Bill Text: CA SB242 | 2021-2022 | Regular Session | Amended
Bill Title: Health care provider reimbursements.
Spectrum: Partisan Bill (Democrat 5-0)
Status: (Passed) 2021-10-05 - Chaptered by Secretary of State. Chapter 538, Statutes of 2021. [SB242 Detail]
Download: California-2021-SB242-Amended.html
Amended
IN
Senate
April 13, 2021 |
Amended
IN
Senate
March 15, 2021 |
Introduced by Senator Newman (Coauthors: Senators Hueso and Wiener) (Coauthors: Assembly Members Robert Rivas and Stone) |
January 21, 2021 |
LEGISLATIVE COUNSEL'S DIGEST
Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and 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 requires the director of the department to establish and periodically review and revise the statewide
Medi-Cal reimbursement rates for health care services. Under existing law, Medi-Cal reimbursement rates do not distinguish between services provided by a physician and services provided by a dentist.
Digest Key
Vote: 2/3 Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 1374.192 is added to the Health and Safety Code, to read:1374.192.
(a) Notwithstanding any other law, a health care service plan, including a specialized health care service plan and a health care service plan that issues, sells, renews, or offers a contract covering dental services, shall reimburse its contracting health care providers for business expenses that are medically necessary to comply with a public health order to render treatment to patients, to protect health care workers, and to prevent the spread of diseases causing public health emergencies, including COVID-19. These medically necessary business expenses include personal protective equipment, infection control supplies or materials, medical testing supplies, test processing, the cost of transporting specimens, information technology systems for tracking infections and processing testing.SEC. 2.
Section 10120.35 is added to the Insurance Code, to read:10120.35.
(a) Notwithstanding any other law, a health insurer, including a specialized health insurer and a health insurer that issues, sells, renews, or offers a contract covering dental services, shall reimburse its contracting health care providers for business expenses that are medically necessary to comply with a public health order to render treatment to patients, to protect health care workers, and to prevent the spread of diseases causing public health emergencies, including COVID-19. These medically necessary business expenses include personal protective equipment, infection control supplies or materials, medical testing supplies, test processing, the cost of transporting specimens, information technology systems for tracking infections and processing testing.(a)Notwithstanding any other law, the department shall reimburse physicians and dentists for business expenses that are medically necessary to render treatment to patients, to protect health care workers, and to comply with a public health order to prevent the spread of diseases causing public health emergencies, including COVID-19. These medically necessary business expenses include personal protective equipment, infection control supplies or materials, medical or diagnostic equipment including testing supplies, test processing, the cost of transporting specimens, information technology systems for tracking infections and
processing testing, or other related information technology expenses.
(b)(1)The department shall undertake a process to set
reimbursement pursuant to subdivision (a) at a reasonable rate after consultation with provider groups. The reimbursement rate paid to dentists shall be the same as the rate paid to physicians, pursuant to Section 14079.5.
(2)The department may provide supplemental payments to a physician or dentist to purchase personal protective equipment, infection control supplies or materials, testing supplies, test processing, test specimen transport, or other medical equipment.
(c)The department shall ensure that reimbursement pursuant to subdivision (a) is provided timely to physicians and dentists. The department may adopt regulations to implement this section.