Bill Text: CA AB1202 | 2023-2024 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Medi-Cal: health care services data: children and pregnant or postpartum persons.

Spectrum: Bipartisan Bill

Status: (Vetoed) 2024-02-12 - Consideration of Governor's veto stricken from file. [AB1202 Detail]

Download: California-2023-AB1202-Introduced.html

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CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill

No. 1202

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Introduced by Assembly Member Lackey

February 16, 2023

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An act to add and repeal Section 14197.01 of the Welfare and Institutions Code, relating to Medi-Cal.

LEGISLATIVE COUNSEL'S DIGEST

AB 1202, as introduced, Lackey. Medi-Cal: time or distance standards: children’s health care services.

Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services through various health care delivery systems, including managed care pursuant to Medi-Cal managed care plan contracts. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.

Existing law establishes, until January 1, 2026, certain time or distance and appointment time standards for specified Medi-Cal managed care covered services, consistent with federal regulations relating to network adequacy standards, to ensure that those services are available and accessible to enrollees of Medi-Cal managed care plans in a timely manner, as specified. Existing law sets forth various limits on the number of miles or minutes from the enrollee’s place of residence, depending on the type of service or specialty and, in some cases, on the county.

Existing law authorizes a Medi-Cal managed care plan to use clinically appropriate video synchronous interaction as a means of demonstrating compliance with those standards. Existing law authorizes the department, upon request of a Medi-Cal managed care plan, to authorize alternative access standards for those standards under certain conditions, with the request being approved or denied on ZIP Code and provider type basis, as specified.

This bill would require the department to conduct an analysis to identify the number of Medi-Cal providers needed to ensure adequate access to children’s health care services, through compliance by Medi-Cal managed care plans with the above-described time or distance and appointment time standards across all service areas or counties of the state. The bill would require the department to prepare a report of the analysis and to submit the report to the Legislature no later than January 1, 2026. The bill would repeal the analysis and reporting provisions on January 1, 2030.

Digest Key

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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Bill Text

The people of the State of California do enact as follows:

SECTION 1.

 Section 14197.01 is added to the Welfare and Institutions Code, immediately following Section 14197, to read:

14197.01.

 (a) The department shall conduct an analysis to identify the number of Medi-Cal providers needed to ensure adequate access to children’s health care services, through compliance by Medi-Cal managed care plans with the time or distance and appointment time standards described in Section 14197, across all service areas or counties of the state.

(b) (1) The department shall prepare a report of the analysis described in subdivision (a) and shall submit the report to the Legislature no later than January 1, 2026.

(2) The report described in paragraph (1) shall be submitted in accordance with Section 9795 of the Government Code.

(c) Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.