Angelique Ashby
- Democratic
- Senator
- District 8
Author
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law requires health care service plan contracts and health insurance policies to provide coverage for certain services and treatments, including medical transportation services. Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services, including emergency medical transport. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law, until January 1, 2031, authorizes a local emergency medical services (EMS) agency to develop a community paramedicine or triage to alternate destination program that, among other things, provides case management services to frequent EMS users or triage paramedic assessments, respectively. This bill would require a health care service plan contract or health insurance policy issued, amended, or renewed on or after July 1, 2025, to establish a process to reimburse for services provided by a community paramedicine program, a triage to alternate destination program, and a mobile integrated health program, as defined. The bill would require those contracts and policies to require an enrollee or insured who receives covered services from a noncontracting program to pay no more than the same cost-sharing amount that they would pay for the same covered services received from a contracting program. The bill would prohibit reimbursement rates adopted pursuant to this provision from exceeding the health care service plan's or health insurer's usual and customary charges for services rendered. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. The bill would also make services provided by these programs covered benefits under the Medi-Cal program. The bill would condition this Medi-Cal coverage on an appropriation, receipt of any necessary federal approvals, and the availability of federal financial participation. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Approved by the Governor.
Chaptered by Secretary of State. Chapter 884, Statutes of 2024.
Enrolled and presented to the Governor at 4 p.m.
Assembly amendments concurred in. (Ayes 40. Noes 0. Page 5749.) Ordered to engrossing and enrolling.
Ordered to special consent calendar.
Read third time. Passed. (Ayes 76. Noes 0. Page 6702.) Ordered to the Senate.
In Senate. Concurrence in Assembly amendments pending.
Read second time. Ordered to third reading.
From committee: Do pass. (Ayes 13. Noes 0.) (August 15).
August 7 set for first hearing. Placed on suspense file.
Read second time and amended. Re-referred to Com. on APPR.
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (June 18).
In Assembly. Read first time. Held at Desk.
Read third time. Passed. (Ayes 35. Noes 0. Page 4092.) Ordered to the Assembly.
Read second time. Ordered to third reading.
Read second time and amended. Ordered to second reading.
From committee: Do pass as amended. (Ayes 5. Noes 0. Page 3974.) (May 16).
Set for hearing May 16.
May 6 hearing: Placed on APPR suspense file.
Set for hearing May 6.
Read second time and amended. Re-referred to Com. on APPR.
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 10. Noes 0. Page 3755.) (April 24).
Set for hearing April 24.
From printer. May be acted upon on or after March 16.
Introduced. Read first time. To Com. on RLS. for assignment. To print.
| Bill Text Versions | Format |
|---|---|
| SB1180 | HTML |
| 02/14/24 - Introduced | |
| 04/29/24 - Amended Senate | |
| 05/16/24 - Amended Senate | |
| 06/24/24 - Amended Assembly | |
| 09/04/24 - Enrolled | |
| 09/28/24 - Chaptered |
| Document | Format |
|---|---|
| 04/22/24- Senate Health | |
| 05/03/24- Senate Appropriations | |
| 05/16/24- Senate Appropriations | |
| 05/18/24- Sen. Floor Analyses | |
| 06/14/24- Assembly Health | |
| 08/05/24- Assembly Appropriations | |
| 08/19/24- ASSEMBLY FLOOR ANALYSIS | |
| 08/29/24- Sen. Floor Analyses |
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