Bill Text: CA SB1212 | 2013-2014 | Regular Session | Amended
Bill Title: Medi-Cal: moratoria on enrollment of providers.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2014-04-30 - Set, first hearing. Testimony taken. Further hearing to be set. [SB1212 Detail]
Download: California-2013-SB1212-Amended.html
BILL NUMBER: SB 1212 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 7, 2014
INTRODUCED BY Senator Walters
FEBRUARY 20, 2014
An act to amend Section 14043.55 of the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
SB 1212, as amended, Walters. Medi-Cal: moratoria on enrollment of
providers.
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 implement a moratorium on the enrollment of providers in the
Medi-Cal program under specified circumstances.
This
This bill would require the department to exempt a clinical
laboratory provider from a moratorium on the enrollment of
clinical laboratories if the provider has an existing relationship
with the Medi-Cal program as a provider of benefits
through a contract with a Medi-Cal managed care plan. The bill
would also make other technical, nonsubstantive
changes to these provisions.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14043.55 of the Welfare and Institutions Code
is amended to read:
14043.55. (a) (1) The department may
implement a 180-day moratorium on the enrollment of providers in a
specific provider of service category, on a statewide basis or within
a geographic area, except that no moratorium shall be implemented on
the enrollment of providers who are licensed as clinics under
Section 1204 of the Health and Safety Code, health facilities under
Chapter 2 (commencing with Section 1250) of the Health and Safety
Code, clinics exempt from licensure under Section 1206 of the Health
and Safety Code, or natural persons licensed or certified under
Division 2 (commencing with Section 500) of the Business and
Professions Code, the Osteopathic Initiative Act, or the Chiropractic
Initiative Act, when the director determines this action is
necessary to safeguard public funds or to maintain the fiscal
integrity of the program. This moratorium may be extended or repeated
when the director determines this action is necessary to safeguard
public funds or to maintain the fiscal integrity of the program. The
authority granted in this section shall not be interpreted as a
limitation on the authority granted to the department in Section
14105.3.
(2) Notwithstanding paragraph (1), if a moratorium is implemented
on the enrollment of clinical laboratories pursuant to paragraph (1),
the department shall exempt from the moratorium a clinical
laboratory provider that has an existing relationship with the
Medi-Cal program as a provider of benefits through a contract with a
Medi-Cal managed care plan.
(b) If the Secretary of the United States Department of Health and
Human Services establishes a temporary moratorium on enrollment as
described in federal regulations, the department shall establish a
corresponding moratorium covering the same period and provider types,
even if those provider types would not ordinarily be subject to a
moratorium under this section, unless the department determines that
the imposition of the moratorium will adversely impact beneficiaries
access to medical assistance. A federal moratorium adopted under this
subdivision shall not be subject to the director's determinations
regarding safeguards of public funds and program integrity or other
prerequisites that are necessary to implement a state-initiated
moratorium.
