California 2015-2016 Regular Session Status: To Executive

SB 610 — Medi-Cal: federally qualified health centers: rural health clinics: managed care contracts.

Last action — Last day to consider Governors veto pursuant to Joint Rule 58.5.

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

This bill died with 2015-2016 Regular Session. It reached “To Executive” 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This bill is no longer active — its legislative session has ended, so there is no live prognosis.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. Existing law provides that federally qualified health center (FQHC) services and rural health clinic (RHC) services, as defined, are covered benefits under the Medi-Cal program to be reimbursed, to the extent that federal financial participation is obtained, to providers on a per-visit basis. Existing law authorizes an FQHC or RHC to apply for an adjustment to its per-visit rate, based on a change in the scope of services provided, as prescribed. Existing law establishes alternative ratesetting procedures with respect to a new entity that first qualifies as an FQHC or RHC in the year 2001 or later, a newly licensed facility at a new location added to an existing FQHC or RHC or an existing FQHC or RHC that is relocated. Two of the procedures are referred to as comparability approaches, based on the rates of 3 similarly situated FQHCs and RHCs. The 3rd procedure requires, at a new entity's one-time election, that the department establish the reimbursement rate, calculated on a per-visit basis, that equals 100% of the projected allowable costs to the FQHC or RHC of furnishing services during its first 12 months of operation as an FQHC or RHC. This bill would require the department to finalize a new rate within 1 year after an FQHC's or RHC's submission of a scope-of-service rate change. With respect to a new FQHC or RHC that has elected for the department to establish its reimbursement rate based on projected allowable costs as described above, this bill would require the department to finalize that rate within 1 year after the submission of the actual cost report from the first full 12 months of operation, as specified. This bill would revise the department's responsibilities with respect to a new entity or a relocated FQHC or RHC that selects either of the comparability approaches. The bill would require the department to review the comparable facilities to determine if any of them do not meet the comparability threshold and, if so, to notify the new entity, and request a supplemental submission, as prescribed. The bill would require the department to conduct an initial review of a scope-of-service rate change request within 30 days after submission by the FQHC or RHC, and notify the FQHC or RHC by the 31st day after submission if the department determines that additional information is necessary, as prescribed. The bill would require the department to finalize the FQHC's or RHC's rate within 1 year after receiving a submission the department determines to be complete. This bill would require the department to correct erroneous payments at least quarterly to reprocess past claims and ensure all claims are reimbursed at the appropriate finalized new rate. Existing law requires the department to administer a program to ensure that total payments to FQHCs and RHCs operating as managed care subcontractors comply with applicable federal law regarding payment for services provided by FQHCs and RHCs. Under the department's program, existing law requires FQHCs and RHCs subcontracting with specified managed care plans to seek supplemental reimbursement from the department through a per visit fee-for-service billing system. To be reimbursed under these provisions, existing law requires each FQHC and RHC to submit to the department for approval a rate differential based on the FQHC's or RHC's reasonable cost or the prospective payment rate. Within 6 months of the end of the FQHC's or RHC's fiscal year, existing law requires, to the extent feasible, the department to perform an annual reconciliation to reasonable cost, and make payments to, or obtain recovery from, the FQHC or RHC. This bill would impose various requirements on the department regarding the reconciliation process described above. The bill would require the department to complete the final reconciliation review and pay to the center or clinic any remaining amount owed within 18 months after the last date of the fiscal year for which the department is conducting the review. This bill would incorporate additional changes to Section 14132.100 of the Welfare and Institutions Code made by this bill and AB 858 to take effect if both bills are chaptered and this bill is chaptered last.

Bill Text

Action History

  1. Last day to consider Governors veto pursuant to Joint Rule 58.5.

  2. In Senate. Consideration of Governor's veto pending.

  3. Vetoed by the Governor.

  4. Enrolled and presented to the Governor at 4:45 p.m.

  5. Assembly amendments concurred in. (Ayes 40. Noes 0. Page 2759.) Ordered to engrossing and enrolling.

  6. In Senate. Concurrence in Assembly amendments pending.

  7. Read third time. Passed. (Ayes 80. Noes 0. Page 3092.) Ordered to the Senate.

  8. Ordered to third reading.

  9. Read third time and amended.

  10. Read second time. Ordered to third reading.

  11. From committee: Do pass. (Ayes 17. Noes 0.) (August 27).

  12. August 19 set for first hearing. Placed on APPR. suspense file.

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

  14. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 18. Noes 0.) (June 30).

  15. Referred to Com. on HEALTH.

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

  17. Read third time. Passed. (Ayes 39. Noes 0. Page 1207.) Ordered to the Assembly.

  18. Read second time. Ordered to third reading.

  19. From committee: Do pass. (Ayes 7. Noes 0. Page 1157.) (May 28).

  20. Set for hearing May 28.

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

  22. Set for hearing May 11.

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

  24. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 8. Noes 0. Page 758.) (April 22).

  25. Set for hearing April 22.

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

  27. Referred to Com. on HEALTH.

  28. Read first time.

  29. From printer. May be acted upon on or after April 1.

  30. Introduced. To Com. on RLS. for assignment. To print.

Sponsors

  • Pan · Primary

Sponsorship breakdown

Export CSV (upgrade) →

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.

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

Unfinished Business SB610 Pan Concurrence

Passed 40 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 37000
Democratic 3000
Total 40000
% of votes cast 100%0%0%0%
How each member voted (40)
Member Party Vote
Beall — Yea
Hernandez — Yea
Huff — Yea
Leyva — Yea
Monning — Yea
Nielsen — Yea
Wieckowski — Yea
Galgiani — Yea
Allen — Yea
Cannella — Yea
Mitchell — Yea
De León — Yea
Runner — Yea
Hall — Yea
Hancock — Yea
Hertzberg — Yea
Anderson — Yea
Bates — Yea
Block — Yea
Hill — Yea
Hueso — Yea
Lara — Yea
Leno — Yea
Liu — Yea
Mendoza — Yea
Moorlach — Yea
Morrell — Yea
Pan — Yea
Pavley — Yea
Roth — Yea
Vidak — Yea
Wolk — Yea
Fuller — Yea
Glazer — Yea
Beth Gaines — Yea
Bill Berryhill — Yea
Mark Stone — Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Nguyen, Stephanie Democratic Yea

Official roll call →

SB 610 Pan Senate Third Reading By BONTA

Passed 80 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 71000
Democratic 4000
Republican 5000
Total 80000
% of votes cast 100%0%0%0%
How each member voted (80)
Member Party Vote
Achadjian — Yea
Baker — Yea
Bloom — Yea
Brough — Yea
Brown — Yea
Low — Yea
Maienschein — Yea
Mathis — Yea
Medina — Yea
Mullin — Yea
Nazarian — Yea
O'Donnell — Yea
Quirk — Yea
Rendon — Yea
Ridley-Thomas — Yea
Santiago — Yea
Wagner — Yea
Wilk — Yea
Eggman — Yea
Cooper — Yea
Daly — Yea
Frazier — Yea
Salas — Yea
Gatto — Yea
Gomez — Yea
Gordon — Yea
Burke — Yea
Harper — Yea
Jones-Sawyer — Yea
Kim — Yea
Levine — Yea
Chang — Yea
Linder — Yea
Mayes — Yea
McCarty — Yea
Melendez — Yea
Gray — Yea
Atkins — Yea
Chau — Yea
Alejo — Yea
Bigelow — Yea
Chiu — Yea
Chu — Yea
Chávez — Yea
Cooley — Yea
Dababneh — Yea
Dodd — Yea
Obernolte — Yea
Olsen — Yea
Perea — Yea
Rodriguez — Yea
Steinorth — Yea
Thurmond — Yea
Waldron — Yea
Weber — Yea
Williams — Yea
Bonilla — Yea
Lopez — Yea
Hadley — Yea
Campos — Yea
Holden — Yea
Ting — Yea
Wood — Yea
Beth Gaines — Yea
Cristina Garcia — Yea
Eduardo Garcia — Yea
Jim Patterson — Yea
Lorena Gonzalez — Yea
Mark Stone — Yea
Roger Hernández — Yea
Travis Allen — Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Gipson, Mike A. Democratic Yea
Irwin, Jacqui Democratic Yea
Dahle, Megan Republican Yea
Gallagher, James Republican Yea
Grove, Shannon Republican Yea
Jones, Brian W. Republican Yea
Lackey, Tom Republican Yea

Official roll call →

Do pass.

Passed 17 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 13000
Republican 2000
Democratic 2000
Total 17000
% of votes cast 100%0%0%0%
How each member voted (17)
Member Party Vote
Holden — Yea
Eggman — Yea
Gomez — Yea
Rendon — Yea
Bigelow — Yea
Bloom — Yea
Chang — Yea
Nazarian — Yea
Quirk — Yea
Wagner — Yea
Weber — Yea
Wood — Yea
Eduardo Garcia — Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Gallagher, James Republican Yea
Jones, Brian W. Republican Yea

Official roll call →

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

Passed 18 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Republican 2000
Unaffiliated 15001
Democratic 1000
Total 18001
% of votes cast 95%0%0%5%
How each member voted (19)
Member Party Vote
Maienschein — Yea
Chávez — Not Voting
Gomez — Yea
Bonilla — Yea
Burke — Yea
Chiu — Yea
McCarty — Yea
Nazarian — Yea
Ridley-Thomas — Yea
Rodriguez — Yea
Steinorth — Yea
Thurmond — Yea
Waldron — Yea
Wood — Yea
Gonzalez — Yea
Roger Hernández — Yea
Bonta, Mia Democratic Yea
Lackey, Tom Republican Yea
Patterson, Joe Republican Yea

Official roll call →

3rd Reading

Passed 39 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 36001
Democratic 3000
Total 39001
% of votes cast 98%0%0%3%
How each member voted (40)
Member Party Vote
Anderson — Yea
Beall — Yea
Block — Yea
Hancock — Yea
Hertzberg — Yea
Hueso — Yea
Leyva — Yea
Mendoza — Yea
Morrell — Yea
Pan — Yea
Pavley — Yea
Vidak — Yea
Fuller — Yea
Cannella — Yea
Galgiani — Yea
Glazer — Yea
Allen — Yea
Hall — Yea
Mitchell — Yea
De León — Yea
Runner — Yea
Hernandez — Yea
Bates — Yea
Hill — Yea
Lara — Yea
Leno — Yea
Liu — Yea
Monning — Yea
Moorlach — Yea
Nielsen — Yea
Roth — Yea
Wieckowski — Yea
Wolk — Yea
Huff — Yea
Beth Gaines — Yea
Bill Berryhill — Yea
Mark Stone — Not Voting
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Nguyen, Stephanie Democratic Yea

Official roll call →

Do pass

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
Hill — Yea
Lara — Yea
Leyva — Yea
Nielsen — Yea
Beall — Yea
Mendoza — Yea

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
Hill — Yea
Leyva — Yea
Mendoza — Yea
Nielsen — Yea
Lara — Yea
Bates — Yea
Beall — Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does SB 610 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. Existing law provides that federally qualified health center (FQHC) services and rural health clinic (RHC) services, as defined, are covered benefits under the Medi-Cal program to be reimbursed, to the extent that federal financial participation is obtained, to providers on a per-visit basis. Existing law authorizes an FQHC or RHC to apply for an adjustment to its per-visit rate, based on a change in the scope of services provided, as prescribed. Existing law establishes alternative ratesetting procedures with respect to a new entity that first qualifies as an FQHC or RHC in the year 2001 or later, a newly licensed facility at a new location added to an existing FQHC or RHC or an existing FQHC or RHC that is relocated. Two of the procedures are referred to as comparability approaches, based on the rates of 3 similarly situated FQHCs and RHCs. The 3rd procedure requires, at a new entity's one-time election, that the department establish the reimbursement rate, calculated on a per-visit basis, that equals 100% of the projected allowable costs to the FQHC or RHC of furnishing services during its first 12 months of operation as an FQHC or RHC. This bill would require the department to finalize a new rate within 1 year after an FQHC's or RHC's submission of a scope-of-service rate change. With respect to a new FQHC or RHC that has elected for the department to establish its reimbursement rate based on projected allowable costs as described above, this bill would require the department to finalize that rate within 1 year after the submission of the actual cost report from the first full 12 months of operation, as specified. This bill would revise the department's responsibilities with respect to a new entity or a relocated FQHC or RHC that selects either of the comparability approaches. The bill would require the department to review the comparable facilities to determine if any of them do not meet the comparability threshold and, if so, to notify the new entity, and request a supplemental submission, as prescribed. The bill would require the department to conduct an initial review of a scope-of-service rate change request within 30 days after submission by the FQHC or RHC, and notify the FQHC or RHC by the 31st day after submission if the department determines that additional information is necessary, as prescribed. The bill would require the department to finalize the FQHC's or RHC's rate within 1 year after receiving a submission the department determines to be complete. This bill would require the department to correct erroneous payments at least quarterly to reprocess past claims and ensure all claims are reimbursed at the appropriate finalized new rate. Existing law requires the department to administer a program to ensure that total payments to FQHCs and RHCs operating as managed care subcontractors comply with applicable federal law regarding payment for services provided by FQHCs and RHCs. Under the department's program, existing law requires FQHCs and RHCs subcontracting with specified managed care plans to seek supplemental reimbursement from the department through a per visit fee-for-service billing system. To be reimbursed under these provisions, existing law requires each FQHC and RHC to submit to the department for approval a rate differential based on the FQHC's or RHC's reasonable cost or the prospective payment rate. Within 6 months of the end of the FQHC's or RHC's fiscal year, existing law requires, to the extent feasible, the department to perform an annual reconciliation to reasonable cost, and make payments to, or obtain recovery from, the FQHC or RHC. This bill would impose various requirements on the department regarding the reconciliation process described above. The bill would require the department to complete the final reconciliation review and pay to the center or clinic any remaining amount owed within 18 months after the last date of the fiscal year for which the department is conducting the review. This bill would incorporate additional changes to Section 14132.100 of the Welfare and Institutions Code made by this bill and AB 858 to take effect if both bills are chaptered and this bill is chaptered last.
Who sponsors SB 610?
SB 610 is sponsored by Pan.
What is the current status of SB 610?
This bill died with 2015-2016 Regular Session. It reached “To Executive” 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 610?
Track SB 610 free on One Click Politics — get push/email alerts when it moves.

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