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SB-1154 Medi-Cal: beneficiaries with HIV or AIDS: managed care plans: reimbursement rates.(2017-2018)

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Date Published: 04/24/2018 09:00 PM
SB1154:v97#DOCUMENT

Amended  IN  Senate  April 24, 2018
Amended  IN  Senate  April 09, 2018

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Senate Bill No. 1154


Introduced by Senator Portantino
(Coauthor: Senator Nielsen)

February 14, 2018


An act to add Section 14087.306 Sections 14087.9726 and 14301.3 to the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


SB 1154, as amended, Portantino. Medi-Cal: beneficiaries with HIV or AIDS. AIDS: managed care plans: reimbursement rates.
Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services and under which health care services are provided to qualified, low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Under existing law, one of the methods by which Medi-Cal services are provided is pursuant to contracts with various types of managed care plans. Existing law requires the department to determine rates of payment for services provided under this chapter for Medi-Cal beneficiaries enrolled in these plans, as specified.
This bill would authorize the department to determine either a separate reimbursement rate for each stage of HIV disease, or a blended rate that covers a person at any stage of the disease.
Existing law authorizes the Board of Supervisors of the County of Los Angeles to establish a commission for the provision, or arrangement for the provision, of health care services under the Medi-Cal program in all or a portion of the geographic area of the county, on a coordinated managed care basis.
This bill would make a beneficiary with HIV disease who is required to enroll in a Medi-Cal managed care plan in the County of Los Angeles eligible to enroll in a plan that provides comprehensive services to persons with HIV disease in his or her county of residence. The the county.
This bill would define “HIV disease” to include any stage of HIV infection, as identified by the federal Centers for Disease Control and Prevention. The bill would authorize the department to determine either a separate reimbursement rate for each stage of HIV disease, or a blended rate that covers a person at any stage of the disease.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 14087.9726 is added to the Welfare and Institutions Code, to read:

14087.9726.
 A beneficiary with HIV disease who is required to enroll in a Medi-Cal managed care plan in the county shall be eligible to enroll in a Medi-Cal managed care plan that provides comprehensive services to persons with HIV disease. For purposes of this section, “HIV disease” includes any stage of HIV infection, as identified by the federal Centers for Disease Control and Prevention.

SEC. 2.

 Section 14301.3 is added to the Welfare and Institutions Code, to read:

14301.3.
 The department may determine either a separate reimbursement rate for each stage of HIV disease, or a blended rate that covers a person at any stage of HIV disease. For purposes of this section, “HIV disease” includes any stage of HIV infection, as identified by the federal Centers for Disease Control and Prevention.

SECTION 1.Section 14087.306 is added to the Welfare and Institutions Code, immediately following Section 14087.305, to read:
14087.306.

(a)(1)A beneficiary with HIV disease who is required to enroll in a Medi-Cal managed care plan shall be eligible to enroll in a Medi-Cal managed care plan that provides comprehensive services to persons with HIV disease in the beneficiary’s county of residence.

(2)For purposes of this section, “HIV disease” includes any stage of HIV infection, as identified by the federal Centers for Disease Control and Prevention.

(b)The department may determine either a separate reimbursement rate for each stage of HIV disease, or a blended rate that covers a person at any stage of HIV disease.