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SB-1644 Medi-Cal: annual review of rates.(2001-2002)

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Passed  IN  Senate  May 16, 2002
Passed  IN  Assembly  August 26, 2002

CALIFORNIA LEGISLATURE— 2001–2002 REGULAR SESSION

Senate Bill
No. 1644

Introduced  by  Senator Poochigian, Monteith
 (Coauthor(s): Assembly Member Ashburn, Cogdill)

February 21, 2002

An act to amend Section 14079 of the Welfare and Institutions Code, relating to Medi-Cal, and declaring the urgency thereof, to take effect immediately.


LEGISLATIVE COUNSEL'S DIGEST


SB 1644, Poochigian. Medi-Cal: annual review of rates.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Services, pursuant to which medical benefits are provided to public assistance recipients and certain other low-income persons. Existing law requires the Director of Health Services to annually review the reimbursement levels for physician and dental services under Medi-Cal by taking into account specified factors, and revise periodically the rates of reimbursement to physicians and dentists to ensure the reasonable access of Medi-Cal beneficiaries to physician and dental services.
This bill would add to the factors to be taken into account for purposes of the annual review the adequacy of Medi-Cal reimbursement rates for physician and dental services in communities that serve disproportionately higher Medi-Cal populations than the average community.
This bill would declare that it is to take effect immediately as an urgency statute.

The people of the State of California do enact as follows:


SECTION 1.

 Section 14079 of the Welfare and Institutions Code is amended to read:

14079.
 The director annually shall review the reimbursement levels for physician and dental services under Medi-Cal, and shall revise periodically the rates of reimbursement to physicians and dentists to ensure the reasonable access of Medi-Cal beneficiaries to physician and dental services.
This annual review, as it relates to rates for physician services, shall take into account at least the following factors:
(a) Annual cost increases for physicians as reflected by the Consumer Price Index.
(b) Physician reimbursement levels of medicare, Blue Shield, and other third-party payors.
(c) Prevailing customary physician charges within the state and in various geographical areas.
(d) Procedures reflected by the current Relative Value Studies (RVS).
(e) Characteristics of the current population of Medi-Cal beneficiaries and the medical services needed.
(f) The adequacy of Medi-Cal reimbursement rates for physician and dental services in communities that serve disproportionately higher Medi-Cal populations than the average community.

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 Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order that the Directors of Health Services may include additional factors in the annual review of reimbursement rates for physician and dental services under the Medi-Cal program, at the earliest possible time, it is necessary that this act take effect immediately.