BILL NUMBER: AB 1310	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 22, 2014
	AMENDED IN SENATE  JULY 1, 2014
	AMENDED IN SENATE  JUNE 10, 2014
	AMENDED IN ASSEMBLY  MAY 24, 2013

INTRODUCED BY   Assembly Member Bonta
   (Principal coauthor: Assembly Member Brown)

                        FEBRUARY 22, 2013

   An act to amend Sections 14122 and 14132.72 of the Welfare and
Institutions Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1310, as amended, Bonta. Medi-Cal: telehealth.
   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 prohibits a requirement of
in-person contact between a health care provider and patient under
the Medi-Cal program for any service otherwise covered by the
Medi-Cal program when the service is appropriately provided by
telehealth, as defined. Existing law, for purposes of payment of
covered treatment or services provided through telehealth, prohibits
the department from limiting the type of setting where services are
provided for the patient or by the health care provider.
   This bill would  prohibit the department from requiring a
health care provider licensed in California to be located in
California as a condition of Medi-Cal provider enrollment or
reimbursement for telehealth services provided to Medi-Cal
beneficiaries located in California at the time of service. 
 require, effective July 1, 2015, in order for a health care
provider that is not located in California to be enrolled in Medi-Cal
for the purpose of providing health care services by way of
telehealth for beneficiaries receiving care in California, the
provider to meet   specified conditions and criteria,
including that the provider be enrolled and in good standing in the
Medicaid program for the state where the provider is located, be
enrolled in good standing in Medicare, or be enrolled in good
standing in both programs, and that the provider not be located
outside the United States of   America. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 14122 of the Welfare and Institutions Code is
amended to read:
   14122.  (a) The department may provide, by regulation and
consistent with the requirements of the Federal Social Security Act,
for the care and treatment, or both, of persons eligible for medical
assistance pursuant to Sections 14005.1, 14005.4, and 14005.7 by
providers in another state in those cases where out-of-state care or
treatment is rendered on an emergency basis or is otherwise in the
best interests of the person under the circumstances.
   (b) This section shall not apply to services provided pursuant to
Section 14132.72.
  SEC. 2.  Section 14132.72 of the Welfare and Institutions Code is
amended to read:
   14132.72.  (a) For purposes of this section, the definitions in
subdivision (a) of Section 2290.5 of the Business and Professions
Code shall apply.
   (b) It is the intent of the Legislature to recognize the practice
of telehealth as a legitimate means by which an individual may
receive health care services from a health care provider without
in-person contact with the provider.
   (c) In-person contact between a health care provider and a patient
shall not be required under the Medi-Cal program for services
appropriately provided through telehealth, subject to reimbursement
policies adopted by the department to compensate a licensed health
care provider who provides health care services through telehealth
that are otherwise reimbursed pursuant to the Medi-Cal program.
Nothing in this section or the Telehealth Advancement Act of 2011
(Chapter 547 of the Statutes of 2011) shall be construed to conflict
with or supersede the provisions of any other existing state laws or
regulations related to reimbursement for services provided by a
noncontracted provider.
   (d) The department shall not require a health care provider to
document a barrier to an in-person visit for Medi-Cal coverage of
services provided via telehealth. 
   (e) The department shall not require a health care provider
licensed in California to be located in California as a condition of
Medi-Cal provider enrollment or reimbursement for telehealth services
provided to Medi-Cal beneficiaries located in California at the time
of service.  
   (e) (1) Effective July 1, 2015, in order for a health care
provider that is not located in California to be enrolled in Medi-Cal
for the purpose of providing health care services by way of
telehealth for beneficiaries receiving care in California, that
provider, shall, at a minimum, meet all of the following conditions
and criteria:  
   (A) The provider shall be licensed pursuant to Division 2
(commencing with Section 500) of the Business and Professions Code or
the Osteopathic Initiative Act, or by the relevant California
licensing entity or board to perform the medical services provided
through telehealth.  
   (B) The provider shall be enrolled and in good standing in the
Medicaid program for the state where the provider is located, be
enrolled in good standing in Medicare, or be enrolled in good
standing in both programs.  
   (C) The provider shall not be located outside the United States of
America.  
   (D) The provider shall satisfy all requirements for enrollment and
participation in the Medi-Cal program, and other statutory
requirements for providing telehealth services.  
   (E) The provider shall consent to Medi-Cal acting through the
state Medicaid program where the provider is located and the Medicare
program with respect to any issues concerning the provider's
enrollment or participation in Medi-Cal.  
   (F) The provider shall consent to jurisdiction and venue in
Sacramento, California, for any and all legal proceedings in any way
related to the provider's enrollment in Medi-Cal, including, but not
limited to, formal or informal proceedings, as well as
administrative, civil, and criminal proceedings.  
   (2) This subdivision shall be implemented only to the extent
permitted by federal law and to the extent that federal financial
participation is available. 
   (f) For the purposes of payment for covered treatment or services
provided through telehealth, the department shall not limit the type
of setting where services are provided for the patient or by the
health care provider.
   (g) Nothing in this section shall be interpreted to authorize the
department to require the use of telehealth when the health care
provider has determined that it is not appropriate.
   (h) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement, interpret, and make specific this section
by means of all-county letters, provider bulletins, and similar
instructions.