BILL NUMBER: AB 2096	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member V. Manuel Pérez

                        FEBRUARY 23, 2012

   An act to amend Section 14182.3 of the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2096, as introduced, V. Manuel Pérez. Public health care:
Medi-Cal: demonstration projects.
   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 establishes the Medi-Cal
Hospital/Uninsured Care Demonstration Project Act, which revises
hospital supplemental payment methodologies under the Medi-Cal
program in order to maximize the use of federal funds consistent with
federal Medicaid law and to stabilize the distribution of funding
for hospitals that provide care to Medi-Cal beneficiaries and
uninsured patients. Existing law requires the department to seek
another demonstration project or federal waiver of Medicaid law to
implement specified objectives, which may include better care
coordination for seniors, persons with disabilities, and children
with special health care needs. Existing law provides that to the
extent the provisions under the Medi-Cal Hospital/Uninsured Care
Demonstration Project Act do not conflict with the provisions of, or
the Special Terms and Conditions of, this demonstration project, the
provisions of the Medi-Cal Hospital/Uninsured Care Demonstration
Project Act shall apply. Under existing law, if the Director of
Health Care Services determines that the amount of base funding
available under the new demonstration project is less than a
specified amount available to public hospitals under the original
demonstration project, the state is authorized to reallocate funding
to increase the amount of base funding for the new demonstration
project.
   This bill would refer ro designated and nondesignated public
hospitals, in the latter provision described above..
   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 14182.3 of the Welfare and Institutions Code is
amended to read:
   14182.3.  (a) To the extent the provisions of Article 5.2
(commencing with Section 14166) do not conflict with the provisions
of this article or the Special Terms and Conditions of the new
demonstration project created under this article, the provisions of
Article 5.2 (commencing with Section 14166) shall continue to apply
to the new demonstration project.
   (b) In the event of a conflict between any provision of this
article and the Special Terms and Conditions required by the federal
Centers for Medicare and Medicaid Services for the approval of the
demonstration project described in Section 14180, the Special Terms
and Conditions shall control.
   (c) (1) Under the demonstration project described in Section
14180, the state shall have priority to claim against and retain the
first five hundred million dollars ($500,000,000) in federal funds
using expenditures incurred under state-only programs or other
programs for which the state is authorized to claim under the Special
Terms and Conditions of the demonstration project or federal
Medicaid law, including state-only programs that serve special
populations, such as those for which state savings were recognized in
the Budget Act for the 2010-11 fiscal year.
   (2) Notwithstanding paragraph (1), if the director determines that
the amount of base funding available under the demonstration project
described in Section 14180 is less than the six hundred eighty-one
million six hundred forty thousand dollars ($681,640,000) available
to  designated and nondesignated  public hospitals under the
original demonstration project, the state may reallocate an amount
from the five hundred million dollars ($500,000,000) described in
paragraph (1) to increase the amount of base funding under the new
demonstration project to six hundred eighty one million six hundred
forty thousand dollars ($681,640,000).
   (3) For purposes of this section, the term "base funding" includes
funding for the safety net care pool or a similar pool or fund for
health coverage expansion, and for an investment, incentive, or
similar pool, but shall not include funds made available to hospitals
or counties for inpatient or outpatient Medi-Cal reimbursements,
expansion of managed care for seniors and persons with disabilities,
or other expansions of systems of care for individuals who are
eligible under the Medi-Cal state plan.
   (4) If the state is unable to claim the full amount of the five
hundred million dollars ($500,000,000) described in paragraph (1),
any portion of the amount that remains unclaimed may be reallocated
to be claimed based on the certified public expenditures of the
designated public hospitals.
   (d) The director shall have authority to maximize available
federal financial participation under the demonstration project
described in Section 14180, including, but not limited to,
authorizing the use of intergovernmental transfers by district
hospitals that are not reimbursed under a contract negotiated
pursuant to the Selective Provider Contracting Program, to fund the
nonfederal share of expenditures to the extent permitted by the
Special Terms and Conditions of the demonstration project.
   (e) Participation in intergovernmental transfers under this
section is voluntary on the part of the transferring entity for
purposes of all applicable federal laws. As part of its voluntary
participation in the nonfederal share of payments under this
subdivision by means of intergovernmental transfers, the transferring
entity agrees to reimburse the state for the nonfederal share of
state staffing or administrative costs directly attributable to the
state's implementation of these voluntary intergovernmental
transfers. This subdivision shall be implemented only to the extent
federal financial participation is not jeopardized.
   (f) Notwithstanding the rulemaking provisions of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code, the department may clarify, interpret, or
implement the provisions of this section by means of provider
bulletins or similar instructions. The department shall notify the
fiscal and appropriate policy committees of the Legislature of its
intent to issue instructions under this section at least five days in
advance of the issuance.