Bill Text: CA SB1045 | 2013-2014 | Regular Session | Chaptered
Bill Title: Medi-Cal Drug Treatment Program: group outpatient drug free services.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Passed) 2014-07-07 - Chaptered by Secretary of State. Chapter 80, Statutes of 2014. [SB1045 Detail]
Download: California-2013-SB1045-Chaptered.html
BILL NUMBER: SB 1045 CHAPTERED
BILL TEXT
CHAPTER 80
FILED WITH SECRETARY OF STATE JULY 7, 2014
APPROVED BY GOVERNOR JULY 7, 2014
PASSED THE SENATE JUNE 26, 2014
PASSED THE ASSEMBLY JUNE 23, 2014
AMENDED IN ASSEMBLY JUNE 19, 2014
AMENDED IN ASSEMBLY JUNE 15, 2014
AMENDED IN SENATE MAY 13, 2014
AMENDED IN SENATE MARCH 28, 2014
INTRODUCED BY Senator Beall
FEBRUARY 18, 2014
An act to amend Section 14021.6 of the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
SB 1045, Beall. Medi-Cal Drug Treatment Program: group outpatient
drug free services.
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. The Medi-Cal program is, in part, governed and funded by
federal Medicaid provisions.
Existing law also provides for the Medi-Cal Drug Treatment Program
(Drug Medi-Cal), under which each county enters into contracts with
the State Department of Health Care Services to provide various drug
treatment services to Medi-Cal recipients, or the department directly
arranges to provide these services if a county elects not to do so.
For purposes of Drug Medi-Cal, existing law requires that the maximum
allowable rate for group outpatient drug free services be set on a
per person basis and requires that a group consist of a minimum of 4,
and a maximum of 10, individuals, at least one of which must be a
Medi-Cal eligible beneficiary.
This bill would instead require a group to consist of a minimum of
2 and a maximum of 12 individuals, at least one of which is a
Medi-Cal eligible beneficiary. The bill would also require, if one of
the individuals in a 2-member group is ineligible for Medi-Cal, that
the individual who is ineligible for Medi-Cal be receiving
outpatient drug free services for a substance abuse disorder
diagnosed by a physician.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14021.6 of the Welfare and Institutions Code is
amended to read:
14021.6. (a) For the fiscal years prior to fiscal year 2004-05,
and subject to the requirements of federal law, the maximum allowable
rates for the Medi-Cal Drug Treatment Program shall be determined by
computing the median rate from available cost data by modality from
the fiscal year that is two years prior to the year for which the
rate is being established.
(b) (1) For the fiscal year 2007-08, and subsequent fiscal years,
and subject to the requirements of federal law, the maximum allowable
rates for the Medi-Cal Drug Treatment Program shall be determined by
computing the median rate from the most recently completed cost
reports, by specific service codes that are consistent with the
federal Health Insurance Portability and Accountability Act of 1996
(42 U.S.C. Sec. 300gg).
(2) For the fiscal years 2005-06 and 2006-07, if the State
Department of Health Care Services and the State Department of
Alcohol and Drug Programs determine that reasonably reliable and
complete cost report data are available, the methodology specified in
this subdivision shall be applied to either or both of those years.
If reasonably reliable and complete cost report data are not
available, the State Department of Health Care Services and the State
Department of Alcohol and Drug Programs shall establish rates for
either or both of those years based upon the usual, customary, and
reasonable charge for the services to be provided, as these two
departments may determine in their discretion. This subdivision is
not intended to modify subdivision (h) of Section 14124.24, which
requires certain providers to submit performance reports.
(c) Notwithstanding subdivision (a), for the 1996-97 fiscal year,
the rates for nonperinatal outpatient methadone maintenance services
shall be set at the rate established for the 1995-96 fiscal year.
(d) Notwithstanding subdivision (a), the maximum allowable rate
for group outpatient drug free services shall be set on a per person
basis. A group shall consist of a minimum of 2 and a maximum of 12
individuals, at least one of which shall be a Medi-Cal eligible
beneficiary. For groups consisting of two individuals, if one of the
individuals is ineligible for Medi-Cal, the individual who is
ineligible for Medi-Cal shall be receiving outpatient drug free
services for a substance abuse disorder diagnosed by a physician.
(e) The department shall develop individual and group rates for
extensive counseling for outpatient drug free treatment, based on a
50-minute individual or a 90-minute group hour, not to exceed the
total rate established for subdivision (d).
(f) The department may adopt regulations as necessary to implement
subdivisions (a), (b), and (c), or to implement cost containment
procedures. These regulations may be adopted as emergency regulations
in accordance with Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code. The adoption
of these emergency regulations shall be deemed an emergency necessary
for the immediate preservation of the public peace, health and
safety, or general welfare.
