BILL NUMBER: SB 1339	CHAPTERED
	BILL TEXT

	CHAPTER  488
	FILED WITH SECRETARY OF STATE  SEPTEMBER 19, 2014
	APPROVED BY GOVERNOR  SEPTEMBER 19, 2014
	PASSED THE SENATE  AUGUST 20, 2014
	PASSED THE ASSEMBLY  AUGUST 19, 2014
	AMENDED IN ASSEMBLY  AUGUST 12, 2014
	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 the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1339, 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 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 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 provide that if the department designates a
nonprofit Drug Medi-Cal provider or applicant as a "high" categorical
risk, the criminal background check and the requirement to submit
fingerprint images and related information would apply to the
officers and executive director of the nonprofit provider or
applicant.


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 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 following persons to submit a set of fingerprints
within 30 days of the department's request, in a manner determined by
the 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).