California 2009-2010 Regular Session Status: Passed Senate

SB 1236 — Medi-Cal: utilization controls.

Last action — From Assembly without further action.

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed Assembly
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2009-2010 Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which basic health care services are provided to qualified low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law establishes a program in Alameda County in which utilization controls shall not be required when, pursuant to federal law under the Medicare Program, a county hospital based utilization review committee has been established to determine the level of authorization for payment under Medi-Cal and a utilization plan has been filed with, and approved by, the department. This bill would establish a program, whereby state utilization controls shall not be required for inpatient hospital services provided by designated public hospitals, as defined, with participation being optional for each hospital. The bill would require the department to consult with designated public hospitals in the development of the program. This bill would require the department, as part of the above-described program, to seek any necessary federal approvals, including waivers and state plan amendments, for an alternative utilization control system, as specified. The bill would provide that an alternative utilization control system established for inpatient hospital services shall apply only to the extent that the nonfederal share of expenditures for the services is incurred by the designated public hospital or governmental entity with which it is affiliated, or is otherwise funded with public funds that are transferred to the state from the hospital or governmental entity. This bill would provide that the above-described provisions shall become inoperative on the date the Director of Health Care Services executes a declaration specifying that either the nonfederal share of expenditures for inpatient hospitalization at designated public hospitals used for purposes of claiming federal financial participation is not comprised of funds that are paid and certified by designated public hospitals in accordance with applicable state and federal requirements or the above-described program will result in increased costs to the General Fund. Under existing law, one of the utilization controls to which services are subject under the Medi-Cal program is the treatment authorization request (TAR) process, which is approval by a department consultant of a specified service in advance of the rendering of that service based upon a determination of medical necessity. Existing law requires the department to pursue additional means to improve and streamline the TAR process. In addition to the above-described program providing designated public hospitals with the option of not using state utilization controls, the bill would authorize the department to utilize any process or program, including any pilot project, that is established or authorized pursuant to the above-described provisions authorizing the department to pursue additional means to improve and streamline the TAR process, that is modified or developed to meet the needs of the particular designated public hospital.

Bill Text

Action History

  1. From Assembly without further action.

  2. From committee without further action.

  3. Set, second hearing. Held in committee and under submission.

  4. Set, first hearing. Referred to APPR. suspense file.

  5. (Heard in committee on June 15.)

  6. From committee: Do pass, but first be re-referred to Com. on APPR. with recommendation: To Consent Calendar. (Ayes 18. Noes 0.) Re-referred to Com. on APPR.

  7. From committee with author's amendments. Read second time. Amended. Re-referred to Com. on HEALTH.

  8. To Com. on HEALTH.

  9. In Assembly. Read first time. Held at Desk.

  10. Read third time. Passed. (Ayes 35. Noes 0. Page 3743.) To Assembly.

  11. To Special Consent Calendar.

  12. Read second time. To third reading.

  13. From committee: Do pass. (Ayes 10. Noes 0. Page 3673.)

  14. (Suspense - for vote only.)

  15. Set for hearing May 27.

  16. From committee with author's amendments. Read second time. Amended. Re-referred to Com. on APPR.

  17. Placed on APPR suspense file.

  18. Set for hearing May 3.

  19. Read second time. Amended. Re-referred to Com. on APPR.

  20. From committee: Do pass as amended, but first amend, and re-refer to Com. on APPR. (Ayes 9. Noes 0. Page 3211.)

  21. Set for hearing April 14.

  22. To Com. on HEALTH.

  23. From print. May be acted upon on or after March 23.

  24. Introduced. Read first time. To Com. on RLS. for assignment. To print.

Sponsors

  • Alquist · Primary
  • Beall · Cosponsor

Sponsorship breakdown

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1 sponsors · 1 co-sponsors · 120 not signed on

Sponsors (1)

  • Alquist

Co-sponsors (1)

  • Beall

Not signed on (120)

120 members have not signed on to this bill.

Show all 120 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Do pass and re-refer to Committee on Appropriations with recommendation: To Consent Calendar.

Passed 25 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 23001
Republican 2000
Total 25001
% of votes cast 96%0%0%4%
How each member voted (26)
Member Party Vote
Carter — Yea
Eng — Yea
Hayashi — Yea
Hernandez — Yea
Conway — Yea
De — Yea
La — Yea
Torre — Yea
De — Yea
Leon — Yea
Fletcher — Yea
Bonnie — Yea
Lowenthal — Yea
V. — Yea
Ammiano — Yea
Manuel — Yea
Perez — Yea
Salas — Yea
Audra — Yea
Monning — Yea
Nava — Not Voting
Nestande — Yea
Smyth — Yea
Beth Gaines — Yea
Jones, Brian W. Republican Yea
Strickland, Tony Republican Yea

Official roll call →

Special Consent #26 SB1236 Alquist

Passed 36 Yea · 0 Nay · 3 Other
Party YeaNayPresentNot Voting
Unaffiliated 33003
Democratic 2000
Republican 1000
Total 36003
% of votes cast 92%0%0%8%
How each member voted (39)
Member Party Vote
Yee — Yea
Hancock — Yea
Cedillo — Yea
Cogdill — Yea
Corbett — Yea
Harman — Not Voting
Hollingsworth — Yea
Kehoe — Yea
Leno — Yea
Liu — Yea
Lowenthal — Yea
Negrete — Yea
Runner — Yea
Ducheny — Yea
Dutton — Yea
McLeod — Yea
Alquist — Yea
Ashburn — Yea
Oropeza — Not Voting
Pavley — Yea
Price — Yea
Steinberg — Yea
Walters — Yea
Wolk — Yea
Wright — Yea
Aanestad — Yea
Huff — Yea
Romero — Yea
Simitian — Yea
Wiggins — Not Voting
Wyland — Yea
Correa — Yea
Cox — Yea
DeSaulnier — Yea
Denham — Yea
Florez — Yea
Calderon, Lisa Democratic Yea
Padilla, Stephen C. Democratic Yea
Strickland, Tony Republican Yea

Official roll call →

Do pass.

Passed 10 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 10001
Total 10001
% of votes cast 91%0%0%9%
How each member voted (11)
Member Party Vote
Yee — Yea
Leno — Yea
Price — Yea
Walters — Yea
Wolk — Yea
Alquist — Yea
Kehoe — Yea
Wyland — Yea
Corbett — Yea
Cox — Not Voting
Denham — Yea

Official roll call →

Placed on Appropriations Suspense file.

Passed 10 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 10001
Total 10001
% of votes cast 91%0%0%9%
How each member voted (11)
Member Party Vote
Yee — Yea
Wyland — Yea
Leno — Yea
Price — Yea
Walters — Yea
Wolk — Yea
Alquist — Not Voting
Kehoe — Yea
Corbett — Yea
Cox — Yea
Denham — Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does SB 1236 do?
Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which basic health care services are provided to qualified low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law establishes a program in Alameda County in which utilization controls shall not be required when, pursuant to federal law under the Medicare Program, a county hospital based utilization review committee has been established to determine the level of authorization for payment under Medi-Cal and a utilization plan has been filed with, and approved by, the department. This bill would establish a program, whereby state utilization controls shall not be required for inpatient hospital services provided by designated public hospitals, as defined, with participation being optional for each hospital. The bill would require the department to consult with designated public hospitals in the development of the program. This bill would require the department, as part of the above-described program, to seek any necessary federal approvals, including waivers and state plan amendments, for an alternative utilization control system, as specified. The bill would provide that an alternative utilization control system established for inpatient hospital services shall apply only to the extent that the nonfederal share of expenditures for the services is incurred by the designated public hospital or governmental entity with which it is affiliated, or is otherwise funded with public funds that are transferred to the state from the hospital or governmental entity. This bill would provide that the above-described provisions shall become inoperative on the date the Director of Health Care Services executes a declaration specifying that either the nonfederal share of expenditures for inpatient hospitalization at designated public hospitals used for purposes of claiming federal financial participation is not comprised of funds that are paid and certified by designated public hospitals in accordance with applicable state and federal requirements or the above-described program will result in increased costs to the General Fund. Under existing law, one of the utilization controls to which services are subject under the Medi-Cal program is the treatment authorization request (TAR) process, which is approval by a department consultant of a specified service in advance of the rendering of that service based upon a determination of medical necessity. Existing law requires the department to pursue additional means to improve and streamline the TAR process. In addition to the above-described program providing designated public hospitals with the option of not using state utilization controls, the bill would authorize the department to utilize any process or program, including any pilot project, that is established or authorized pursuant to the above-described provisions authorizing the department to pursue additional means to improve and streamline the TAR process, that is modified or developed to meet the needs of the particular designated public hospital.
Who sponsors SB 1236?
SB 1236 is sponsored by Alquist and Beall.
What is the current status of SB 1236?
This bill died with 2009-2010 Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 1236?
Track SB 1236 free on One Click Politics — get push/email alerts when it moves.

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