AB 19

Bill Subjects

Abstract

Existing law provides for 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. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law requires the department to impose a uniform quality assurance fee on each skilled nursing facility, with certain exceptions, in accordance with a prescribed formula. The formula is based on the determination of the projected net revenues, as defined, of skilled nursing facilities. Under existing law, the fee will cease to be assessed after July 31, 2012, and these provisions will be repealed on January 1, 2013. This bill would provide that, beginning in the 2011–12 rate year, a unit that provides freestanding pediatric subacute care services in a skilled nursing facility will no longer be exempt from the quality assurance fee. This bill would require that the definition for net revenues as it applies for the 2009–10 to 2011–12, inclusive, rate years, shall also apply to each rate year thereafter. This bill would extend the repeal date of these provisions until January 1, 2014. This bill would also make conforming changes to reimbursement rates for freestanding pediatric subacute care units, as prescribed. Existing law provides for the licensure and regulation of long-term care facilities by the State Department of Public Health, and provides for a citation system for the imposition of civil sanctions against long-term care facilities in violation of applicable laws and regulations. This bill would increase the amount that may be imposed on a skilled nursing facility or an intermediate care facility for a class "B" citation to $2,000. Existing law, the Medi-Cal Long-Term Care Reimbursement Act, requires the State Department of Health Care Services to implement a facility-specific reimbursement ratesetting system for certain skilled nursing facilities. Reimbursement rates for freestanding skilled nursing facilities are funded by a combination of federal funds and moneys collected pursuant to the skilled nursing uniform quality assurance fee. Existing law also establishes the Skilled Nursing Facility Quality and Accountability Special Fund in the State Treasury, which is a continuously appropriated fund that contains moneys from the assessment of specified administrative penalties and set asides of General Fund moneys, for the purposes of making quality and accountability payments. Existing law provides that this rate methodology shall cease to be implemented after July 31, 2012, and that these provisions be repealed on January 1, 2013. This bill would extend the implementation date of the skilled nursing facility rate reimbursement provisions through July 31, 2013, would make various conforming changes to these provisions, and would extend the repeal date for all of these provisions until January 1, 2014. This bill would also modify, for the 2011–12 and 2012–13 rate years, the facility reimbursement formula to be used under these provisions. By extending the period of time during which transfers are made to the Skilled Nursing Facility Quality and Accountability Special Fund, this bill would make an appropriation. The California Constitution authorizes the Governor to declare a fiscal emergency and to call the Legislature into special session for that purpose. Governor Schwarzenegger issued a proclamation declaring a fiscal emergency, and calling a special session for this purpose, on December 6, 2010. Governor Brown issued a proclamation on January 20, 2011, declaring and reaffirming that a fiscal emergency exists and stating that his proclamation supersedes the earlier proclamation for purposes of that constitutional provision. This bill would state that it addresses the fiscal emergency declared and reaffirmed by the Governor by proclamation issued on January 20, 2011, pursuant to the California Constitution. This bill would declare that it is to take effect immediately as an urgency statute.