Bill Text: CA AB2051 | 2013-2014 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Medi-Cal: providers: affiliate primary care clinics.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Passed) 2014-09-16 - Chaptered by Secretary of State - Chapter 356, Statutes of 2014. [AB2051 Detail]

Download: California-2013-AB2051-Amended.html

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BILL NUMBER: AB 2051	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 29, 2014

INTRODUCED BY   Assembly Members Gonzalez and Bocanegra

                        FEBRUARY 20, 2014

   An act to add Section 14043.17 to the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2051, as amended, Gonzalez. Medi-Cal: providers: affiliate
primary care clinics.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions.
   Existing law authorizes the department to adopt regulations for
certification of each applicant and each provider in the Medi-Cal
program. Existing law requires certain applicants or providers, as
defined, to submit a complete application package for enrollment,
continuing enrollment, or enrollment at a new location or a change in
location. Existing law generally requires the department to give
written notice regarding the status of an application to an applicant
or provider within a prescribed period of time, as specified.
   This bill would require the department, within 15 days after
receiving an application and certification package from an applicant
that is an affiliate primary care clinic, to provide specified
written notice of the status of the application, or to approve the
application  on the 16th day after receiving the package,
  effective on the date the affiliate primary care
clinic license was issued,  as specified. The bill would also
require the department, within 15 days after  approving
  the approval of  an application,  to
provide written notice regarding certain conditions imposed on the
provider, or, on the 16th day after approving an application,
 to approve the provider's participation in specified public
health programs.
   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 14043.17 is added to the Welfare and
Institutions Code, to read:
   14043.17.  (a) Notwithstanding any other law, within 15 days of
receiving an application and certification package to be certified as
a Medi-Cal provider from an affiliate primary care clinic that is
licensed pursuant to Section 1218.1 of the Health and Safety Code and
that has been certified for enrollment by the State Department of
Public Health, the department shall do either of the following:
   (1) Provide written notice to the applicant that one of the
following applies:
   (A) The applicant is being granted provisional provider status for
a period of 12 months, effective from the date on the notice.
   (B) The application package is incomplete. The notice shall
identify additional information or documentation that is needed to
complete the application package. 
   (C) 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.  
   (D) 
    (C)  The application package is denied for any of the
following reasons:
   (i) Pursuant to Section 14043.2 or 14043.36.
   (ii) 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.   primary care clinic license. 
   (iii) The period of time during which an applicant or provider has
been barred from reapplying has not passed.
   (iv) For other stated reasons authorized by law.
   (v) For failing to submit fingerprints as required by federal
Medicaid regulations.
   (vi) For failing to pay an application fee as required by federal
Medicaid regulations. 
   (2) Approve the application effective on the date the affiliate
primary care clinic license was issued by the State Department of
Public Health.  
   (2) 
    (b)  On the 16th day after receiving the application,
 approve the application and make   if action is
not taken pursuant to paragraph (1) or (2) of subdivision (a), then
the application is deemed approved and  that approval  is
 effective on the date the affiliate primary care  clinic
 license was issued by the State Department of Public Health.

   (b) 
    (c)  Notwithstanding any other law, within 15 days of
 approving   the approval of  an
application pursuant to subdivision (a)  or (b)  , the
department shall  do either of the following:  
approve the provider's requested participation in any of the programs
described in Section 1222 of the Health and Safety Code. On the 16th
day after approving the application, if action is not taken, the
provider's requested participation in any of   those
programs is deemed approved.  
   (1) Provide written notice to the provider that one of the
following applies:  
   (A) The provider is being granted provisional provider status for
a period of 12 months, effective from the date on the notice.
 
   (B) 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.  
   (2) On the 16th day after approving the application, approve the
provider's participation in any of the programs described in Section
1222 of the Health and Safety Code.  
   (d) This section shall not be construed to limit the department's
authority pursuant to Section 14043.37, 14043.4, or 14043.7 to
conduct background checks, preenrollment inspections, or unannounced
visits.