SB 920 — Medi-Cal: hospitals.

Summary

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 services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law establishes the continuously appropriated Private Hospital Supplemental Fund, administered by the California Medical Assistance Commission, which consists of moneys from various sources used to fund the nonfederal share of supplemental payments to private hospitals. Existing law requires that the California Medical Assistance Commission be dissolved after June 30, 2012, and requires that, upon dissolution of the commission, all powers, duties, and responsibilities of the commission be transferred to the Director of Health Care Services. This bill, effective the first fiscal year in which reimbursement is provided to private hospitals under a specified methodology, would require the Director of Health Care Services to allocate the fund among eligible private hospitals pursuant to a methodology that is developed in consultation with the statewide associations representing children's hospitals and private DSH hospitals and that ensures, to the extent possible, the hospitals are allocated funding at the level of payments received for the 2011–12 fiscal year, taking into consideration applicable eligibility criteria. Existing law, subject to federal approval, imposes a quality assurance fee, as specified, on certain general acute care hospitals for the period of July 1, 2011, through December 31, 2013. Existing law requires the hospitals to pay the fee in 10 equal installments, as specified, and requires that the moneys collected from the quality assurance fee be deposited into the Hospital Quality Assurance Revenue Fund. Existing law, subject to federal approval, requires that the moneys in the fund be available, upon appropriation by the Legislature, only for certain purposes, including, among other things, making supplemental payments for certain services to private hospitals, increased capitation payments to Medi-Cal managed care plans, and increased payments to mental health plans. Existing law also authorizes designated and nondesignated public hospitals to be paid direct grants in support of health care expenditures funded by the quality assurance fee. Existing law, subject to federal approval of a Medicaid demonstration project, requires the department to authorize local Low Income Health Programs (LIHPs) , as defined, to provide scheduled health care services to eligible individuals, which includes the Medicaid Coverage Expansion (MCE) population, as defined. Existing law establishes the Low Income Health Program MCE Out-of-Network Emergency Care Services Fund, which consists of moneys transferred from governmental entities on a voluntary basis and from the Hospital Quality Assurance Revenue Fund in specified amounts, to be used by the department, upon appropriation by the Legislature, to fund the nonfederal share of supplemental payments made to private hospitals and nondesignated public hospitals that are outside the LIHP coverage network for providing emergency and poststabilization services to the MCE population. Existing law provides that the provisions governing the various payments and grants shall become inoperative on September 1, 2013, if the department has not received federal approval or a specified letter that indicates likely federal approval on or before September 1, 2013. Existing law also provides that the provisions governing the various payments and grants shall remain in effect only until July 1, 2014, the date of the last payment of quality assurance fee payments, or the date of the last payment of specified payments from the department, whichever is later. This bill would modify the calculation of the quality assurance fee and the installment payment provisions, and would make changes to the calculation of the supplemental amounts paid to private hospitals for the provision of hospital inpatient services. This bill would also increase the aggregate amount of the grants to nondesignated public hospitals for each fiscal year. This bill would reduce the amount of the proceeds from the quality assurance fee that would be transferred into the Low Income Health Program MCE Out-of-Network Emergency Care Services Fund per subject fiscal year and would delete nondesignated public hospitals as recipients of moneys from that fund. This bill would authorize the department to make supplemental payments from that fund directly to the private hospitals, as an alternative to, and in lieu of, disbursing moneys from the fund to the LIHPs. This bill would instead provide that the provisions governing the various payments and grants shall become inoperative on December 1, 2013, if the department has not received federal approval or the specified letter indicating likely federal approval. This bill would extend the operative date of the provisions governing the various payments and grants to January 1, 2015, and make related changes. This bill would make other technical, nonsubstantive changes to these provisions. This bill would declare that it is to take effect immediately as an urgency statute.

Bill Text

• Chaptered 09/22/12 - Chaptered Current pdf September 22, 2012
• Enrolled 08/27/12 - Enrolled pdf August 27, 2012
• Amended 08/20/12 - Amended Assembly pdf August 20, 2012
• Amended 08/06/12 - Amended Assembly pdf August 06, 2012
• Amended 06/27/12 - Amended Assembly pdf June 27, 2012
• Amended 01/04/12 - Amended Senate pdf January 04, 2012
• Introduced 02/18/11 - Introduced pdf February 18, 2011
• SB920 View text html

Action History

1. September 22, 2012

   Chaptered by Secretary of State. Chapter 452, Statutes of 2012.

2. September 22, 2012

   Approved by the Governor.

3. August 29, 2012

   Enrolled and presented to the Governor at 4:30 p.m.

4. August 23, 2012

   Assembly amendments concurred in. (Ayes 37. Noes 0. Page 4766.) Ordered to engrossing and enrolling.

5. August 23, 2012

   Urgency clause adopted.

6. August 22, 2012

   In Senate. Concurrence in Assembly amendments pending.

7. August 22, 2012

   Read third time. Urgency clause adopted. Passed. (Ayes 76. Noes 1. Page 6127.) Ordered to the Senate.

8. August 21, 2012

   Read second time. Ordered to third reading.

9. August 20, 2012

   Read second time and amended. Ordered to second reading.

10. August 16, 2012

    From committee: Do pass as amended. (Ayes 17. Noes 0.) (August 16).

11. August 08, 2012

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

12. August 06, 2012

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

13. July 05, 2012

    From committee: Do pass and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (July 3). Re-referred to Com. on APPR.

14. June 27, 2012

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

15. June 26, 2012

    Set, first hearing. Hearing canceled at the request of author.

16. April 16, 2012

    Referred to Com. on HEALTH.

17. January 23, 2012

    In Assembly. Read first time. Held at Desk.

18. January 23, 2012

    Read third time. Passed. (Ayes 34. Noes 0. Page 2697.) Ordered to the Assembly.

19. January 17, 2012

    Read second time. Ordered to third reading.

20. January 13, 2012

    From committee: Be placed on second reading file pursuant to Senate Rule 28.8.

21. January 12, 2012

    From committee: Do pass and re-refer to Com. on APPR. (Ayes 5. Noes 0. Page 2649.) (January 11). Re-referred to Com. on APPR.

22. January 05, 2012

    Set for hearing January 11.

23. January 04, 2012

    Re-referred to Com. on HEALTH.

24. January 04, 2012

    From committee with author's amendments. Read second time and amended. Re-referred to Com. on RLS.

25. March 10, 2011

    Referred to Com. on RLS.

26. February 20, 2011

    From printer. May be acted upon on or after March 22.

27. February 18, 2011

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

Sponsors

• Hernandez · Primary

Votes

Subjects