes," for hospitals with
risk-adjusted outcomes higher than the norm.
(3) "Average outcomes," for hospitals with average risk-adjusted
outcomes.
(4) "Lower than average outcomes," for hospitals with
risk-adjusted outcomes lower than the norm.
(5) "Much lower than average outcomes," for hospitals with
risk-adjusted outcomes much lower than the norm.
(e) For coronary artery bypass graft surgery reports and any other
outcome reports for which auditing is appropriate, the office shall
conduct periodic auditing of data at hospitals.
(f) The office shall publish in the annual reports required under
this section the risk-adjusted mortality rate for each hospital and
for those reports that include physician reporting, for each
physician.
(g) The office shall either include in the annual reports required
under this section, or make separately available at cost to any
person requesting it, risk-adjusted outcomes data assessing the
statistical significance of hospital or physician data at each of the
following three levels: 99 percent confidence level (0.01 p-value),
95 percent confidence level (0.05 p-value), and 90 percent confidence
level (.10 p-value). The office shall include any other analysis or
comparisons of the data in the annual reports required under this
section that the office deems appropriate to further the purposes of
this chapter.
SEC. 15. Section 10123.91 of the Insurance Code is amended to
read:
10123.91. (a) On or after January 1, 2009, every insurer that
issues, amends, or renews an individual or group policy of health
insurance that covers hospital, medical, or surgical expenses shall
provide coverage for human immunodeficiency virus (HIV) testing,
regardless of whether the testing is related to a primary diagnosis.
(b) It shall remain within the sole discretion of the health
insurer as to the provider of the testing with which it chooses to
contract. Reimbursement shall be provided according to the respective
principles and policies of the health insurer.
(c) This section shall not apply to specialized health insurance
policies, Medicare supplement policies, CHAMPUS-supplement insurance
policies, TRICARE supplement insurance policies, accident-only
insurance policies, or insurance policies excluded from the
definition of "health insurance" under subdivision (b) of Section
106.
SEC. 16. Section 14043.26 of the Welfare and Institutions Code is
amended to read:
14043.26. (a) (1) On and after January 1, 2004, an applicant that
currently is not enrolled in the Medi-Cal program, or a provider
applying for continued enrollment, upon written notification from the
department that enrollment for continued participation of all
providers in a specific provider of service category or subgroup of
that category to which the provider belongs will occur, or, except as
provided in subdivisions (b) and (e), a provider not currently
enrolled at a location where the provider intends to provide
services, goods, supplies, or merchandise to a Medi-Cal beneficiary,
shall submit a complete application package for enrollment,
continuing enrollment, or enrollment at a new location or a change in
location.
(2) Clinics licensed by the department pursuant to Chapter 1
(commencing with Section 1200) of Division 2 of the Health and Safety
Code and certified by the department to participate in the Medi-Cal
program shall not be subject to this section.
(3) Health facilities licensed by the department pursuant to
Chapter 2 (commencing with Section 1250) of Division 2 of the Health
and Safety Code and certified by the department to participate in the
Medi-Cal program shall not be subject to this section.
(4) Adult day
health care providers licensed pursuant to Chapter 3.3 (commencing
with Section 1570) of Division 2 of the Health and Safety Code and
certified by the department to participate in the Medi-Cal program
shall not be subject to this section.
(5) Home health agencies licensed pursuant to Chapter 8
(commencing with Section 1725) of Division 2 of the Health and Safety
Code and certified by the department to participate in the Medi-Cal
program shall not be subject to this section.
(6) Hospices licensed pursuant to Chapter 8.5 (commencing with
Section 1745) of Division 2 of the Health and Safety Code and
certified by the department to participate in the Medi-Cal program
shall not be subject to this section.
(b) A physician and surgeon licensed by the Medical Board of
California or the Osteopathic Medical Board of California practicing
in an individual physician practice, who is enrolled and in good
standing in the Medi-Cal program, and who is changing locations of
that individual physician practice within the same county, shall be
eligible to continue enrollment at the new location by filing a
change of location form to be developed by the department. The form
shall comply with all minimum federal requirements related to
Medicaid provider enrollment. Filing this form shall be in lieu of
submitting a complete application package pursuant to subdivision
(a).
(c) (1) Except as provided in paragraph (2), within 30 days after
receiving an application package submitted pursuant to subdivision
(a), the department shall provide written notice that the application
package has been received and, if applicable, that there is a
moratorium on the enrollment of providers in the specific provider of
service category or subgroup of the category to which the applicant
or provider belongs. This moratorium shall bar further processing of
the application package.
(2) Within 15 days after receiving an application package from a
physician, or a group of physicians, licensed by the Medical Board of
California or the Osteopathic Medical Board of California, or a
change of location form pursuant to subdivision (b), the department
shall provide written notice that the application package or the
change of location form has been received.
(d) (1) If the application package submitted pursuant to
subdivision (a) is from an applicant or provider who meets the
criteria listed in paragraph (2), the applicant or provider shall be
considered a preferred provider and shall be granted preferred
provisional provider status pursuant to this section and for a period
of no longer than 18 months, effective from the date on the notice
from the department. The ability to request consideration as a
preferred provider and the criteria necessary for the consideration
shall be publicized to all applicants and providers. An applicant or
provider who desires consideration as a preferred provider pursuant
to this subdivision shall request consideration from the department
by making a notation to that effect on the application package, by
cover letter, or by other means identified by the department in a
provider bulletin. Request for consideration as a preferred provider
shall be made with each application package submitted in order for
the department to grant the consideration. An applicant or provider
who requests consideration as a preferred provider shall be notified
within 60 days whether the applicant or provider meets or does not
meet the criteria listed in paragraph (2). If an applicant or
provider is notified that the applicant or provider does not meet the
criteria for a preferred provider, the application package submitted
shall be processed in accordance with the remainder of this section.
(2) To be considered a preferred provider, the applicant or
provider shall meet all of the following criteria:
(A) Hold a current license as a physician and surgeon issued by
the Medical Board of California or the Osteopathic Medical Board of
California, which license shall not have been revoked, whether stayed
or not, suspended, placed on probation, or subject to other
limitation.
(B) Be a current faculty member of a teaching hospital or a
children's hospital, as defined in Section 10727, accredited by the
Joint Commission or the American Osteopathic Association, or be
credentialed by a health care service plan that is licensed under the
Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code) or county organized health system, or be a current member in
good standing of a group that is credentialed by a health care
service plan that is licensed under the Knox-Keene Act.
(C) Have full, current, unrevoked, and unsuspended privileges at a
Joint Commission or American Osteopathic Association accredited
general acute care hospital.
(D) Not have any adverse entries in the federal Healthcare
Integrity and Protection Data Bank.
(3) The department may recognize other providers as qualifying as
preferred providers if criteria similar to those set forth in
paragraph (2) are identified for the other providers. The department
shall consult with interested parties and appropriate stakeholders to
identify similar criteria for other providers so that they may be
considered as preferred providers.
(e) (1) If a Medi-Cal applicant meets the criteria listed in
paragraph (2), the applicant shall be enrolled in the Medi-Cal
program after submission and review of a short form application to be
developed by the department. The form shall comply with all minimum
federal requirements related to Medicaid provider enrollment. The
department shall notify the applicant that the department has
received the application within 15 days of receipt of the
application. The department shall issue the applicant a provider
number or notify the applicant that the applicant does not meet the
criteria listed in paragraph (2) within 90 days of receipt of the
application.
(2) Notwithstanding any other provision of law, an applicant or
provider who meets all of the following criteria shall be eligible
for enrollment in the Medi-Cal program pursuant to this subdivision,
after submission and review of a short form application:
(A) The applicant's or provider's practice is based in one or more
of the following: a general acute care hospital, a rural general
acute care hospital, or an acute psychiatric hospital, as defined in
subdivisions (a) and (b) of Section 1250 of the Health and Safety
Code.
(B) The applicant or provider holds a current, unrevoked, or
unsuspended license as a physician and surgeon issued by the Medical
Board of California or the Osteopathic Medical Board of California.
An applicant or provider shall not be in compliance with this
subparagraph if a license revocation has been stayed, the licensee
has been placed on probation, or the license is subject to any other
limitation.
(C) The applicant or provider does not have an adverse entry in
the federal Healthcare Integrity and Protection Data Bank.
(3) An applicant shall be granted provisional provider status
under this subdivision for a period of 12 months.
(f) Except as provided in subdivision (g), within 180 days after
receiving an application package submitted pursuant to subdivision
(a), or from the date of the notice to an applicant or provider that
the applicant or provider does not qualify as a preferred provider
under subdivision (d), the department shall give written notice to
the applicant or provider that any of the following applies, or shall
on the 181st day grant the applicant or provider provisional
provider status pursuant to this section for a period no longer than
12 months, effective from the 181st day:
(1) The applicant or provider is being granted provisional
provider status for a period of 12 months, effective from the date on
the notice.
(2) The application package is incomplete. The notice shall
identify additional information or documentation that is needed to
complete the application package.
(3) The department is exercising its authority under Section
14043.37, 14043.4, or 14043.7, and is conducting background checks,
preenrollment inspections, or unannounced visits.
(4) The application package is denied for any of the following
reasons:
(A) Pursuant to Section 14043.2 or 14043.36.
(B) For lack of a license necessary to perform the health care
services or to provide the goods, supplies, or merchandise directly
or indirectly to a Medi-Cal beneficiary, within the applicable
provider of service category or subgroup of that category.
(C) The period of time during which an applicant or provider has
been barred from reapplying has not passed.
(D) For other stated reasons authorized by law.
(g) Notwithstanding subdivision (f), within 90 days after
receiving an application package submitted pursuant to subdivision
(a) from a physician or physician group licensed by the Medical Board
of California or the Osteopathic Medical Board of California, or
from the date of the notice to that physician or physician group that
does not qualify as a preferred provider under subdivision (d), or
within 90 days after receiving a change of location form submitted
pursuant to subdivision (b), the department shall give written notice
to the applicant or provider that either paragraph (1), (2), (3), or
(4) of subdivision (f) applies, or shall on the 91st day grant the
applicant or provider provisional provider status pursuant to this
section for a period no longer than 12 months, effective from the
91st day.
(h) (1) If the application package that was noticed as incomplete
under paragraph (2) of subdivision (f) is resubmitted with all
requested information and documentation, and received by the
department within 60 days of the date on the notice, the department
shall, within 60 days of the resubmission, send a notice that any of
the following applies:
(A) The applicant or provider is being granted provisional
provider status for a period of 12 months, effective from the date on
the notice.
(B) The application package is denied for any other reasons
provided for in paragraph (4) of subdivision (f).
(C) The department is exercising its authority under Section
14043.37, 14043.4, or 14043.7 to conduct background checks,
preenrollment inspections, or unannounced visits.
(2) (A) If the application package that was noticed as incomplete
under paragraph (2) of subdivision (f) is not resubmitted with all
requested information and documentation and received by the
department within 60 days of the date on the notice, the application
package shall be denied by operation of law. The applicant or
provider may reapply by submitting a new application package that
shall be reviewed de novo.
(B) If the failure to resubmit is by a provider applying for
continued enrollment, the failure shall make the provider also
subject to deactivation of the provider's number and all of the
business addresses used by the provider to provide services, goods,
supplies, or merchandise to Medi-Cal beneficiaries.
(C) Notwithstanding subparagraph (A), if the notice of an
incomplete application package included a request for information or
documentation related to grounds for denial under Section 14043.2 or
14043.36, the applicant or provider shall not reapply for enrollment
or continued enrollment in the Medi-Cal program or for participation
in any health care program administered by the department or its
agents or contractors for a period of three years.
(i) (1) If the department exercises its authority under Section
14043.37, 14043.4, or 14043.7 to conduct background checks,
preenrollment inspections, or unannounced visits, the applicant or
provider shall receive notice, from the department, after the
conclusion of the background check, preenrollment inspection, or
unannounced visit of either of the following:
(A) The applicant or provider is granted provisional provider
status for a period of 12 months, effective from the date on the
notice.
(B) Discrepancies or failure to meet program requirements, as
prescribed by the department, have been found to exist during the
preenrollment period.
(2) (A) The notice shall identify the discrepancies or failures,
and whether remediation can be made or not, and if so, the time
period within which remediation must be accomplished. Failure to
remediate discrepancies and failures as prescribed by the department,
or notification that remediation is not available, shall result in
denial of the application by operation of law. The applicant or
provider may reapply by submitting a new application package that
shall be reviewed de novo.
(B) If the failure to remediate is by a provider applying for
continued enrollment, the failure shall make the provider also
subject to deactivation of the provider's number and all of the
business addresses used by the provider to provide services, goods,
supplies, or merchandise to Medi-Cal beneficiaries.
(C) Notwithstanding subparagraph (A), if the discrepancies or
failure to meet program requirements, as prescribed by the director,
included in the notice were related to grounds for denial under
Section 14043.2 or 14043.36, the applicant or provider shall not
reapply for three years.
(j) If provisional provider status or preferred provisional
provider status is granted pursuant to this section, a provider
number shall be used by the provider for each business address for
which an application package has been approved. This provider number
shall be used exclusively for the locations for which it is
issued was approved , unless the practice of the
provider's profession or delivery of services, goods, supplies, or
merchandise is such that services, goods, supplies, or merchandise
are rendered or delivered at locations other than the provider's
business address and this practice or delivery of services, goods,
supplies, or merchandise has been disclosed in the application
package approved by the department when the provisional provider
status or preferred provisional provider status was granted.
(k) Except for providers subject to subdivision (c) of Section
14043.47, a provider currently enrolled in the Medi-Cal program at
one or more locations who has submitted an application package for
enrollment at a new location or a change in location pursuant to
subdivision (a), or filed a change of location form pursuant to
subdivision (b), may submit claims for services, goods, supplies, or
merchandise rendered at the new location until the application
package or change of location form is approved or denied under this
section, and shall not be subject, during that period, to
deactivation, or be subject to any delay or nonpayment of claims as a
result of billing for services rendered at the new location as
herein authorized. However, the provider shall be considered during
that period to have been granted provisional provider status or
preferred provisional provider status and be subject to termination
of that status pursuant to Section 14043.27. A provider that is
subject to subdivision (c) of Section 14043.47 may come within the
scope of this subdivision upon submitting documentation in the
application package that identifies the physician providing
supervision for every three locations. If a provider submits claims
for services rendered at a new location before the application for
that location is received by the department, the department may deny
the claim.
(l) An applicant or a provider whose application for enrollment,
continued enrollment, or a new location or change in location has
been denied pursuant to this section, may appeal the denial in
accordance with Section 14043.65.
(m) (1) Upon receipt of a complete and accurate claim for an
individual nurse provider, the department shall adjudicate the claim
within an average of 30 days.
(2) During the budget proceedings of the 2006-07 fiscal year, and
each fiscal year thereafter, the department shall provide data to the
Legislature specifying the timeframe under which it has processed
and approved the provider applications submitted by individual nurse
providers.
(3) For purposes of this subdivision, "individual nurse providers"
are providers authorized under certain home- and community-based
waivers and under the state plan to provide nursing services to
Medi-Cal recipients in the recipients' own homes rather than in
institutional settings.
(n) The amendments to subdivision (b), which implement a change
of location form, and the addition of paragraph (2) to subdivision
(c), the amendments to subdivision (e), and the addition of
subdivision (g), which prescribe different processing timeframes for
physicians and physician groups, as contained in Chapter 693 of the
Statutes of 2007, shall become operative on July 1, 2008.
SEC. 17. Section 14043.28 of the Welfare and Institutions Code is
amended to read:
14043.28. (a) (1) If an application package is denied under
Section 14043.26 or provisional provider status or preferred
provisional provider status is terminated under Section 14043.27, the
applicant or provider may not reapply is
prohibited from reapplying for enrollment or continued
enrollment in the Medi-Cal program or for participation in any health
care program administered by the department or its agents or
contractors for a period of three years from the date the application
package is denied or the provisional provider status is terminated,
or from the date of the final decision following an appeal from that
denial or termination, except as provided otherwise in paragraph (2)
of subdivision (e) (h) , or paragraph
(2) of subdivision (f) (i) , of Section
14043.26 and as set forth in this section.
(2) If the application is denied under paragraph (2) of
subdivision (e) (h) of Section 14043.26
because the applicant failed to resubmit an incomplete application
package or is denied under paragraph (2) of subdivision (f)
(i) of Section 14043.26 because the applicant
failed to remediate discrepancies, the applicant may resubmit an
application in accordance with paragraph (2) of subdivision
(d) (h) or paragraph (2) of subdivision
(f) (i) , respectively.
(3) If the denial of the application package is based upon a
conviction for any offense or for any act included in Section
14043.36 or termination of the provisional provider status or
preferred provisional provider status is based upon a conviction for
any offense or for any act included in paragraph (1) of subdivision
(c) of Section 14043.27, the applicant or provider may not reapply
for enrollment or continued enrollment in the Medi-Cal program or for
participation in any health care program administered by the
department or its agents or contractors for a period of 10 years from
the date the application package is denied or the provisional
provider status or preferred provisional provider status is
terminated or from the date of the final decision following an appeal
from that denial or termination.
(4) If the denial of the application package is based upon two or
more convictions for any offense or for any two or more acts included
in Section 14043.36 or termination of the provisional provider
status or preferred provisional provider status is based upon two or
more convictions for any offense or for any two acts included in
paragraph (1) of subdivision (c) of Section 14043.27, the applicant
or provider shall be permanently barred from enrollment or continued
enrollment in the Medi-Cal program or for participation in any health
care program administered by the department or its agents or
contractors.
(5) The prohibition in paragraph (1) against reapplying for three
years shall not apply if the denial of the application or termination
of provisional provider status or preferred provisional provider
status is based upon any of the following:
(A) The grounds provided for in paragraph (4), or subparagraph (B)
of paragraph (7), of subdivision (c) of Section 14043.27.
(B) The grounds provided for in subdivision (d) of Section
14043.27, if the investigation is closed without any adverse action
being taken.
(C) The grounds provided for in paragraph (6) of subdivision (c)
of Section 14043.27. However, the department may deny reimbursement
for claims submitted while the provider was noncompliant with CLIA.
(b) (1) If an application package is denied under subparagraph
(A), (B), or (D) of paragraph (4) of subdivision (d)
(f) of Section 14043.26, or with respect to a
provider described in subparagraph (B) of paragraph (2) of
subdivision (e) (h) , or subparagraph
(B) of paragraph (2) of subdivision (f) (i)
, of Section 14043.26, or provisional provider status or
preferred provisional provider status is terminated based upon any of
the grounds stated in subparagraph (A) of paragraph (7), or
paragraphs (1), (2), (3), (5), and (8) to (12), inclusive, of
subdivision (c) of Section 14043.27, all business addresses of the
applicant or provider shall be deactivated and the applicant or
provider shall be removed from enrollment in the Medi-Cal program by
operation of law.
(2) If the termination of provisional provider status is based
upon the grounds stated in subdivision (d) of Section 14043.27 and
the investigation is closed without any adverse action being taken,
or is based upon the grounds in subparagraph (B) of paragraph (7) of
subdivision (c) of Section 14043.27 and the applicant or provider
obtains the appropriate license, permits, or approvals covering the
period of provisional provider status, the termination taken pursuant
to subdivision (c) of Section 14043.27 shall be rescinded, the
previously deactivated provider numbers shall be reactivated, and the
provider shall be reenrolled in the Medi-Cal program, unless there
are other grounds for taking these actions.
(c) Claims that are submitted or caused to be submitted by an
applicant or provider who has been suspended from the Medi-Cal
program for any reason or who has had its provisional provider status
terminated or had its application package for enrollment or
continued enrollment denied and all business addresses deactivated
may not be paid for services, goods, merchandise, or supplies
rendered to Medi-Cal beneficiaries during the period of suspension or
termination or after the date all business addresses are
deactivated.
SEC. 18. Section 14043.29 of the Welfare and Institutions Code is
amended to read:
14043.29. (a) If, at the end of the period for which provisional
provider status or preferred provisional provider status was granted
under Section 14043.26, all of the following conditions are met, the
provisional status shall cease and the provider shall be enrolled in
the Medi-Cal program without designation as a provisional provider:
(1) The provider has demonstrated an appropriate volume of
business.
(2) The provisional provider status or preferred provisional
provider status has not been terminated or if it has been terminated,
the act of termination was rescinded.
(3) The provider continues to meet the standards for enrollment in
the Medi-Cal program as set forth in this article and Section 51000
and following of Title 22 of the California Code of Regulations.
(b) (1) An applicant or a provider who applied for enrollment or
continued enrollment in the Medi-Cal program, prior to May 1, 2003,
and for whom the application has not been approved or denied, or who
has not received a notice on or before January 1, 2004, that the
department is exercising its authority under Section 14043.37,
14043.4, or 14043.7 to conduct background checks, preenrollment
inspections, or unannounced visits, shall be granted provisional
provider status effective on January 1, 2004. Applications from
applicants or providers who have been so noticed prior to January 1,
2004, shall be processed in accordance with subdivision (e)
(h) of Section 14043.26.
(2) Applications from applicants or providers that have been
received by the department after May 1, 2003, but prior to January 1,
2004, shall be processed in accordance with Section 14043.26, except
that these application packages shall be deemed to have been
received by the department on January 1, 2004.
SEC. 19. Section 14115.8 of the Welfare and Institutions Code is
amended to read:
14115.8. (a) (1) The department shall amend the Medicaid state
plan with respect to the billing option for services by local
education educational agencies, to
ensure that schools shall be reimbursed for all eligible services
that they provide that are not precluded by federal requirements.
(2) The department shall examine methodologies for increasing
school participation in the Medi-Cal billing option for local
education educational agencies so that
schools can meet the health care needs of their students.
(3) The department, to the extent possible shall simplify claiming
processes for local education educational
agency billing.
(4) The department shall eliminate and modify state plan and
regulatory requirements that exceed federal requirements when they
are unnecessary.
(b) If a rate study for the LEA Medi-Cal billing option is
completed pursuant to Section 52 of Chapter 171 of the Statutes of
2001, the department, in consultation with the entities named in
subdivision (c), shall implement the recommendations from the study,
to the extent feasible and appropriate.
(c) In order to assist the department in formulating the state
plan amendments required by subdivisions (a) and (b), the department
shall regularly consult with the State Department of Education,
representatives of urban, rural, large and small school districts,
and county offices of education, the local education consortium,
local education educational agencies,
and the local education educational
agency technical assistance project. It is the intent of the
Legislature that the department also consult with staff from Region
IX of the federal Centers for Medicare and Medicaid Services, experts
from the fields of both health and education, and state legislative
staff.
(d) Notwithstanding any other provision of law, or any other
contrary state requirement, the department shall take whatever action
is necessary to ensure that, to the extent there is capacity in its
certified match, a local education
educational agency shall be reimbursed retroactively for the
maximum period allowed by the federal government for any department
change that results in an increase in reimbursement to local
education educational agency providers.
(e) The department may undertake all necessary activities to
recoup matching funds from the federal government for reimbursable
services that have already
been provided in the state's public schools. The department shall
prepare and take whatever action is necessary to implement all
regulations, policies, state plan amendments, and other requirements
necessary to achieve this purpose.
(f) The department shall file an annual report with the
Legislature that shall include at least all of the following:
(1) A copy of the annual comparison required by subdivision (i).
(2) A state-by-state comparison of school-based Medicaid total and
per eligible child claims and federal revenues. The comparison shall
include a review of the most recent two years for which completed
data is available.
(3) A summary of department activities and an explanation of how
each activity contributed toward narrowing the gap between California'
s per eligible student federal fund recovery and the per student
recovery of the top three states.
(4) A listing of all school-based services, activities, and
providers approved for reimbursement by the federal Centers for
Medicare and Medicaid Services in other state plans that are not yet
approved for reimbursement in California's state plan and the service
unit rates approved for reimbursement.
(5) The official recommendations made to the department by the
entities named in subdivision (c) and the action taken by the
department regarding each recommendation.
(6) A one-year timetable for state plan amendments and other
actions necessary to obtain reimbursement for those items listed in
paragraph (4).
(7) Identify any barriers to local education
educational agency reimbursement, including those
specified by the entities named in subdivision (c), that are not
imposed by federal requirements, and describe the actions that have
been, and will be, taken to eliminate them.
(g) (1) These activities shall be funded and staffed by
proportionately reducing federal Medicaid payments allocable to local
educational agencies for the provision of benefits funded by the
federal Medicaid program under the billing option for services by
local educational agencies specified in this section. Moneys
collected as a result of the reduction in federal Medicaid payments
allocable to local educational agencies shall be deposited into the
Local Education Educational Agency
Medi-Cal Recovery Account Fund , which
is hereby established in the Special Deposit Fund established
pursuant to Section 16370 of the Government Code. These funds shall
be used , upon appropriation by the Legislature, only to
support the department to meet all the requirements of this section.
As of January 1, 2010, unless If the
Legislature enacts a new statute or extends the date beyond
January 1, 2010 that ends this program , all
funds in the Local Education Educational
Agency Medi-Cal Recovery Account Fund
shall be returned proportionally to all local educational
agencies whose federal Medicaid funds were used to create this
account fund . The annual amount funded
shall not exceed one million five hundred thousand dollars
($1,500,000).
(2) Commencing with the 2003-04 fiscal year, funding
Funding received pursuant to paragraph (1) shall
derive only from federal Medicaid funds that exceed the baseline
amount of local educational agency Medicaid billing option revenues
for the 2000-01 fiscal year.
(h) (1) The department may enter into a sole source
contract to comply with the requirements of this section.
(2) The level of additional staff to comply with the requirements
of this section, including, but not limited to, staff for which the
department has contracted for pursuant to paragraph (1), shall be
limited to that level that can be funded with revenues derived
pursuant to subdivision (g).
(i) The activities of the department shall include all of the
following:
(1) An annual comparison of the school-based Medicaid systems in
comparable states.
(2) Efforts to improve communications with the federal government,
the State Department of Education, and local education
educational agencies.
(3) The development and updating of written guidelines to local
education educational agencies
regarding best practices to avoid audit exceptions, as needed.
(4) The establishment and maintenance of a local
education educational agency friendly
interactive Web site.
(j) This section shall remain in effect only until January 1,
2010, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2010, deletes or extends
that date.
