California 2017-2018 Regular Session Status: Enacted

SB 1287 — Medi-Cal: medically necessary services.

Last action — Chaptered by Secretary of State. Chapter 855, Statutes of 2018.

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

This bill has been enacted into law. Introduced February 16, 2018. Enacted.

Prognosis

Likely to advance 70% · 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.

  • 1 sponsor

    1 primary, 0 co-sponsors signed on.

  • Cleared a recorded vote

    Passed 6 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, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive medically necessary health care services, including Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) for an individual under 21 years of age who is covered under the Medi-Cal program, subject to utilization controls, and consistent with federal requirements. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing state law, a service is "medically necessary" if it is reasonable and necessary to protect life, to prevent significant illness or significant disability, or to alleviate severe pain. This bill would revise the Medi-Cal definition of "medically necessary" for purposes of an individual under 21 years of age to incorporate the existing federal standards related to EPSDT services. The bill would require the department and its contractors to update any model evidence of specified materials to ensure the medical necessity standard for coverage for individuals under 21 years of age is accurately reflected in all materials. The bill would require the department to implement, interpret, and make specific these provisions by means of all-county letters or similar instructions until regulations are revised or adopted by July 1, 2022. The bill would also clarify the meaning of "medically necessary" with regard to prior authorization controls in the Medi-Cal program.

Bill Text

Action History

  1. Chaptered by Secretary of State. Chapter 855, Statutes of 2018.

  2. Approved by the Governor.

  3. Enrolled and presented to the Governor at 4 p.m.

  4. Assembly amendments concurred in. (Ayes 39. Noes 0. Page 5869.) Ordered to engrossing and enrolling.

  5. In Senate. Concurrence in Assembly amendments pending.

  6. Read third time. Passed. (Ayes 80. Noes 0. Page 6583.) Ordered to the Senate.

  7. Ordered to third reading.

  8. Read third time and amended.

  9. Read second time. Ordered to third reading.

  10. From committee: Do pass. (Ayes 17. Noes 0.) (August 15).

  11. From committee: Do pass and re-refer to Com. on APPR. (Ayes 15. Noes 0.) (June 26). Re-referred to Com. on APPR.

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

  13. Referred to Com. on HEALTH.

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

  15. Read third time. Passed. (Ayes 38. Noes 0. Page 4334.) Ordered to the Assembly.

  16. Read second time. Ordered to third reading.

  17. Ordered to second reading.

  18. Read third time and amended.

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

  20. From committee: Do pass as amended. (Ayes 9. Noes 0. Page 4656.) (April 11).

  21. Set for hearing April 11.

  22. Re-referred to Com. on HEALTH.

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

  24. Referred to Com. on RLS.

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

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

Sponsors

  • Hernandez · Primary

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 121 not signed on

Sponsors (1)

  • Hernandez

Co-sponsors (0)

None.

Not signed on (121)

121 members have not signed on to this bill.

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"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

Unfinished Business SB1287 Hernandez et al. Concurrence

Passed 39 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 34001
Democratic 5000
Total 39001
% of votes cast 98%0%0%3%
How each member voted (40)
Member Party Vote
Anderson — Yea
Beall — Yea
Hernandez — Yea
Leyva — Yea
Moorlach — Yea
Morrell — Yea
Nielsen — Yea
Fuller — Yea
Galgiani — Yea
Cannella — Yea
Chang — Yea
Allen — Yea
Mitchell — Yea
Atkins — Yea
Portantino — Yea
Glazer — Yea
De León — Yea
Delgado — Yea
Dodd — Yea
Hertzberg — Yea
Hill — Yea
Hueso — Yea
Lara — Yea
Bates — Yea
Bradford — Yea
Monning — Yea
Pan — Yea
Roth — Yea
Skinner — Yea
Vidak — Yea
Wieckowski — Yea
Wilk — Yea
Beth Gaines — Yea
Bill Berryhill — Not Voting
Mark Stone — Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Nguyen, Stephanie Democratic Yea
Stern, Henry I. Democratic Yea
Wiener, Scott D. Democratic Yea

Official roll call →

SB 1287 Hernandez Senate Third Reading By WOOD

Passed 80 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 58000
Democratic 16000
Republican 6000
Total 80000
% of votes cast 100%0%0%0%
How each member voted (80)
Member Party Vote
Acosta — Yea
Baker — Yea
Bigelow — Yea
Bloom — Yea
Brough — Yea
Jones-Sawyer — Yea
Kiley — Yea
Maienschein — Yea
Mathis — Yea
Melendez — Yea
Obernolte — Yea
Thurmond — Yea
Waldron — Yea
Chiu — Yea
Gonzalez Fletcher — Yea
Burke — Yea
Fong — Yea
Salas — Yea
Gloria — Yea
Holden — Yea
Gray — Yea
Kamlager-Dove — Yea
Levine — Yea
Rubio — Yea
Low — Yea
Rivas — Yea
Mayes — Yea
McCarty — Yea
Medina — Yea
Chau — Yea
Mullin — Yea
Chu — Yea
Chávez — Yea
Cooley — Yea
Cooper — Yea
Nazarian — Yea
Quirk — Yea
Rendon — Yea
Rodriguez — Yea
Santiago — Yea
Ting — Yea
Voepel — Yea
Weber — Yea
Wood — Yea
Harper — Yea
O'Donnell — Yea
Steinorth — Yea
Eggman — Yea
Cunningham — Yea
Daly — Yea
Frazier — Yea
Friedman — Yea
Cristina Garcia — Yea
Eduardo Garcia — Yea
Jim Patterson — Yea
Mark Stone — Yea
Travis Allen — Yea
Wendy Carrillo — Yea
Aguiar-Curry, Cecilia M. Democratic Yea
Arambula, Joaquin Democratic Yea
Berman, Marc Democratic Yea
Bonta, Mia Democratic Yea
Caballero, Anna M. Democratic Yea
Calderon, Lisa Democratic Yea
Cervantes, Sabrina Democratic Yea
Gabriel, Jesse Democratic Yea
Gipson, Mike A. Democratic Yea
Grayson, Timothy S. Democratic Yea
Irwin, Jacqui Democratic Yea
Kalra, Ash Democratic Yea
Limón, Monique Democratic Yea
Muratsuchi, Al Democratic Yea
Quirk-Silva, Sharon Democratic Yea
Reyes, Eloise Gómez Democratic Yea
Chen, Phillip Republican Yea
Choi, Steven S. Republican Yea
Dahle, Megan Republican Yea
Flora, Heath Republican Yea
Gallagher, James Republican Yea
Lackey, Tom Republican Yea

Official roll call →

Do pass.

Passed 17 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 13000
Democratic 3000
Republican 1000
Total 17000
% of votes cast 100%0%0%0%
How each member voted (17)
Member Party Vote
Bigelow — Yea
Bloom — Yea
Brough — Yea
Nazarian — Yea
Quirk — Yea
Fong — Yea
Obernolte — Yea
Gonzalez Fletcher — Yea
Chau — Yea
Eggman — Yea
Friedman — Yea
Eduardo Garcia — Yea
Wendy Carrillo — Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Reyes, Eloise Gómez Democratic Yea
Gallagher, James Republican Yea

Official roll call →

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

Passed 15 Yea · 0 Nay
Party YeaNayPresentNot Voting
Democratic 3000
Unaffiliated 11000
Republican 1000
Total 15000
% of votes cast 100%0%0%0%
How each member voted (15)
Member Party Vote
McCarty — Yea
Rodriguez — Yea
Thurmond — Yea
Wood — Yea
Mayes — Yea
Burke — Yea
Bigelow — Yea
Nazarian — Yea
Santiago — Yea
Waldron — Yea
Wendy Carrillo — Yea
Aguiar-Curry, Cecilia M. Democratic Yea
Bonta, Mia Democratic Yea
Limón, Monique Democratic Yea
Flora, Heath Republican Yea

Official roll call →

3rd Reading

Passed 38 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 33001
Democratic 5000
Total 38001
% of votes cast 97%0%0%3%
How each member voted (39)
Member Party Vote
Anderson — Yea
Bradford — Yea
Hertzberg — Yea
Hueso — Yea
Lara — Yea
Newman — Yea
Nielsen — Yea
Skinner — Yea
Galgiani — Yea
Hernandez — Yea
Hill — Yea
Bates — Yea
Portantino — Yea
Allen — Yea
Leyva — Yea
Atkins — Yea
Mitchell — Yea
Beall — Yea
Dodd — Yea
Monning — Yea
Moorlach — Yea
Pan — Yea
Roth — Yea
Vidak — Yea
Wieckowski — Yea
Wilk — Yea
De León — Yea
Fuller — Yea
Cannella — Yea
Morrell — Yea
Glazer — Yea
Beth Gaines — Yea
Bill Berryhill — Not Voting
Mark Stone — Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Nguyen, Stephanie Democratic Yea
Stern, Henry I. Democratic Yea
Wiener, Scott D. Democratic Yea

Official roll call →

Do pass as amended

Passed 9 Yea · 0 Nay
Party YeaNayPresentNot Voting
Democratic 1000
Unaffiliated 8000
Total 9000
% of votes cast 100%0%0%0%
How each member voted (9)
Member Party Vote
Hernandez — Yea
Mitchell — Yea
Leyva — Yea
Monning — Yea
Newman — Yea
Nielsen — Yea
Pan — Yea
Roth — Yea
Nguyen, Stephanie Democratic Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does SB 1287 do?
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive medically necessary health care services, including Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) for an individual under 21 years of age who is covered under the Medi-Cal program, subject to utilization controls, and consistent with federal requirements. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under existing state law, a service is "medically necessary" if it is reasonable and necessary to protect life, to prevent significant illness or significant disability, or to alleviate severe pain. This bill would revise the Medi-Cal definition of "medically necessary" for purposes of an individual under 21 years of age to incorporate the existing federal standards related to EPSDT services. The bill would require the department and its contractors to update any model evidence of specified materials to ensure the medical necessity standard for coverage for individuals under 21 years of age is accurately reflected in all materials. The bill would require the department to implement, interpret, and make specific these provisions by means of all-county letters or similar instructions until regulations are revised or adopted by July 1, 2022. The bill would also clarify the meaning of "medically necessary" with regard to prior authorization controls in the Medi-Cal program.
Who sponsors SB 1287?
SB 1287 is sponsored by Hernandez.
What is the current status of SB 1287?
This bill has been enacted into law. Introduced February 16, 2018. Enacted.
Where can I track SB 1287?
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Last checked for changes 3 months ago · updated continuously

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