BILL NUMBER: AB 1462 AMENDED
BILL TEXT
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, as amended, 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.
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 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 which that
would reduce costs, promote access, or enhance the quality of care.
(g) Graduate medical education programs.
(g)
(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.
(h)
(j) Recognition of the variations in severity of
illness and complexity of care.
(i)
(k) Existing labor-management collective bargaining
agreements.
(j)
(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.
(k)
(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.
(l)
(n) The costs of providing complex emergency services,
including the costs of meeting and maintaining state and local
requirements for trauma center designation.
(m)
(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.
(n)
(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.
(o)
(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.
(p)
(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
bullet proof 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.