California 2009-2010 Regular Session Status: Enacted

AB 1653 — Medi-Cal: hospitals: managed health care plans: mental health plans: quality assurance fee.

Last action — Chaptered by Secretary of State - Chapter 218, Statutes of 2010.

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

This bill has been enacted into law. Introduced January 14, 2010. Enacted.

Prognosis

Likely to advance 72% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 2 sponsors

    1 primary, 1 co-sponsors signed on.

  • Cleared a recorded vote

    Passed 9 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

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, subject to federal approval, requires the department to make supplemental payments for certain services, as specified, to private hospitals, nondesignated public hospitals, and designated public hospitals, as defined, for subject federal fiscal years, as defined. Existing law provides that these provisions shall remain in effect only until January 1, 2013, and as of that date are repealed. This bill would make various changes to the formulas used to determine the amount of supplemental payments made to private and designated public hospitals. This bill would expand the definition of a nondesignated public hospital. Existing law prescribes certain deadlines by which the above-described supplemental payments are required to be made to hospitals depending upon the federal fiscal year for which the payment is to be made. This bill would require the department to make to hospitals the supplemental payments for the 2008–09, 2009–10, and 2010–11 federal fiscal years in 7 payments, as specified. Existing law requires the department to make enhanced payments to managed health care plans, as defined, and requires the state to make enhanced payments to mental health plans, as defined, for each subject federal fiscal year, as specified. Existing law requires the managed health care plans and mental health plans that received enhanced payments to make supplemental payments to subject hospitals, as defined, pursuant to specified formulas. This bill would, instead, refer to the payments made by the department to the managed health care plans and mental health plans as increased capitation payments and increased payments, respectively, and would change the definition of a managed care plan. The bill would require the department to determine the amount of increased capitation payments for each Medi-Cal managed care plan and to consider prescribed factors in making that determination. The bill would prohibit the amount of increased capitation payments to each Medi-Cal managed health care plan from exceeding an amount that results in capitation payments that are certified by the state's actuary as meeting federal requirements. The bill would require each managed health care plan to expend 100% of any increased capitation payments it receives from the department on hospital services. This bill would make various changes to the provisions relating to the increased payments to mental health plans, including requiring the department to take into consideration prescribed factors when making these payments. Existing law, subject to federal approval, also imposes, as a condition of participation in state-funded health insurance programs other than the Medi-Cal program, a quality assurance fee, as specified, on certain general acute care hospitals through and including December 31, 2010. Existing law creates the Hospital Quality Assurance Revenue Fund in the State Treasury and requires that the money collected from the quality assurance fee be deposited into the fund. Existing law provides that the moneys in the fund shall, upon appropriation by the Legislature, be available only for certain purposes, including providing the above-described supplemental payments to hospitals and health care coverage for children. Existing law provides that these provisions shall remain in effect only until January 1, 2013, and as of that date are repealed. This bill would expand the definitions of a nondesignated public hospital and private hospital, and modify the formulas used in calculating the amount of the quality assurance fee imposed on hospitals pursuant to the above-described provisions. The bill would provide that the quality assurance fee shall not be imposed on a converted hospital, as defined, for a subject federal fiscal year in which the hospital becomes a converted hospital or for subsequent federal fiscal years. Prior to federal approval of implementation of the above-described provisions, existing law requires each general acute care hospital that is not an exempt facility to certify to the best of its knowledge that the hospital is prepared to pay the aggregate quality assurance fee, as defined. This bill would delete the above-described certification requirement. The bill would require hospitals to pay the quality assurance fee in 7 equal installments, as specified and subject to federal approval of the above-described provisions. Existing law authorizes the department, as necessary to receive federal approval for the implementation of the above-described provisions, to increase or decrease certain amounts used to calculate the quality assurance fee. This bill would delete the above-described authorization. This bill would provide that the department may impose and collect the quality assurance fee and make the supplemental payments, pursuant to the above-described provisions that require federal approval, based upon receiving a letter from the federal Centers for Medicare and Medicaid Services or the United States Department of Health and Human Services that indicates likely federal approval, but only if and to the extent that the letter is sufficient, as specified. This bill would provide that if final federal approval is denied, any fees collected shall be refunded and any payments made shall be recouped, as prescribed. This bill would provide that if the above-described letter indicating likely federal approval is not received on or before December 1, 2010, then provisions relating to the quality assurance fee and the supplemental payments shall become inoperative, and shall be repealed on December 1, 2010. Existing law establishes the Medi-Cal Hospital/Uninsured Care Demonstration Project Act, which revises hospital supplemental payment methodologies under the Medi-Cal program in order to maximize the use of federal funds consistent with federal Medicaid law and to stabilize the distribution of funding for hospitals that provide care to Medi-Cal beneficiaries and uninsured patients. This demonstration project provides for funding, in supplementation of Medi-Cal reimbursement, to various hospitals, including designated public hospitals, nondesignated public hospitals, and private hospitals, as defined, in accordance with certain provisions relating to disproportionate share hospitals. Under existing law, the department has the discretion to claim for any additional and all demonstration project funding, including federal funds, as specified. This bill would, subject to certain conditions, provide that a portion, equal to an amount determined in accordance with the above-described Medi-Cal quality assurance fee provisions, of additional federal funding claimed pursuant to the above-described provisions shall be allocated to the designated public hospitals. This bill would declare that it is to take effect immediately as an urgency statute.

Bill Text

Action History

  1. Chaptered by Secretary of State - Chapter 218, Statutes of 2010.

  2. Approved by the Governor.

  3. Enrolled and to the Governor at 3 p.m.

  4. Senate amendments concurred in. To enrollment. (Ayes 77. Noes 0. Page 6872.)

  5. From committee: With recommendation: That Senate amendments be concurred in. (Ayes 16. Noes 0.) (August 30).

  6. Joint Rule 62(a), file notice suspended. (Page 6819.)

  7. Re-referred to Com. on HEALTH. pursuant to Assembly Rule 77.2.

  8. In Assembly. Concurrence in Senate amendments pending.

  9. Read third time. Urgency clause adopted. Passed and to Assembly. (Ayes 31. Noes 2. Page 4961.)

  10. Senate Rule 29.10 suspended.

  11. (Corrected September 2.)

  12. Read third time, amended, and returned to third reading. (Page 4960.).

  13. Joint Rule 61(b)(16) suspended. (Ayes 27. Noes 7. Page 4959.)

  14. Read second time. To third reading.

  15. Read third time, amended. To second reading.

  16. Read second time and amended. Ordered to third reading.

  17. From committee: Amend, and do pass as amended. (Ayes 10. Noes 1.) (August 12).

  18. In committee: Placed on APPR suspense file.

  19. From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on APPR.

  20. In committee: Hearing postponed by committee.

  21. Read second time and amended. Re-referred to Com. on APPR.

  22. From committee: Amend, do pass as amended, and re-refer to Com. on APPR. (Ayes 6. Noes 2.) (June 30).

  23. In committee: Set, first hearing. Hearing canceled at the request of author.

  24. Referred to Com. on HEALTH.

  25. In Senate. Read first time. To Com. on RLS. for assignment.

  26. Read third time. Urgency clause adopted. Passed and to Senate. (Ayes 63. Noes 14. Page 5417.)

  27. Read second time. To third reading.

  28. From committee: Do pass. (Ayes 12. Noes 5.) (May 28).

  29. In committee: Set, first hearing. Referred to APPR. suspense file.

  30. From committee: Do pass, and re-refer to Com. on APPR. Re-referred. (Ayes 16. Noes 1.) (April 6).

  31. Referred to Com. on HEALTH.

  32. From printer. May be heard in committee February 14.

  33. Read first time. To print.

Sponsors

  • Alquist · Cosponsor
  • Jones · Primary

Sponsorship breakdown

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1 sponsors · 1 co-sponsors · 120 not signed on · 2 voted No

Sponsors (1)

  • Jones

Co-sponsors (1)

  • Alquist

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

Senate amendments be concurred in.

Passed 22 Yea · 0 Nay · 3 Other
Party YeaNayPresentNot Voting
Unaffiliated 20003
Republican 2000
Total 22003
% of votes cast 88%0%0%12%
How each member voted (25)
Member Party Vote
Carter — Yea
Ammiano — Yea
De — Yea
La — Yea
Torre — Yea
Fletcher — Yea
Bonnie — Yea
Lowenthal — Yea
V. — Yea
Manuel — Yea
Perez — Yea
Salas — Yea
Audra — Yea
De — Not Voting
Leon — Not Voting
Conway — Yea
Eng — Yea
Hayashi — Yea
Hernandez — Yea
Nava — Yea
Smyth — Not Voting
Monning — Yea
Beth Gaines — Yea
Jones, Brian W. Republican Yea
Strickland, Tony Republican Yea

Official roll call →

AB 1653 Jones Concurrence in Senate Amendments

Passed 89 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 83001
Democratic 3000
Republican 3000
Total 89001
% of votes cast 99%0%0%1%
How each member voted (90)
Member Party Vote
Hall — Yea
Eng — Yea
Evans — Yea
Carter — Yea
Fuentes — Yea
Chesbro — Yea
Conway — Yea
Cook — Yea
Bill — Yea
Tom — Yea
Furutani — Yea
Galgiani — Yea
Charles — Yea
De — Yea
La — Yea
Torre — Yea
De — Yea
Leon — Yea
Fletcher — Yea
Fong — Yea
Ammiano — Yea
Anderson — Yea
Beall — Yea
Block — Yea
Yamada — Yea
Bonnie — Yea
Lowenthal — Yea
V. — Yea
Manuel — Yea
Perez — Yea
Portantino — Yea
Salas — Yea
Saldana — Yea
Audra — Yea
John — Yea
A. — Yea
Perez — Yea
Gilmore — Yea
Hagman — Yea
Harkey — Yea
Hernandez — Yea
Hill — Yea
Huffman — Yea
Jeffries — Yea
Lieu — Yea
Logue — Yea
Mendoza — Yea
Miller — Yea
Nava — Yea
Nestande — Yea
Norby — Not Voting
Ruskin — Yea
Silva — Yea
Skinner — Yea
Smyth — Yea
Swanson — Yea
Torlakson — Yea
Torrico — Yea
Tran — Yea
Adams — Yea
Bass — Yea
Blumenfield — Yea
Bradford — Yea
Brownley — Yea
Buchanan — Yea
Hayashi — Yea
Huber — Yea
Knight — Yea
Ma — Yea
Monning — Yea
Nielsen — Yea
Solorio — Yea
Torres — Yea
Villines — Yea
Coto — Yea
Feuer — Yea
Davis — Yea
DeVore — Yea
Fuller — Yea
Garrick — Yea
Gatto — Yea
Beth Gaines — Yea
Bill Berryhill — Yea
Bill Berryhill — Yea
Arambula, Joaquin Democratic Yea
Caballero, Anna M. Democratic Yea
Calderon, Lisa Democratic Yea
Jones, Brian W. Republican Yea
Niello, Roger W. Republican Yea
Strickland, Tony Republican Yea

Official roll call →

Assembly 3rd Reading AB1653 Jones By Alquist

Passed 31 Yea · 2 Nay · 7 Other
Party YeaNayPresentNot Voting
Unaffiliated 29206
Republican 1000
Democratic 1001
Total 31207
% of votes cast 78%5%0%18%
How each member voted (40)
Member Party Vote
Yee — Yea
Hancock — Not Voting
Ashburn — Yea
Wyland — Yea
Lowenthal — Yea
Runner — Yea
Harman — Yea
Negrete — Not Voting
Cedillo — Yea
Cogdill — Yea
Huff — Yea
Kehoe — Yea
Leno — Yea
McLeod — Not Voting
Pavley — Yea
Price — Yea
Simitian — Yea
Walters — Nay
Wiggins — Not Voting
Blakeslee — Yea
Corbett — Yea
Correa — Yea
Ducheny — Yea
Dutton — Yea
Wright — Yea
Aanestad — Yea
Alquist — Yea
Hollingsworth — Nay
Liu — Yea
Oropeza — Not Voting
Romero — Yea
Steinberg — Yea
Wolk — Yea
Emmerson — Yea
DeSaulnier — Yea
Denham — Not Voting
Florez — Yea
Calderon, Lisa Democratic Not Voting
Padilla, Stephen C. Democratic Yea
Strickland, Tony Republican Yea

Official roll call →

Do pass as amended.

Passed 10 Yea · 1 Nay
Party YeaNayPresentNot Voting
Unaffiliated 10100
Total 10100
% of votes cast 91%9%0%0%
How each member voted (11)
Member Party Vote
Yee — Yea
Wyland — Yea
Kehoe — Yea
Ashburn — Yea
Price — Yea
Walters — Nay
Alquist — Yea
Leno — Yea
Wolk — Yea
Corbett — Yea
Emmerson — 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
Corbett — Yea
Kehoe — Yea
Leno — Yea
Ashburn — Yea
Price — Yea
Walters — Not Voting
Wolk — Yea
Alquist — Yea
Wyland — Yea
Emmerson — Yea

Official roll call →

AB 1653 JONES Third Reading Urgency

Passed 73 Yea · 14 Nay · 4 Other
Party YeaNayPresentNot Voting
Unaffiliated 681403
Democratic 3000
Republican 2001
Total 731404
% of votes cast 80%15%0%4%
How each member voted (91)
Member Party Vote
Carter — Yea
Chesbro — Yea
Conway — Yea
Cook — Yea
Bill — Yea
Eng — Yea
Evans — Yea
Fuentes — Yea
Fuller — Yea
Charles — Yea
Furutani — Yea
Gilmore — Yea
Hall — Yea
Hernandez — Yea
Hill — Yea
Huffman — Yea
De — Yea
La — Yea
Torre — Yea
De — Yea
Leon — Yea
Fletcher — Yea
Fong — Yea
Bonnie — Yea
Lowenthal — Yea
V. — Yea
Manuel — Yea
Perez — Yea
Portantino — Yea
Salas — Yea
Saldana — Yea
John — Yea
A. — Yea
Perez — Yea
Bass — Yea
Beall — Yea
Coto — Yea
Lieu — Yea
Mendoza — Yea
Monning — Yea
Nestande — Yea
Ruskin — Yea
Skinner — Yea
Solorio — Yea
Swanson — Yea
Torres — Yea
Torrico — Yea
Tom — Not Voting
Audra — Not Voting
Hagman — Nay
Harkey — Nay
Anderson — Nay
DeVore — Nay
Jeffries — Nay
Miller — Nay
Norby — Nay
Silva — Nay
Tran — Nay
Adams — Yea
Ammiano — Yea
Blakeslee — Nay
Block — Yea
Blumenfield — Yea
Bradford — Yea
Brownley — Yea
Buchanan — Yea
Hayashi — Yea
Huber — Yea
Knight — Nay
Logue — Nay
Ma — Yea
Nava — Yea
Nielsen — Yea
Smyth — Yea
Torlakson — Yea
Villines — Yea
Emmerson — Yea
Feuer — Yea
Davis — Yea
Yamada — Yea
Galgiani — Yea
Garrick — Nay
Beth Gaines — Nay
Bill Berryhill — Yea
Bill Berryhill — Not Voting
Arambula, Joaquin Democratic Yea
Caballero, Anna M. Democratic Yea
Calderon, Lisa Democratic Yea
Jones, Brian W. Republican Yea
Niello, Roger W. Republican Yea
Strickland, Tony Republican Not Voting

Official roll call →

Do pass.

Passed 13 Yea · 5 Nay
Party YeaNayPresentNot Voting
Unaffiliated 12500
Democratic 1000
Total 13500
% of votes cast 72%28%0%0%
How each member voted (18)
Member Party Vote
Conway — Nay
Charles — Yea
Fuentes — Yea
Harkey — Nay
Miller — Nay
Ammiano — Yea
Nielsen — Nay
Skinner — Yea
Solorio — Yea
Torlakson — Yea
Torrico — Yea
Bradford — Yea
Monning — Yea
Norby — Nay
Ruskin — Yea
Coto — Yea
Davis — Yea
Calderon, Lisa Democratic Yea

Official roll call →

Do pass and be re-referred to the Committee on Appropriations.

Passed 20 Yea · 2 Nay · 2 Other
Party YeaNayPresentNot Voting
Unaffiliated 19102
Republican 1100
Total 20202
% of votes cast 83%8%0%8%
How each member voted (24)
Member Party Vote
Eng — Yea
Hernandez — Yea
Nava — Yea
Leon — Yea
Fletcher — Yea
Bonnie — Yea
Lowenthal — Yea
V. — Yea
Manuel — Yea
Perez — Yea
Salas — Yea
Audra — Nay
Carter — Yea
De — Yea
Conway — Yea
Ammiano — Yea
Bradford — Yea
Hayashi — Yea
Monning — Yea
Smyth — Yea
Emmerson — Not Voting
Beth Gaines — Not Voting
Jones, Brian W. Republican Yea
Strickland, Tony Republican Nay

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does AB 1653 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, subject to federal approval, requires the department to make supplemental payments for certain services, as specified, to private hospitals, nondesignated public hospitals, and designated public hospitals, as defined, for subject federal fiscal years, as defined. Existing law provides that these provisions shall remain in effect only until January 1, 2013, and as of that date are repealed. This bill would make various changes to the formulas used to determine the amount of supplemental payments made to private and designated public hospitals. This bill would expand the definition of a nondesignated public hospital. Existing law prescribes certain deadlines by which the above-described supplemental payments are required to be made to hospitals depending upon the federal fiscal year for which the payment is to be made. This bill would require the department to make to hospitals the supplemental payments for the 2008–09, 2009–10, and 2010–11 federal fiscal years in 7 payments, as specified. Existing law requires the department to make enhanced payments to managed health care plans, as defined, and requires the state to make enhanced payments to mental health plans, as defined, for each subject federal fiscal year, as specified. Existing law requires the managed health care plans and mental health plans that received enhanced payments to make supplemental payments to subject hospitals, as defined, pursuant to specified formulas. This bill would, instead, refer to the payments made by the department to the managed health care plans and mental health plans as increased capitation payments and increased payments, respectively, and would change the definition of a managed care plan. The bill would require the department to determine the amount of increased capitation payments for each Medi-Cal managed care plan and to consider prescribed factors in making that determination. The bill would prohibit the amount of increased capitation payments to each Medi-Cal managed health care plan from exceeding an amount that results in capitation payments that are certified by the state's actuary as meeting federal requirements. The bill would require each managed health care plan to expend 100% of any increased capitation payments it receives from the department on hospital services. This bill would make various changes to the provisions relating to the increased payments to mental health plans, including requiring the department to take into consideration prescribed factors when making these payments. Existing law, subject to federal approval, also imposes, as a condition of participation in state-funded health insurance programs other than the Medi-Cal program, a quality assurance fee, as specified, on certain general acute care hospitals through and including December 31, 2010. Existing law creates the Hospital Quality Assurance Revenue Fund in the State Treasury and requires that the money collected from the quality assurance fee be deposited into the fund. Existing law provides that the moneys in the fund shall, upon appropriation by the Legislature, be available only for certain purposes, including providing the above-described supplemental payments to hospitals and health care coverage for children. Existing law provides that these provisions shall remain in effect only until January 1, 2013, and as of that date are repealed. This bill would expand the definitions of a nondesignated public hospital and private hospital, and modify the formulas used in calculating the amount of the quality assurance fee imposed on hospitals pursuant to the above-described provisions. The bill would provide that the quality assurance fee shall not be imposed on a converted hospital, as defined, for a subject federal fiscal year in which the hospital becomes a converted hospital or for subsequent federal fiscal years. Prior to federal approval of implementation of the above-described provisions, existing law requires each general acute care hospital that is not an exempt facility to certify to the best of its knowledge that the hospital is prepared to pay the aggregate quality assurance fee, as defined. This bill would delete the above-described certification requirement. The bill would require hospitals to pay the quality assurance fee in 7 equal installments, as specified and subject to federal approval of the above-described provisions. Existing law authorizes the department, as necessary to receive federal approval for the implementation of the above-described provisions, to increase or decrease certain amounts used to calculate the quality assurance fee. This bill would delete the above-described authorization. This bill would provide that the department may impose and collect the quality assurance fee and make the supplemental payments, pursuant to the above-described provisions that require federal approval, based upon receiving a letter from the federal Centers for Medicare and Medicaid Services or the United States Department of Health and Human Services that indicates likely federal approval, but only if and to the extent that the letter is sufficient, as specified. This bill would provide that if final federal approval is denied, any fees collected shall be refunded and any payments made shall be recouped, as prescribed. This bill would provide that if the above-described letter indicating likely federal approval is not received on or before December 1, 2010, then provisions relating to the quality assurance fee and the supplemental payments shall become inoperative, and shall be repealed on December 1, 2010. Existing law establishes the Medi-Cal Hospital/Uninsured Care Demonstration Project Act, which revises hospital supplemental payment methodologies under the Medi-Cal program in order to maximize the use of federal funds consistent with federal Medicaid law and to stabilize the distribution of funding for hospitals that provide care to Medi-Cal beneficiaries and uninsured patients. This demonstration project provides for funding, in supplementation of Medi-Cal reimbursement, to various hospitals, including designated public hospitals, nondesignated public hospitals, and private hospitals, as defined, in accordance with certain provisions relating to disproportionate share hospitals. Under existing law, the department has the discretion to claim for any additional and all demonstration project funding, including federal funds, as specified. This bill would, subject to certain conditions, provide that a portion, equal to an amount determined in accordance with the above-described Medi-Cal quality assurance fee provisions, of additional federal funding claimed pursuant to the above-described provisions shall be allocated to the designated public hospitals. This bill would declare that it is to take effect immediately as an urgency statute.
Who sponsors AB 1653?
AB 1653 is sponsored by Alquist and Jones.
What is the current status of AB 1653?
This bill has been enacted into law. Introduced January 14, 2010. Enacted.
Where can I track AB 1653?
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