Mitchell
Author
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, including specialty mental health services. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Under existing law, specialty mental health services are generally provided by mental health plans that contract with the department. Existing law establishes the Drug Medi-Cal Treatment Program (Drug Medi-Cal) , under which the department is authorized to enter into contracts with each county for various alcohol and drug treatment services, including substance use disorder services, narcotic treatment program services, naltrexone services, and outpatient drug-free services, to Medi-Cal beneficiaries, or the department is required to directly arrange for these services if a county elects not to do so. 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 FQHCs and RHCs to elect to have pharmacy or dental services reimbursed on a fee-for-service basis, utilizing the current fee schedules established for those services and requires those costs to be adjusted out of the FQHC's or RHC's clinic base rate as scope-of-service changes. This bill additionally would authorize FQHCs and RHCs to elect to enroll as a Drug Medi-Cal certified provider under Drug Medi-Cal to provide Drug Medi-Cal services and would set forth the reimbursement requirements for these services. The bill would require the costs of providing Drug Medi-Cal services to be adjusted out of the FQHC's or RHC's clinic base rate as scope-of-service changes, as specified, and would prohibit the FQHC or RHC from billing the per-visit prospective payment system (PPS) rate for services reimbursed by Drug Medi-Cal. The bill would authorize a county to contract with the FQHCs and RHCs for these Drug Medi-Cal services. The bill would authorize an FQHC or RHC that entered into a contract on or before January 1, 2017, with a mental health plan to provide specialty mental health services to continue to provide, and be reimbursed for, those specialty mental health services if the costs of providing specialty mental health services are reimbursed outside of the per-visit rate. The bill's requirements would be implemented only to the extent that federal financial participation is available and any federal approvals have been obtained. This bill would incorporate additional changes in Section 14132.100 of the Welfare and Institutions Code proposed by AB 1863, that would become operative only if AB 1863 and this bill are both chaptered and become effective on or before January 1, 2017, and this bill is chaptered last.
Ordered to inactive file on request of Assembly Member Calderon.
Ordered to third reading.
Read third time and amended.
Read second time. Ordered to third reading.
From committee: Do pass. (Ayes 20. Noes 0.) (August 11).
August 3 set for first hearing. Placed on APPR. suspense file.
From committee with author's amendments. Read second time and amended. Re-referred to Com. on APPR.
From committee: Do pass and re-refer to Com. on APPR. with recommendation: To consent calendar. (Ayes 17. Noes 0.) (June 21). Re-referred to Com. on APPR.
In Assembly. Read first time. Held at Desk.
Read third time. Passed. (Ayes 39. Noes 0. Page 4053.) Ordered to the Assembly.
From committee: Do pass. (Ayes 7. Noes 0. Page 4008.) (May 27).
Read second time. Ordered to third reading.
Set for hearing May 27.
May 9 hearing: Placed on APPR. suspense file.
Set for hearing May 9.
Read second time and amended. Re-referred to Com. on APPR.
From committee: Do pass as amended and re-refer to Com. on APPR. with recommendation: To consent calendar. (Ayes 9. Noes 0. Page 3559.) (April 13).
From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
Set for hearing April 13.
April 6 set for first hearing canceled at the request of author.
Set for hearing April 6.
Read first time.
From printer. May be acted upon on or after March 23.
Introduced. To Com. on RLS. for assignment. To print.
| Bill Text Versions | Format |
|---|---|
| SB1335 | HTML |
| 02/19/16 - Introduced | |
| 04/05/16 - Amended Senate | |
| 04/20/16 - Amended Senate | |
| 08/01/16 - Amended Assembly | |
| 08/18/16 - Amended Assembly |
| Document | Format |
|---|---|
| No related documents. |
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