Today's Law As Amended


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AB-2439 Medi-Cal: disproportionate share hospital replacement payment adjustments.(2019-2020)



As Amends the Law Today


SECTION 1.

 Section 14166.3 of the Welfare and Institutions Code is amended to read:

14166.3.
 (a) During the demonstration project and successor demonstration project terms, a  payment adjustments adjustment  to a  disproportionate share hospitals hospital  shall not be made pursuant to Section 14105.98. Payment adjustments to  A payment adjustment to a  disproportionate share hospitals hospital  shall be made solely  in accordance with this article.
(b) Except as otherwise  provided in this article, the department shall continue to make all  eligibility determinations and perform all payment adjustment amount computations under the disproportionate share hospital payment adjustment program pursuant to Section 14105.98 and pursuant to  the disproportionate share hospital provisions of the Medicaid state plan in effect as of the 2004–05 state fiscal year. For purposes of these determinations and computations, services that are  any service  rendered under the Health Care Coverage Initiative authorized pursuant to Part 3.5 (commencing with Section 15900) or the Low Income Health Program authorized pursuant to Part 3.6 (commencing with Section 15909)  shall be included.
(c) (1) Notwithstanding Section 14105.98, the federal disproportionate share hospital allotment specified for California under Section 1396r-4(f) of Title 42 of the United States Code for each of  federal fiscal years 2006 to 2015, inclusive, and federal fiscal year 2016 with respect to the pro rata portion of the allotment that will apply during successor demonstration year 10 pursuant to paragraph (2), shall be distributed solely  among the following hospitals:
(A) Eligible hospitals,  An eligible hospital,  as determined pursuant to Section 14105.98 for each project year and successor demonstration year in which the particular federal fiscal year commences, which meet that meets  the definition of a public hospital as specified in paragraph (25) of subdivision (a) of Section 14105.98.
(B) Hospitals  A hospital  that are is  licensed to the University of California, which meet California and meets  the requirements set forth in Section 1396r-4(d) of Title 42 of the United States Code.
(2) The federal disproportionate share hospital allotment for each of  the federal fiscal years 2006 to 2015, inclusive, shall be aligned with the project year or successor demonstration year in which the applicable federal fiscal year commences. The payment adjustment year, as used within the meaning of  defined in  paragraph (6) of subdivision (a) of Section 14105.98, shall be the corresponding project year or successor demonstration year. With respect to successor demonstration year 10, the period of July 1, 2015, through October 31, 2015, shall be aligned with a pro rata portion of the federal disproportionate share hospital allotment for federal fiscal year 2016.
(3) Uncompensated Medi-Cal and uninsured costs costs,  as reported pursuant to Section 14166.8, shall be used by the department as the basis for determining the hospital-specific disproportionate share hospital payment limits required by Section 1396r-4(g) of Title 42 of the United States Code for the hospitals described in paragraph (1).
(4) The distribution of the federal disproportionate share hospital allotment to hospitals described in paragraph (1) shall satisfy the state’s payment obligations, if any, with respect  to those hospitals under Section 1396r-4 of Title 42 of the United States Code.
(d) Eligible hospitals, as determined pursuant to  An eligible hospital, as described in paragraph (3) of subdivision (a) of  Section 14105.98 for each project year and each successor demonstration year, which are nonpublic hospitals, nonpublic-converted hospitals, and converted hospitals, that is a nonpublic hospital, nonpublic-converted hospital, or converted hospital,  as those terms are defined in paragraphs (26), (27), and (28), respectively, of subdivision (a) of Section 14105.98, shall receive Medi-Cal disproportionate share hospital replacement payment adjustments pursuant to Section 14166.11 and other provisions of  this chapter. The payment adjustments so  provided shall satisfy the state’s payment obligations, if any, with respect to those hospitals to that hospital  under Section 1396r-4 of Title 42 of the United States Code. The federal share of these payments shall not be claimed from the federal disproportionate share hospital allotment described in subdivision (c).
(e) If an eligible hospital, as described in paragraph (3) of subdivision (a) of Section 14105.98, is a nondesignated public hospital, the eligible hospital shall receive Medi-Cal disproportionate share hospital replacement payment adjustments pursuant to Section 14166.11 and this chapter.
(e) (f)  The nonfederal share of payments described in subdivisions (c) and (d) shall be derived from the following sources:
(1) With respect to the payments a payment  described in paragraph (1) of subdivision (c) that are is  made to a  designated public hospitals, hospital,  the nonfederal share shall consist of certified public expenditures described in subparagraphs (A) and (C) of paragraph (2) (1)  of subdivision (a) of Section 14166.9, and intergovernmental transfer amounts described in paragraph (2) of subdivision (d) of Section 14166.6.
(2) With respect to the payments a payment  described in paragraph (1) of subdivision (c) that are is  made to a  nondesignated public hospitals, hospital,  the nonfederal share shall consist solely of state General Fund appropriations.
(3) With respect to the payments a payment  described in subdivision (d), the nonfederal share shall consist of state General Fund appropriations.
(f) (g)  (1)  During the terms of the demonstration project and successor demonstration project, for the 2005–06 state fiscal year and any subsequent state fiscal years, no a  public entity shall not  be obligated to make any intergovernmental transfer pursuant to Section 14163, and all  transfer amount determinations for those state fiscal years shall be suspended. However, during the demonstration project and successor demonstration project terms, intergovernmental transfers shall be made with respect  to the disproportionate share hospital payment adjustments made in accordance with paragraph (2) of subdivision (d) of Section 14166.6, or paragraph (2) of subdivision (d) of Section 14166.61, as applicable.
(2) During the terms of the demonstration project and successor demonstration project, for the 2005–06 state fiscal year and any  subsequent state fiscal years, transfer amounts from the Medi-Cal Inpatient Payment Adjustment Fund to the Health Care Deposit Fund, as provided for pursuant to paragraph (2) of subdivision (d) of Section 14163, are hereby  reduced to zero. Unless otherwise specified in this article, this paragraph shall be disregarded for purposes of the calculations made under Section 14105.98 during the demonstration project and successor demonstration project.
SEC. 2.
 This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to maximize innovative health care and hospital financing within the Medi-Cal program, it is necessary that this act take effect immediately.