California 2015-2016 Regular Session Status: Passed Senate 1 D cosponsors

SB 447 — Medi-Cal: clinics: drugs, devices, and supplies.

Last action — August 11 hearing. Held in committee and under submission.

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

This bill died with 2015-2016 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This bill is no longer active — its legislative session has ended, so there is no live prognosis.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 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 benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. The Medi-Cal program administers a program known as the Family Planning, Access, Care, and Treatment (Family PACT) Program, to provide comprehensive clinical family planning services to any person who has a family income at or below 200% of the federal poverty level and who is eligible to receive those services. Existing law specifies various requirements relating to reimbursement for the provision of drugs and supplies under the Medi-Cal program and the Family PACT Program that are applicable to licensed community clinics, free clinics, or intermittent clinics. Existing law requires reimbursement for drugs and supplies covered under the Medi-Cal program and the Family PACT Program and provided by these clinics to be the lesser of the amount billed or the Medi-Cal reimbursement rate and caps reimbursement at the net cost of the drugs or products as provided by retail pharmacies under the Medi-Cal program. Existing law sets the costs for drugs and supplies covered under those programs at an aggregate amount equivalent to the sum of the actual acquisition cost of a drug or supply plus a clinic dispensing fee not to exceed $12 per billing unit, as specified. Existing law also sets the cost for a take-home drug that is dispensed for use by the patient within a specific timeframe of 5 or fewer days from the date medically indicated at the actual acquisition cost for that drug plus a clinic dispensing fee, not to exceed $17 per prescription. This bill would also require reimbursement for devices covered under the Medi-Cal Program and the Family PACT Program. The bill would revise the reimbursement formula described above and would instead specify separate reimbursement formulas for contraceptive drugs, devices, and supplies, and non-contraceptive drugs, devices, and supplies. The bill would, for contraceptive drugs, devices, and supplies, require a clinic to bill the Medi-Cal program and the Family PACT Program at the Medi-Cal reimbursement rate. The bill would, for non-contraceptive drugs, devices, and supplies, require a clinic to bill the Medi-Cal program or the Family PACT Program at the lesser of the clinic's usual charge made to the general public, or its cost, defined as an aggregate amount equivalent to the sum of the actual acquisition cost of the drug, device, or supply plus a clinic dispensing fee. The bill would provide that the clinic dispensing fee shall be determined by the department, as specified, or, if not determined by the department, shall be the difference between the actual acquisition cost and the Medi-Cal reimbursement rate. The bill would require reimbursement for non-contraceptive drugs, devices, and supplies to be the lesser of the amount billed, as described above, or the Medi-Cal reimbursement rate, and would cap reimbursement at the net cost of the drug, device, or supply when provided by retail pharmacies under the Medi-Cal program. The bill would require the department to seek federal approval of any state plan amendments necessary to implement these provisions. The bill would require the department, by July 1, 2018, to adopt regulations to implement these provisions, as specified. Until those regulations are adopted the bill would require the department to implement these provisions by provider bulletins or similar instructions and provide the Legislature with a semiannual status report, as specified.

Bill Text

Action History

  1. August 11 hearing. Held in committee and under submission.

  2. August 3 set for first hearing. Placed on APPR. suspense file.

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

  4. August 26 hearing postponed by committee.

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

  6. From committee: Do pass and re-refer to Com. on APPR. (Ayes 18. Noes 0.) (July 7). Re-referred to Com. on APPR.

  7. Referred to Com. on HEALTH.

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

  9. Read third time. Passed. (Ayes 27. Noes 4. Page 1254.) Ordered to the Assembly.

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

  11. From committee: Do pass as amended. (Ayes 5. Noes 1. Page 1154.) (May 28).

  12. Set for hearing May 28.

  13. May 11 hearing: Placed on APPR. suspense file.

  14. Set for hearing May 11.

  15. May 4 hearing postponed by committee.

  16. Set for hearing May 4.

  17. From committee: Do pass and re-refer to Com. on APPR. (Ayes 9. Noes 0. Page 651.) (April 15). Re-referred to Com. on APPR.

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

  19. Set for hearing April 15.

  20. April 8 set for first hearing canceled at the request of author.

  21. Set for hearing April 8.

  22. Referred to Com. on HEALTH.

  23. From printer. May be acted upon on or after March 28.

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

Sponsors

Sponsorship breakdown

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

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (121)

121 members have not signed on to this bill.

Show all 121 →

"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 be re-referred to the Committee on [Appropriations]

Passed 18 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Democratic 1000
Unaffiliated 16000
Republican 1001
Total 18001
% of votes cast 95%0%0%5%
How each member voted (19)
Member Party Vote
Nazarian — Yea
Ridley-Thomas — Yea
Steinorth — Yea
Waldron — Yea
Wood — Yea
Bonilla — Yea
Maienschein — Yea
Burke — Yea
Chiu — Yea
Chávez — Yea
Rodriguez — Yea
Santiago — Yea
Thurmond — Yea
Gomez — Yea
Gonzalez — Yea
Roger Hernández — Yea
Bonta, Mia Democratic Yea
Lackey, Tom Republican Yea
Patterson, Joe Republican Not Voting

Official roll call →

3rd Reading

Passed 27 Yea · 4 Nay · 9 Other
Party YeaNayPresentNot Voting
Unaffiliated 25408
Democratic 2001
Total 27409
% of votes cast 68%10%0%23%
How each member voted (40)
Member Party Vote
Anderson — Nay
Bates — Not Voting
Hueso — Yea
Huff — Yea
Leno — Yea
Leyva — Yea
Mendoza — Yea
Monning — Yea
Pavley — Yea
Roth — Yea
Wolk — Not Voting
Cannella — Yea
Allen — Yea
Galgiani — Yea
Mitchell — Yea
De León — Yea
Glazer — Yea
Hall — Yea
Runner — Not Voting
Beall — Yea
Block — Yea
Hernandez — Yea
Hertzberg — Yea
Hill — Yea
Lara — Yea
Liu — Yea
Moorlach — Nay
Morrell — Nay
Nielsen — Nay
Pan — Yea
Vidak — Not Voting
Wieckowski — Not Voting
Fuller — Not Voting
Hancock — Yea
Beth Gaines — Yea
Bill Berryhill — Not Voting
Mark Stone — Not Voting
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Not Voting
Nguyen, Stephanie Democratic Yea

Official roll call →

Do pass as amended

Passed 5 Yea · 1 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 5101
Total 5101
% of votes cast 71%14%0%14%
How each member voted (7)
Member Party Vote
Lara — Yea
Leyva — Yea
Mendoza — Yea
Beall — Yea
Hill — Yea
Nielsen — Nay
Bates — Not Voting

Official roll call →

Placed on suspense file

Passed 7 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 7000
Total 7000
% of votes cast 100%0%0%0%
How each member voted (7)
Member Party Vote
Bates — Yea
Lara — Yea
Leyva — Yea
Mendoza — Yea
Nielsen — Yea
Hill — Yea
Beall — Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does SB 447 do?
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 benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. The Medi-Cal program administers a program known as the Family Planning, Access, Care, and Treatment (Family PACT) Program, to provide comprehensive clinical family planning services to any person who has a family income at or below 200% of the federal poverty level and who is eligible to receive those services. Existing law specifies various requirements relating to reimbursement for the provision of drugs and supplies under the Medi-Cal program and the Family PACT Program that are applicable to licensed community clinics, free clinics, or intermittent clinics. Existing law requires reimbursement for drugs and supplies covered under the Medi-Cal program and the Family PACT Program and provided by these clinics to be the lesser of the amount billed or the Medi-Cal reimbursement rate and caps reimbursement at the net cost of the drugs or products as provided by retail pharmacies under the Medi-Cal program. Existing law sets the costs for drugs and supplies covered under those programs at an aggregate amount equivalent to the sum of the actual acquisition cost of a drug or supply plus a clinic dispensing fee not to exceed $12 per billing unit, as specified. Existing law also sets the cost for a take-home drug that is dispensed for use by the patient within a specific timeframe of 5 or fewer days from the date medically indicated at the actual acquisition cost for that drug plus a clinic dispensing fee, not to exceed $17 per prescription. This bill would also require reimbursement for devices covered under the Medi-Cal Program and the Family PACT Program. The bill would revise the reimbursement formula described above and would instead specify separate reimbursement formulas for contraceptive drugs, devices, and supplies, and non-contraceptive drugs, devices, and supplies. The bill would, for contraceptive drugs, devices, and supplies, require a clinic to bill the Medi-Cal program and the Family PACT Program at the Medi-Cal reimbursement rate. The bill would, for non-contraceptive drugs, devices, and supplies, require a clinic to bill the Medi-Cal program or the Family PACT Program at the lesser of the clinic's usual charge made to the general public, or its cost, defined as an aggregate amount equivalent to the sum of the actual acquisition cost of the drug, device, or supply plus a clinic dispensing fee. The bill would provide that the clinic dispensing fee shall be determined by the department, as specified, or, if not determined by the department, shall be the difference between the actual acquisition cost and the Medi-Cal reimbursement rate. The bill would require reimbursement for non-contraceptive drugs, devices, and supplies to be the lesser of the amount billed, as described above, or the Medi-Cal reimbursement rate, and would cap reimbursement at the net cost of the drug, device, or supply when provided by retail pharmacies under the Medi-Cal program. The bill would require the department to seek federal approval of any state plan amendments necessary to implement these provisions. The bill would require the department, by July 1, 2018, to adopt regulations to implement these provisions, as specified. Until those regulations are adopted the bill would require the department to implement these provisions by provider bulletins or similar instructions and provide the Legislature with a semiannual status report, as specified.
Who sponsors SB 447?
SB 447 is sponsored by Allen, Benjamin (Democratic).
What is the current status of SB 447?
This bill died with 2015-2016 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 447?
Track SB 447 free on One Click Politics — get push/email alerts when it moves.

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