Today's Law As Amended


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AB-882 Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program.(2021-2022)



As Amends the Law Today


SECTION 1.

 Section 14114 of the Welfare and Institutions Code is amended to read:

14114.
 (a) This section shall be known, and may be cited, as the Proposition 56  Medi-Cal Physicians and Dentists Loan Repayment Program  Act.
(b) (1)  Notwithstanding any other law, the department shall develop and administer the Proposition 56  Medi-Cal Physicians and Dentists Loan Repayment Act  Program to provide loan assistance payments to qualifying, recent graduate physicians and dentists that who  serve beneficiaries of existing health care programs described in Chapter 7 (commencing with Section 14000) to Chapter 8.9 (commencing with Section 14700), inclusive. To implement this section, the department shall consult with other state entities, including the Department Office  of Statewide  Health Care Access  Planning  and Information, Development,  and with affected stakeholders.
(2) By January 1, 2022, and subject to subdivision (c), the department shall exclusively provide loan assistance payments, as specified under paragraph (1), to individuals who maintain a patient caseload composed of a minimum of 30 percent Medi-Cal beneficiaries and who meet one or more of the following requirements:
(A) Practice in a health professional shortage area, as determined by the federal Health Resources and Services Administration.
(B) Practice in a specialty and serve a Medi-Cal patient population where the department has demonstrated a provider shortage exists in the Medi-Cal program, Medi-Cal behavioral health program, or Medi-Cal dental program using one or more of the following:
(c) (i)  (1) Network  The Medi-Cal Physicians and Dentists Loan Repayment Program shall be funded using moneys appropriated   adequacy standards, annual network certification, or other quantitative provider participation measurements submitted  to the department for this purpose. pursuant to Sections 438.68, 438.206, and 438.207 of Title 42 of the Code of Federal Regulations and Section 14197 of this code. 
(ii) Measures of the ratio of active dentists-to-beneficiaries in a county or service area where the ratio exceeds 1 to 2,000.
(iii) Measures of dental specialists in Medi-Cal where the department has demonstrated there exists an inadequate number of active and participating dental specialists serving Medi-Cal beneficiaries.
(2) (iv)  The Loan Repayment Program Account is hereby continued in the State Treasury within the Healthcare Treatment Fund established pursuant to Section 30130.55 of the Revenue and Taxation Code. The Loan Repayment Program Account shall contain funds appropriated by the Legislature from the Healthcare Treatment Fund to the Medi-Cal Physicians and Dentists Loan Repayment Program. Notwithstanding Section 13340 of the Government Code, the Loan Repayment Program Account is hereby continuously appropriated, without regard to fiscal year, to implement the Medi-Cal Physicians and Dentists Loan Repayment Program. An approved alternative access request submitted by a Medi-Cal managed care plan, as defined in subdivision (h) of Section 14197, and approved by the department pursuant to subdivision (e) of Section 14197 within the previous two years. 
(v) Other quantified data that demonstrate a provider shortage for Medi-Cal beneficiaries.
(3) The Medi-Cal Loan Repayment Program Special Fund is hereby established in the State Treasury. The Medi-Cal Loan Repayment Program Special Fund shall contain funds transferred from the California Electronic Cigarette Excise Tax Fund pursuant to Section 31005 of the Revenue and Taxation Code, funds transferred pursuant to paragraph (2) of subdivision (c) of Section 14197.2, and any other moneys appropriated to the Medi-Cal Physicians and Dentists Loan Repayment Program other than funds appropriated from the Health Care Treatment Fund described in paragraph (2). The department and the State Controller’s office shall maintain separate subaccounts for funds appropriated or transferred from each funding source. Notwithstanding Section 13340 of the Government Code, the Medi-Cal Loan Repayment Program Special Fund is hereby continuously appropriated, without regard to fiscal year, to implement the Medi-Cal Physicians and Dentists Loan Repayment Program. department shall annually verify that participating providers continue to meet the program requirements, consistent with paragraph (2) and as outlined within their Awardee Agreement. Any determination regarding individual provider recertification shall be at the discretion of the department and any entity contracted with pursuant to subdivision (h). 
(4) The department shall expend all funds available in the Loan Repayment Program Account of the Healthcare Treatment Fund prior to expending any funds from the Medi-Cal Loan Repayment Program Special Fund. Paragraph (2) does not apply to an individual who enters into, and maintains compliance with, an Awardee Agreement to receive loan assistance payments before January 1, 2022. 
(5) (c)  Within each fund and subaccount, the department  The Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program shall be funded using moneys appropriated to the department for this purpose in the annual Budget Act from the Healthcare Treatment Fund established pursuant to subdivision (a) of Section 30130.55 of the Revenue and Taxation Code. The department  shall administer two separate payment pools for participating physicians and dentists, respectively, consistent with the allocations provided for in Item 4260-102-3305 of the Budget Act of 2018, Item 4260-102-3305 of the Budget Act of 2019, Section 31005 the annual Budget Act. To the extent authorized by subdivision (f) of Section 30130.57  of the Revenue and Taxation Code, and paragraph (2) of subdivision (c) of Section 14197.2. moneys appropriated to the department to implement this section shall be available to fund the administrative costs incurred by the department and any entity contracted with pursuant to subdivision (h). 
(6) Moneys appropriated to the department to implement this section shall be available to fund the administrative costs incurred by the department and any entity contracted with pursuant to subdivision (g). Administrative costs from the Loan Repayment Program Account of the Healthcare Treatment Fund are limited by subdivision (f) of Section 30130.57 of the Revenue and Taxation Code.
(d) The department shall develop the eligibility criteria to be used to evaluate physician and dentist participation in the Proposition 56  Medi-Cal Physicians and Dentists Loan Repayment Act  Program. In developing these criteria, the  and consistent with subdivision (a) of Section 30130.55 of the Revenue and Taxation Code, the  department shall prioritize ensuring timely access, limiting geographic shortages of services, and ensuring quality care in the Medi-Cal program. The department shall develop separate criteria for distribution of payments from the physician and dentist payment pools. At a minimum, the department shall establish the maximum number of years a physician or dentist may be in practice to qualify for payments pursuant to this section, and the minimum number of years a participating physician or dentist receiving payments pursuant to this section shall agree to participate as an enrolled provider in the Medi-Cal program.
(e) The selection of physicians and dentists for participation in the Proposition 56  Medi-Cal Physicians and Dentists Loan Repayment Act  Program and the amount of loan repayment assistance awarded to a participating physician or dentist shall be at the discretion of the department and any entity contracted with pursuant to subdivision (g), (h),  and shall be based on the criteria developed pursuant to subdivision (d). An exercise of discretion by the department and its contractors pursuant to this subdivision  shall not be subject to judicial review, except that an applicant physician or dentist who is not selected for participation in the program may file for a writ of mandate pursuant to Section 1085 of the Code of Civil Procedure to rectify an abuse of discretion by the department and its contractors.
(f) The Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Act Program shall post any annual report prepared by the program on the program’s internet website.
(f) (g)  Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, in whole or in part, by means of policy letters, provider bulletins, or other similar instructions, without taking regulatory action. The department shall consult with affected stakeholders before taking action pursuant to this subdivision.
(g) (h)  To implement this section, the department may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this subdivision shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and the review or approval of a division of the Department of General Services.
(h) (i)  This section shall be implemented only to the extent that the department determines that federal financial participation under the Medi-Cal program is not jeopardized. If the department determines there is a reasonable likelihood that federal financial participation is available for expenditures pursuant to this section, it may seek the federal approvals necessary to obtain federal financial participation.
(i) (j)  The Legislature finds and declares that the expenditures authorized by paragraph (2) of subdivision (c)  this section  are all of the following:
(1) Made in accordance with the California Healthcare, Research and Prevention Tobacco Tax Act of 2016 (Article 2 (commencing with Section 30121) of Chapter 2 of Part 13 of Division 2 of the Revenue and Taxation Code).
(2) Based on criteria developed and periodically updated as part of the annual budget process in accordance with subdivision (a) of Section 30130.55 of the Revenue and Taxation Code.
(3) Consistent with the purposes and conditions for expenditures described in subdivision (a) of Section 30130.55 of the Revenue and Taxation Code.
(j) (k)  The Legislature finds and declares that this section is a state law within the meaning of Section 1621(d) of Title 8 of the United States Code.