Bill Text: CA AB411 | 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: performance measures.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Vetoed) 2014-03-06 - Last day to consider Governor's veto pursuant to Joint Rule 58.5. [AB411 Detail]

Download: California-2013-AB411-Amended.html

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BILL NUMBER: AB 411	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 18, 2013
	AMENDED IN ASSEMBLY  APRIL 9, 2013

INTRODUCED BY   Assembly Member Pan

                        FEBRUARY 15, 2013

   An act to add Section 14029.91 to the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 411, as amended, Pan. Medi-Cal: performance measures.
   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. Under existing law, one of the methods
by which Medi-Cal services are provided is pursuant to contracts with
managed care plans.
   This bill would require all Medi-Cal managed care plans to analyze
their Healthcare Effectiveness Data and Information Set (HEDIS)
measures, or their External Accountability Set (EAS) performance
measure equivalent, by geographic region,  primary language,
 race, ethnicity,  and primary language,  
and, to the extent data is available, by sexual orientation and
gender identity,  and to implement strategies to reduce
identified disparities between members from different regions, 
with different primary languages, and  of different 
races and   races,  ethnicities,  sexual
orientations,  and  with different primary languages.
  gender identities.  The bill would also require
that these analyses be reported to the State Department of Health
Care Services annually and be made available to the public via the
department's Internet Web site. This bill would further require all
Medi-Cal managed care plans to link individual level data collected
as a part of analyzing their HEDIS measures, or their EAS performance
measure equivalent, to personal identifiers and to submit that data
to the department annually. The department would be required to make
the individual level data available for research purposes, as
specified.
   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 14029.91 is added to the Welfare and
Institutions Code, to read:
   14029.91.  (a) (1) The department shall require all Medi-Cal
managed care plans, including county organized health systems and
plans contracting with the department to provide services pursuant to
two-plan and geographic managed care models, to analyze their
Healthcare Effectiveness Data and Information Set (HEDIS) measures,
or their External Accountability Set (EAS) performance measure
equivalent, by geographic region,  primary language,  race,
 and ethnicity   ethnicity,   and, to
the extent data is available, by sexual orientation and gender
identity  in order to identify disparities in medical treatment
between Medi-Cal managed care members from different  regions
  regions, with different primary languages,  and
of different  races and ethnicities   races,
ethnicities, sexual orientations, and gender identities,  and to
implement strategies to reduce those disparities. 
   (2) The department shall require the plans described in paragraph
(1) to analyze their HEDIS measures, or their EAS performance measure
equivalent, by primary language in order to identify disparities in
medical treatment between Medi-Cal managed care members with
different primary languages and to implement strategies to reduce
those disparities.  
   (3) 
    (   2)  The results of the analyses prepared in
accordance with this subdivision shall be reported to the department
annually. The department shall make such analyses available to the
public through the department's Internet Web site.
   (b) The department shall require the plans described in paragraph
(1) of subdivision (a) to link all individual level data collected as
a part of analyzing their HEDIS measures, or their EAS performance
measure equivalent, to patient identifiers in a manner that allows
for an analysis of disparities in medical treatment by geographic
region,  primary language,  race, ethnicity,  and
primary language,   and, to the extent data is
available, by sexual orientation and gender identity,  and to
provide that information to the department annually. The department
shall make this data available, in a format that complies with the
Health Insurance Portability and Accountability Act of 1996, for
research purposes through a data use or business associate agreement.