Bill Text: CA SB1339 | 2013-2014 | Regular Session | Amended

California Senate Bill 1339 (Prior Session Legislation)

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

Bill Title: Medi-Cal: Drug Medi-Cal Treatment Program providers.

Spectrum: Moderate Partisan Bill (Republican 4-1)

Status: (Passed) 2014-09-19 - Chaptered by Secretary of State. Chapter 488, Statutes of 2014. [SB1339 Detail]

Download: California-2013-SB1339-Amended.html

BILL NUMBER: SB 1339	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  AUGUST 7, 2014
	AMENDED IN ASSEMBLY  JUNE 26, 2014
	AMENDED IN SENATE  MAY 27, 2014
	AMENDED IN SENATE  APRIL 29, 2014

INTRODUCED BY   Senator Cannella
   (Coauthors: Senators Huff and Vidak)
   (Coauthors: Assembly Members Medina and Wilk)

                        FEBRUARY 21, 2014

   An act to  amend Section 14043.38 of, and to  add Section
14124.27 to ,  the Welfare and Institutions Code, relating
to Medi-Cal.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1339, as amended, Cannella. Medi-Cal: Drug Medi-Cal Treatment
Program providers.
   Existing law provides for the Drug Medi-Cal (DMC) Treatment
Program, under which counties enter into contracts with the State
Department of Health Care Services  (DHCS)  for the
provision of various drug treatment services to Medi-Cal recipients,
or the department directly arranges for the provision of these
services if a county elects not to do so.
   Existing law requires the  DHCS   State
Department of Health Care Services  to screen Medi-Cal providers
and designate each provider  or applicant  as "limited,"
"moderate," or "high" categorical risk. Existing law requires a
provider or applicant designated as a "high" categorical risk, and a
person with a 5% or greater direct or indirect ownership interest in
the provider, to submit to the Department of Justice fingerprint
images and related information for the purpose of obtaining
information as to the existence of past criminal conduct, as
specified. Existing law requires the Department of Justice to charge
a fee, to be paid by the applicant or provider, sufficient to cover
the cost of processing the criminal background check request.
   This bill would require DMC providers to be designated as a "high"
categorical risk and be subject to the background checks described
above.  The bill would provide that if the provider or applicant
is a nonprofit Drug Medi-Cal provider or applicant, the criminal
background check and  the requirement to submit fingerprint
images and related information would apply to the officers and
executive director of the provider or applicant.  The bill would
permit the department to designate a DMC provider as a "limited" or
"moderate" categorical risk by executing a declaration stating the
reason or reasons that a "high" categorical risk designation is no
longer warranted. The bill would provide that it is the
responsibility of the DMC provider, or the person with a 5% or
greater direct or indirect ownership interest in the provider, to pay
the fee imposed for processing the criminal background check
request, as applicable. The bill would prohibit, except as provided
by federal law, a DMC provider from being excluded from contracting
with a county or the department based solely on the existence of a
past criminal record of the DMC provider or a person with a 5% or
greater direct or indirect ownership interest in the provider.
   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 14043.38 of the  
Welfare and Institutions Code   is amended to read: 
   14043.38.  (a) Provider types are designated as "limited,"
"moderate," or "high" categorical risk by the federal government in
Section 424.518 of Title 42 of the Code of Federal Regulations. The
department shall, at minimum, utilize the federal regulations in
determining a provider's or applicant's categorical risk.
   (b) In accordance with Section 455.450 of Title 42 of the Code of
Federal Regulations, the department shall designate a provider or
applicant as a "high" categorical risk if any of the following occur:

   (1) The department imposes a payment suspension based on a
credible allegation of fraud, waste, or abuse.
   (2) The provider or applicant has an existing Medicaid overpayment
based on fraud, waste, or abuse.
   (3) The provider or applicant has been excluded by the federal
Office of the Inspector General or another state's Medicaid program
within the previous 10 years.
   (4) The federal Centers for Medicare and Medicaid Services lifted
a temporary moratorium within the previous six months for the
particular provider type submitting the application, the applicant
would have been prevented from enrolling based on that previous
moratorium, and the applicant applies for enrollment as a provider at
any time within six months from the date the moratorium was lifted.
   (c) If the department designates a provider or applicant as a
"high" categorical risk, the department or its designee shall do both
of the following:
   (1) Conduct a criminal background check of  the provider
or applicant, and any person with a 5-percent or greater direct or
indirect ownership interest in the provider or applicant. 
 the following persons:  
   (A) The provider or applicant. If the provider or applicant is a
nonprofit Drug Medi-Cal provider or applicant, the officers and
executive director of the provider or applicant.  
   (B) Any person with a 5-percent or greater direct or indirect
ownership interest in the provider or applicant. 
   (2) Require  the provider or applicant, and any person
with a 5-percent or greater direct or indirect ownership interest in
the provider or applicant,   the following persons 
to submit a set of fingerprints within 30 days of the department's
request, in a manner determined by the  department. 
 department:  
   (A) The provider or applicant. If the provider or applicant is a
nonprofit Drug Medi-Cal provider or applicant, the officers and
executive director of the provider or applicant.  
   (B) Any person with a 5-percent or greater direct or indirect
ownership interest in the provider or applicant. 
   (d) (1) The department shall submit to the Department of Justice
fingerprint images and related information required by the Department
of Justice of Medi-Cal providers or applicants determined to be a
"high" categorical risk pursuant to subdivision (a), and any person
with a 5-percent or greater direct or indirect ownership interest in
those providers and applicants, for the purposes of obtaining
information as to the existence and content of a record of state or
federal convictions and state or federal arrests and also information
as to the existence and content of a record of state or federal
arrests for which the Department of Justice establishes that the
person is free on bail or on his or her recognizance pending trial or
appeal.
   (2) When received, the Department of Justice shall forward to the
Federal Bureau of Investigation requests for federal summary criminal
history information received pursuant to this section. The
Department of Justice shall review the information returned from the
Federal Bureau of Investigation and compile and disseminate a
response to the department.
   (3) The Department of Justice shall provide a state or federal
level response to the department pursuant to paragraph (1) of
subdivision (p) of Section 11105 of the Penal Code.
   (4) The department shall request from the Department of Justice
subsequent notification service, as provided pursuant to Section
11105.2 of the Penal Code, for persons described in paragraph (1).
   (5) The Department of Justice shall charge a fee sufficient to
cover the cost of processing the request described in this section.
That fee shall be paid by the subject of the criminal background
check.
   (e) For persons subject to the requirements of subdivision (a) of
Section 15660, the procedure for obtaining and submitting
fingerprints and notification by the Department of Justice of
criminal record information set forth in subdivision (c) of Section
15660 shall apply instead of the procedure set forth in subdivision
(d).
   SECTION 1.   SEC. 2.   Section 14124.27
is added to the Welfare and Institutions Code, to read:
   14124.27.  (a) (1) Certified Drug Medi-Cal (DMC) providers shall
be designated as a "high" categorical risk pursuant to Section
14043.38 and the provider and any person with a 5 percent or greater
direct or indirect ownership interest in the provider shall be
subject to background checks pursuant to the provisions of that
section.
   (2) The department may designate a DMC provider as a "limited" or
"moderate" categorical risk for purposes of Section 14043.38 and
federal regulations. To designate a DMC provider as a "limited" or
"moderate" categorical risk, the department shall execute a
declaration, to be retained by the director, with a copy to be posted
on the department's Internet Web site and a copy transmitted to the
Legislature, stating the reason or reasons that a "high" categorical
risk designation for that provider is no longer warranted.
   (b) Payment of the fee imposed pursuant to paragraph (5) of
subdivision (d) of Section 14043.38 shall be the responsibility of
the DMC provider or person with a 5 percent or greater direct or
indirect ownership interest in the provider, as applicable.
   (c) Except as provided by federal law, a DMC provider shall not be
excluded from contracting with a county or the department based
solely on the existence of a past criminal record of the DMC provider
or a person with 5 percent or greater direct or indirect ownership
interest in the provider.