Bill Text: CA AB882 | 2021-2022 | Regular Session | Amended
Bill Title: Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program.
Sponsorship: Partisan Bill (Democrat 3)
Status: (Failed) 2022-02-01 - From committee: Filed with the Chief Clerk pursuant to Joint Rule 56. [AB882 Detail]
Download: California-2021-AB882-Amended.html
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Amended
IN
Assembly
April 15, 2021 |
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Amended
IN
Assembly
March 22, 2021 |
CALIFORNIA LEGISLATURE—
2021–2022 REGULAR SESSION
Assembly Bill
No. 882
| Introduced by Assembly Members Gray and Salas (Principal coauthor: Senator Hurtado) |
February 17, 2021 |
An act to amend Section 14114 of the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 882, as amended, Gray.
Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program.
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, the California Healthcare, Research and Prevention Tobacco Tax Act of 2016, an initiative measure approved as Proposition 56 at the November 8, 2016, statewide general election, increases taxes imposed on distributors of cigarettes and tobacco products and requires all revenues to be deposited into the California Healthcare, Research and Prevention Tobacco Tax Act of 2016 Fund, a continuously appropriated fund. Proposition 56 requires the Controller to transfer 82% of those revenues to the Healthcare Treatment Fund, to be used
by the department to increase funding for the Medi-Cal program and other specified health care programs and services in a way that, among other things, ensures timely access, limits geographic shortages of services, and ensures quality care. The act authorizes the Legislature to amend the provision relating to the allocation of revenues in the Healthcare Treatment Fund to further the purposes of the act with a 2/3 vote of the membership of each house of the Legislature.
Existing law, until January 1, 2026, establishes the Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program, which requires the department to develop and administer the program to provide loan assistance payments to qualifying, recent graduate physicians and dentists that
who serve beneficiaries of the Medi-Cal program and other specified health care programs using moneys from the Healthcare Treatment Fund. Existing law requires this program to be funded using moneys appropriated to the department for this purpose in the Budget Act of 2018, and requires the department to administer 2 separate payment pools for participating physicians and dentists, respectively, consistent with the allocations provided for in the Budget Act of 2018.
For purposes of that program, and by January 1, 2022, this bill would require the department to exclusively provide loan assistance payments to Medi-Cal physicians and dentists who practice in federally designated health professional shortage areas and who maintain a patient caseload composed of a minimum of 30% Medi-Cal beneficiaries, and to annually verify that these providers continue to practice in those designated areas. The
beneficiaries and who meet one or more of specified requirements relating to practicing in areas, or serving populations, with provider shortages. The bill would make this provision inapplicable to an individual who enters into, and maintains compliance with, an Awardee Agreement to receive loan assistance payments before January 1, 2022. The bill would require the department to annually verify that participating providers continue to meet the program requirements, as specified. The bill would require the program to post any annual report prepared by it on its internet website.
The bill would delete the provision making this program inoperative on January 1, 2026, would delete the references to the Budget Act of 2018, and would instead refer to the
annual Budget Act. By extending the operation of this program and the authority to allocate revenues in the fund for this authorized expenditure, the bill would amend Proposition 56.
Digest Key
Vote: 2/3 Appropriation: NO Fiscal Committee: YES Local Program: NOBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 14114 of the Welfare and Institutions Code is amended to read:14114.
(a) This section shall be(b) (1) Notwithstanding any other law, the department shall develop and administer the Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program to provide loan assistance
payments to qualifying, recent graduate physicians and dentists that who serve beneficiaries of existing health care programs described in Chapter 7 (commencing with Section 14000) to Chapter 8.9 (commencing with Section 14700), inclusive. To implement this section, the department shall consult with other state entities, including the Office of Statewide Health Planning and Development, and with affected stakeholders.
(2) By January 1, 2022, and subject to subdivision (c), the department shall exclusively provide loan assistance payments, as specified under paragraph (1), to individuals who practice in health professional shortage areas, as determined by the federal Health Resources and Services Administration, and
who maintain a patient caseload composed of a minimum of 30 percent Medi-Cal beneficiaries. The department shall annually verify that these providers continue to practice in those designated areas. beneficiaries and who meet one or more of the following requirements:
(A) Practice in a health professional shortage area, as determined by the federal Health Resources and Services Administration.
(B) Practice in a specialty and serve a Medi-Cal patient population where the department has demonstrated a provider shortage exists in the Medi-Cal program, Medi-Cal
behavioral health program, or Medi-Cal dental program using one or more of the following:
(i) Network adequacy standards, annual network certification, or other quantitative provider participation measurements submitted to the department pursuant to Sections 438.68, 438.206, and 438.207 of Title 42 of the Code of Federal Regulations and Section 14197 of this code.
(ii) Measures of the ratio of active dentists-to-beneficiaries in a county or service area where the ratio exceeds 1 to 2,000.
(iii) Measures of dental specialists in Medi-Cal where the department has demonstrated there exists an inadequate number of active and participating dental specialists serving Medi-Cal beneficiaries.
(iv) An approved alternative access request submitted by a Medi-Cal
managed care plan, as defined in subdivision (h) of Section 14197, and approved by the department pursuant to subdivision (e) of Section 14197 within the previous two years.
(v) Other quantified data that demonstrate a provider shortage for Medi-Cal beneficiaries.
(3) The department shall annually verify that participating providers continue to meet the program requirements, consistent with paragraph (2) and as outlined within their Awardee Agreement. Any determination regarding individual provider recertification shall be at the discretion of the department and any entity contracted with pursuant to subdivision (h).
(4) Paragraph (2) does not apply to an individual who enters into, and maintains compliance with, an Awardee Agreement to receive loan assistance payments before January 1, 2022.
(c) The Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program shall be funded using moneys appropriated to the department for this purpose in the annual Budget Act from the Healthcare Treatment Fund established pursuant to subdivision (a) of Section 30130.55 of the Revenue and Taxation Code. The department shall administer two separate payment pools for participating physicians and dentists, respectively, consistent with the allocations provided for in the annual Budget Act. To the extent authorized by subdivision (f) of Section 30130.57 of the Revenue and Taxation Code, moneys appropriated to the department to implement this section shall be available to fund the administrative costs incurred by the department and any entity contracted with pursuant to subdivision (g).
(h).
(d) The department shall develop the eligibility criteria to be used to evaluate physician and dentist participation in the Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program. In developing this these criteria, and consistent with subdivision (a) of Section 30130.55 of the Revenue and Taxation Code, the department shall prioritize ensuring timely access, limiting geographic shortages of services, and ensuring quality care in the Medi-Cal program. The department shall develop separate criteria for distribution of payments from the physician and dentist payment pools. At a minimum, the department shall establish
the maximum number of years a physician or dentist may be in practice to qualify for payments pursuant to this section, and the minimum number of years a participating physician or dentist receiving payments pursuant to this section shall agree to participate as an enrolled provider in the Medi-Cal program.
(e) The selection of physicians and dentists for participation in the Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program and the amount of loan repayment assistance awarded to a participating physician or dentist shall be at the discretion of the department and any entity contracted with pursuant to subdivision (g), (h), and shall be based on the
criteria developed pursuant to subdivision (d). An exercise of discretion by the department and its contractors shall not be subject to judicial review, except that an applicant physician or dentist who is not selected for participation in the program may file for a writ of mandate pursuant to Section 1085 of the Code of Civil Procedure to rectify an abuse of discretion by the department and its contractors.
(f) The Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program shall post any annual report prepared by the program on the program’s internet website.
(f)
(g) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, in whole or in part, by means of policy letters, provider bulletins, or other similar instructions, without taking regulatory action. The department shall consult with affected stakeholders before taking action pursuant to this subdivision.
(g)
(h) To
implement this section, the department may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this subdivision shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and the review or approval of a division of the Department of General Services.
(h)
(i) This section shall be implemented only to the extent that the department determines that federal
financial participation under the Medi-Cal program is not jeopardized. If the department determines there is a reasonable likelihood that federal financial participation is available for expenditures pursuant to this section, it may seek the federal approvals necessary to obtain federal financial participation.
(i)
(j) The Legislature finds and declares that the expenditures authorized by this section are all of the following:
(1) Made in accordance with the California Healthcare, Research and Prevention Tobacco Tax Act of
2016 (Article 2 (commencing with Section 30121) of Chapter 2 of Part 13 of Division 2 of the Revenue and Taxation Code).
(2) Based on criteria developed and periodically updated as part of the annual budget process in accordance with subdivision (a) of Section 30130.55 of the Revenue and Taxation Code.
(3) Consistent with the purposes and conditions for expenditures described in subdivision (a) of Section 30130.55 of the Revenue and Taxation Code.
(j)
(k) The Legislature
finds and declares that this section is a state law within the meaning of Section 1621(d) of Title 8 of the United States Code.
