Bill Text: CA AB367 | 2009-2010 | Regular Session | Amended

California Assembly Bill 367 (Prior Session Legislation)

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

Bill Title: Medi-Cal: HIV drug treatment: developmental services:

Sponsorship: Bipartisan Bill

Status: (Introduced - Dead) 2010-02-02 - From committee: Filed with the Chief Clerk pursuant to Joint Rule 56. [AB367 Detail]

Download: California-2009-AB367-Amended.html

BILL NUMBER: AB 367	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 13, 2009

INTRODUCED BY   Assembly Members Galgiani and Audra Strickland

                        FEBRUARY 23, 2009

    An act relating to Medi-Cal.   An act to
amend Section 16531.1 of the Government Code, and to repeal Section
14041.1 of the Welfare and Insti   tutions Code, relating to
Medi-Cal, and making an appropriation therefor. 


	LEGISLATIVE COUNSEL'S DIGEST


   AB 367, as amended, Galgiani.  Medi-Cal: skilled nursing
facilities and intermediate care facilities for persons with
developmental disabilities.   Medi-Cal: HIV drug
treatment: developmental services: provider reimbursement.  

   Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which basic health
care services are provided to qualified low-income persons. 

   Existing law creates the continuously appropriated Medical
Providers Interim Payment Fund, for the purposes of paying Medi-Cal
providers, providers of drug treatment services for persons infected
with HIV, and providers of services for the developmentally disabled,
on and after July 1, and before September 1, of the fiscal year for
which a budget has not yet been enacted or there is a deficiency in
the Medi-Cal budget in any fiscal year, and appropriates, for each
fiscal year in which these payments are necessary, up to
$1,000,000,000 from the General Fund, in the form of loans, and
$1,000,000,000 from the Federal Trust Fund to the Medical Providers
Interim Payment Fund.  
   This bill would, instead, provide that these transfers to the
Medical Providers Interim Payment Fund shall be in an amount
sufficient to make continued payments to the above-described
providers. To the extent that the bill would increase the amount
transferred into a continuously appropriated fund, this bill would
make an appropriation.  
   Under existing law, notwithstanding any other provision of law,
and to the extent not otherwise conflicting with federal law, the
department is authorized to hold, or direct the medical fiscal
intermediary for the Medi-Cal program to hold, payments for Medi-Cal
providers, as described, for a period of one month for a month ending
prior to June 30, 2009.  
   This bill would delete the above provisions.  
   Existing law provides for the Medi-Cal program, administered by
the State Department of Health Care Services, under which health care
services, including skilled nursing facility services and
intermediate care facility services for persons with developmental
disabilities, are provided to qualified low-income persons. 

   This bill would state the intent of the Legislature to enact
legislation that would ensure that facilities serving the elderly and
persons with developmental disabilities receive the uninterrupted
Medi-Cal payments necessary to ensure continuous services for those
who rely on their care. 
   Vote:  majority   2/3  . Appropriation:
 no   yes  . Fiscal committee:  no
  yes  . State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 16531.1 of the  
Government Code   is amended to read: 
   16531.1.  (a) Notwithstanding any other provision of law and
without regard to fiscal year, if the annual State Budget is not
enacted by June 30 of any fiscal year preceding the fiscal year to
which the budget would apply or there is a deficiency in the Medi-Cal
budget during any fiscal year, both of the following shall occur:
   (1)  (A)    The Controller shall 
annually  transfer from the General Fund, in the form of one
or more loans, an amount  not to exceed a cumulative total
of one billion dollars ($1,000,000,000) in any fiscal year, 
 sufficient to make continued payments to Medi-Cal providers,
providers of services under Chapter 6 (commencing with Section
120950) of Part 4 of Division 105 of the Health and Safety Code, and
providers of services under Division 4.5 (commencing with Section
4500) of the Welfare and Institutions Code,  to the Medical
Providers Interim Payment Fund, which is hereby created in the State
Treasury. Notwithstanding Section 13340  of the Government
Code  , the Medical Providers Interim Payment Fund is hereby
continuously appropriated  without regard to fiscal year 
for the purpose of making payments  to Medi-Cal providers,
providers of services under Chapter 6 (commencing with Section
120950) of Part 4 of Division 105 of the Health and Safety Code, and
providers of services under Division 4.5 (commencing with Section
4500) of the Welfare and Institutions Code, on   in
either of the following ways: 
    (i)     On  or after July 1 of the
fiscal year for which no budget has been enacted  and before
September 1 of that year or for the purpose of making payments
  , and until the date upon which a budget is enacted
for that year,  to Medi-Cal providers, providers of services
under Chapter 6 (commencing with Section 120950) of Part 4 of
Division 105 of the Health and Safety Code, and providers of services
under Division 4.5 (commencing with Section 4500) of the Welfare and
Institutions Code  , during the period in which the Medi-Cal
program has a deficiency  . 
   (ii) During the period in which the Medi-Cal program has a
deficiency, to Medi-Cal providers. 
    (B)    Payments shall be made pursuant to this
subdivision if both of the following conditions have been met:

   (A) 
    (i)  An invoice has been submitted for the services.

   (B) 
    (ii)  Payment for the services is due and payable and
the State Department of Health  Care  Services determines
that payment would be valid.
   (2) For any fiscal year to which this subdivision applies, there
is hereby appropriated  the sum of one billion dollars
($1,000,000,000)   an amount of money that is sufficient
to make additional continued payments to the providers described in
paragraph (1) of subdivision (a) on or after July 1 of the fiscal
year in which no budget has been enacted and until the date upon
which a budget is enacted for that year, or during the period in
which the Medi-Cal program has a deficiency,  from the Federal
Trust Fund to the Medical Providers Interim Payment Fund.
   (b) Upon the enactment of the annual Budget Act or a deficiency
bill in any fiscal year to which subdivision (a) applies, the
Controller shall transfer all expenditures and unexpended funds in
the Medical Providers Interim Payment Fund to the appropriate Budget
Act item.
   (c) The amount of any loan made pursuant to subdivision (a) and
for which moneys were expended from the Medical Providers Interim
Payment Fund shall be repaid by debiting the appropriate Budget Act
item in accordance with the procedure prescribed by the Department of
Finance.
   SEC. 2.    Section 14041.1 of the   Welfare
and Institutions Code   is repealed.  
   14041.1.  (a) Notwithstanding any other provision of law, and to
the extent not otherwise conflicting with federal law, the department
may hold for a period of one month, or direct the medical fiscal
intermediary for the Medi-Cal program to hold for a period of one
month, payments to providers or their designated agents for health
care services that are provided pursuant to this chapter, and
payments to entities that contract with the department pursuant to
this chapter, Chapter 8 (commencing with Section 14200) and Chapter
8.75 (commencing with Section 14590) for the delivery of health care
services.
   (b) The authority described in subdivision (a) shall be limited to
payments for one month only, and only for a month ending prior to
June 30, 2009.  
  SECTION 1.    (a) The Legislature finds and
declares all of the following:
   (1) Skilled nursing facilities and intermediate care facilities
for persons with developmental disabilities provide comprehensive
24-hour care to more than 300,000 of California's most vulnerable
citizens each year.
   (2) Sixty-five percent of the elderly patients in skilled nursing
facilities, and nearly 100 percent of the clients in intermediate
care facilities for persons with developmental disabilities, rely on
Medi-Cal benefits. A delay in Medi-Cal payments places many
individual providers and the people they serve in extreme jeopardy.
   (3) Services provided by skilled nursing facilities and
intermediate care facilities for persons with developmental
disabilities are dictated by very prescriptive federal and state
requirements that make it impossible for these providers to discharge
patients, delay services, or change the intensity of their care to
accommodate a delay in reimbursement.
   (4) Because the government is a dominant payor for services
provided by skilled nursing facilities and intermediate care
facilities for persons with developmental disabilities, it is also
impossible for these providers to compensate for delayed Medi-Cal
payments by shifting costs to other payors or generating revenue from
alternative sources.
   (5) In light of the compromised state of the current credit
market, skilled nursing facilities and intermediate care facilities
for persons with developmental disabilities are either unable to
secure short-term loans or forced to pay exorbitant rates for money
they borrow to compensate for the lack of Medi-Cal revenue.
   (b) It is therefore the intent of the Legislature to enact
legislation that would ensure that facilities serving the elderly and
persons with developmental disabilities receive the uninterrupted
Medi-Cal payments necessary to ensure continuous services for those
who rely on their care.