Bill Text: CA AB1462 | 2009-2010 | Regular Session | Enrolled
Bill Title: Medi-Cal: inpatient hospital services contracts.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Vetoed) 2010-01-14 - Consideration of Governor's veto stricken from file. [AB1462 Detail]
Download: California-2009-AB1462-Enrolled.html
BILL NUMBER: AB 1462 ENROLLED
BILL TEXT
PASSED THE SENATE SEPTEMBER 3, 2009
PASSED THE ASSEMBLY SEPTEMBER 9, 2009
AMENDED IN SENATE JULY 14, 2009
AMENDED IN ASSEMBLY APRIL 14, 2009
INTRODUCED BY Assembly Member Feuer
FEBRUARY 27, 2009
An act to amend Section 14083 of the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 1462, Feuer. Medi-Cal: inpatient hospital services contracts.
Existing law provides for the Medi-Cal program, administered by
the State Department of Health Care Services, under which qualified
low-income persons are provided with health care services.
Under existing law, the California Medical Assistance Commission
is authorized to negotiate inpatient hospital services contracts
binding upon the State Department of Health Care Services. Existing
law requires the commission to consider certain factors in
negotiating inpatient hospital services contracts.
This bill would add graduate medical education programs to the
list of factors the commission is required to consider when
negotiating inpatient hospital services contracts.
This bill would incorporate additional changes in Section 14083 of
the Welfare and Institutions Code proposed by AB 366, that would
become operative only if AB 366 and this bill are both chaptered and
become effective on or before January 1, 2010, and this bill is
chaptered last.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14083 of the Welfare and Institutions Code is
amended to read:
14083. The factors to be considered by the negotiator in
negotiating contracts under this article, or in drawing
specifications for competitive bidding, include, but are not limited
to, all of the following:
(a) Beneficiary access.
(b) Utilization controls.
(c) Ability to render quality services efficiently and
economically.
(d) Demonstrated ability to provide or arrange needed specialized
services.
(e) Protection against fraud and abuse.
(f) Any other factor which would reduce costs, promote access, or
enhance the quality of care.
(g) Graduate medical education programs.
(h) The capacity to provide a given tertiary service, such as
specialized children's services, on a regional basis.
(i) Recognition of the variations in severity of illness and
complexity of care.
(j) Existing labor-management collective bargaining agreements.
(k) The situation of county hospitals and university medical
centers contracting with counties for provision of health care to
indigent persons entitled to care under Section 17000, which are
burdened to a greater extent than private hospitals with bad debts,
indirect costs, medical education programs, and capital needs.
(l) The special circumstances of hospitals serving a
disproportionate number of Medi-Cal beneficiaries and patients who
are not covered by other third-party payers, including the costs
associated with assuring an adequate supply of registered nurses.
(m) The costs of providing complex emergency services, including
the costs of meeting and maintaining state and local requirements for
trauma center designation.
(n) The hospital does any of the following:
(1) Provides additional obstetrical beds.
(2) Contracts with one or more comprehensive perinatal providers.
(3) Permits certified nurse midwives, subject to hospital rules,
and consistent with existing laws and regulations, to admit patients
to the health facility.
(4) Expands overall obstetrical services in the hospital.
(o) The special circumstances of hospitals whose Medi-Cal
inpatient utilization rate exceeds the mean Medicaid inpatient
utilization rate by at least one-half of one standard deviation.
(p) The ability and capacity of the contracting hospital in a
closed health facility planning area to provide health care services
to beneficiaries who are in life threatening or emergency situations,
but have been sufficiently stabilized at another noncontracting
facility in order to facilitate transportation to the contracting
hospital.
(q) The ability of the contracting hospital to provide a secure
environment for the provision of health care services. In this
regard, the negotiator shall consider additional security measures
that the contracting hospital may have taken to provide a secure
environment, including, but not limited to, the use of detection
equipment or procedures to detect lethal weapons, the appropriate use
of surveillance cameras, limiting access of unauthorized personnel
to the emergency department, installation of bulletproof glass as
appropriate in designated areas, the use of emergency "panic" buttons
to alert local law enforcement agencies, and assigning full-time
security personnel to the emergency department.
SEC. 1.5. Section 14083 of the Welfare and Institutions Code is
amended to read:
14083. The factors to be considered by the negotiator in
negotiating contracts under this article, or in drawing
specifications for competitive bidding, include, but are not limited
to, all of the following:
(a) Beneficiary access.
(b) Utilization controls.
(c) Ability to render quality services efficiently and
economically.
(d) Demonstrated ability to provide or arrange needed specialized
services.
(e) Protection against fraud and abuse.
(f) Any other factor that would reduce costs, promote access, or
enhance the quality of care.
(g) Graduate medical education programs.
(h) The capacity to provide a given tertiary service, such as
specialized children's services, on a regional basis.
(i) Specialization in orthopedic implantation related to cancers
of the bone.
(j) Recognition of the variations in severity of illness and
complexity of care.
(k) Existing labor-management collective bargaining agreements.
(l) The situation of county hospitals and university medical
centers contracting with counties for provision of health care to
indigent persons entitled to care under Section 17000, which are
burdened to a greater extent than private hospitals with bad debts,
indirect costs, medical education programs, and capital needs.
(m) The special circumstances of hospitals serving a
disproportionate number of Medi-Cal beneficiaries and patients who
are not covered by other third-party payers, including the costs
associated with assuring an adequate supply of registered nurses.
(n) The costs of providing complex emergency services, including
the costs of meeting and maintaining state and local requirements for
trauma center designation.
(o) The hospital does any of the following:
(1) Provides additional obstetrical beds.
(2) Contracts with one or more comprehensive perinatal providers.
(3) Permits certified nurse midwives, subject to hospital rules,
and consistent with existing laws and regulations, to admit patients
to the health facility.
(4) Expands overall obstetrical services in the hospital.
(p) The special circumstances of hospitals whose Medi-Cal
inpatient utilization rate exceeds the mean Medicaid inpatient
utilization rate by at least one-half of one standard deviation.
(q) The ability and capacity of the contracting hospital in a
closed health facility planning area to provide health care services
to beneficiaries who are in life threatening or emergency situations,
but have been sufficiently stabilized at another noncontracting
facility in order to facilitate transportation to the contracting
hospital.
(r) The ability of the contracting hospital to provide a secure
environment for the provision of health care services. In this
regard, the negotiator shall consider additional security measures
that the contracting hospital may have taken to provide a secure
environment, including, but not limited to, the use of detection
equipment or procedures to detect lethal weapons, the appropriate use
of surveillance cameras, limiting access of unauthorized personnel
to the emergency department, installation of bulletproof glass as
appropriate in designated areas, the use of emergency "panic" buttons
to alert local law enforcement agencies, and assigning full-time
security personnel to the emergency department.
SEC. 2. Section 1.5 of this bill incorporates amendments to
Section 14083 of the Welfare and Institutions Code proposed by both
this bill and AB 366. It shall only become operative if (1) both
bills are enacted and become effective on or before January 1, 2010,
(2) each bill amends Section 14083 of the Welfare and Institutions
Code, and (3) this bill is enacted after AB 366, in which case
Section 1 of this bill shall not become operative.
