California 2019-2020 Regular Session Status: In Committee

SB 936 — Medi-Cal managed care plans: contracts.

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

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

This bill died with 2019-2020 Regular Session. It reached “In Committee” 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This bill is no longer active — its legislative session has ended, so there is no live prognosis.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, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services either through a fee-for-service or managed care delivery system. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes the department to enter into various types of contracts for the provision of services to beneficiaries, including contracts with managed care plans, and imposes requirements upon those contracted managed care plans, such as network adequacy standards. This bill would require the Director of Health Care Services to conduct a contract procurement at least once every 5 years if the director contracts with a commercial Medi-Cal managed care plan for the provision of care of Medi-Cal beneficiaries on a state-wide or limited geographic basis, and would authorize the director to extend an existing contract for one year if the director takes specified action, including providing notice to the Legislature, at least one year before exercising that extension. The bill would require the department to perform specified duties, including establishing a stakeholder process in the planning and development of each commercial Medi-Cal managed care contract procurement process, and receiving public comment on the model contract, procurement qualifications, and evaluation criteria. The bill would authorize a county to submit to the department its preferences for any commercial Medi-Cal managed care plan to provide services in that county, and to request and receive from the department any report on specified matters, such as beneficiary health outcomes. The bill would authorize the department to contract with any commercial Medi-Cal managed care plan only if the plan can demonstrate its ability to meet specified evaluation criteria set forth by the department, including the ability of a commercial Medi-Cal managed care plan to comply with time and distance requirements, appointment time standards, and performance targets, as established by the department. With respect to Medi-Cal managed care plan contracts generally, this bill would require those contractors to collaborate with identified stakeholders, including consumer advocates and public health experts in their respective Medi-Cal managed care plans' service area, on identifying and achieving health priorities in that service area.

Bill Text

Action History

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

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

  3. April 1 hearing postponed by committee.

  4. Set for hearing April 1.

  5. Referred to Com. on HEALTH.

  6. From printer. May be acted upon on or after March 8.

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

Sponsors

  • Pan · Primary

Sponsorship breakdown

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

Sponsors (1)

  • Pan

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

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does SB 936 do?
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services either through a fee-for-service or managed care delivery system. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes the department to enter into various types of contracts for the provision of services to beneficiaries, including contracts with managed care plans, and imposes requirements upon those contracted managed care plans, such as network adequacy standards. This bill would require the Director of Health Care Services to conduct a contract procurement at least once every 5 years if the director contracts with a commercial Medi-Cal managed care plan for the provision of care of Medi-Cal beneficiaries on a state-wide or limited geographic basis, and would authorize the director to extend an existing contract for one year if the director takes specified action, including providing notice to the Legislature, at least one year before exercising that extension. The bill would require the department to perform specified duties, including establishing a stakeholder process in the planning and development of each commercial Medi-Cal managed care contract procurement process, and receiving public comment on the model contract, procurement qualifications, and evaluation criteria. The bill would authorize a county to submit to the department its preferences for any commercial Medi-Cal managed care plan to provide services in that county, and to request and receive from the department any report on specified matters, such as beneficiary health outcomes. The bill would authorize the department to contract with any commercial Medi-Cal managed care plan only if the plan can demonstrate its ability to meet specified evaluation criteria set forth by the department, including the ability of a commercial Medi-Cal managed care plan to comply with time and distance requirements, appointment time standards, and performance targets, as established by the department. With respect to Medi-Cal managed care plan contracts generally, this bill would require those contractors to collaborate with identified stakeholders, including consumer advocates and public health experts in their respective Medi-Cal managed care plans' service area, on identifying and achieving health priorities in that service area.
Who sponsors SB 936?
SB 936 is sponsored by Pan.
What is the current status of SB 936?
This bill died with 2019-2020 Regular Session. It reached “In Committee” 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 936?
Track SB 936 free on One Click Politics — get push/email alerts when it moves.

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