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SB-365 E-consult service.(2021-2022)

Senate:
1st
Cmt
2nd
3rd
Pass
Pass
Veto
Assembly:
1st
Cmt
2nd
3rd
Pass
Bill Status
SB-365
Caballero (S)
-
Dahle (S) , Wiener (S)
E-consult service.
03/13/21
An act to amend Section 14132.72 of the Welfare and Institutions Code, relating to Medi-Cal.
Senate
09/03/21
05/04/21

Type of Measure
Active Bill - In Floor Process
Majority Vote Required
Non-Appropriation
Fiscal Committee
Non-State-Mandated Local Program
Non-Urgency
Non-Tax levy
Last 5 History Actions
Date Action
10/06/21 In Senate. Consideration of Governor's veto pending.
10/06/21 Vetoed by the Governor.
09/09/21 Enrolled and presented to the Governor at 1 p.m.
09/01/21 In Senate. Ordered to engrossing and enrolling.
09/01/21 Read third time. Passed. (Ayes 78. Noes 0. Page 2603.) Ordered to the Senate.
Governor's Veto Message
To the Members of the California State Senate:

I am returning Senate Bill 365 without my signature.

SB 365 would require an "e-consult" provided by an enrolled Medi-Cal provider, including a Federally Qualified Health Center (FQHC) and Rural Health Clinics (RHC) to be reimbursed under Medi-Cal.

Current Medi-Cal reimbursement policy allows for a health care provider to bill for an e-consult when the benefits or services delivered meet the procedural definition and components of the Current Procedural Terminology (CPT) code set and requirements in the Department of Health Care Services (DHCS) Medi-Cal provider manual.

SB 365's definition of e-consult services is inconsistent with federal law, which explicitly states that reimbursement for visits in FQHCs and RHCs is only permitted between a FQHC and RHC billable provider and a patient. Moreover, the Centers for Medicare and Medicaid Services has communicated to DHCS that e-consult services are not separately reimbursable to FQHCs and RHCs because a patient is not included during the encounter. As a result, the state would not be entitled to federal matching funds for e-consult services reimbursed separately to FQHCs and RHCs.

For these reasons, I am returning this bill without my signature.


Sincerely,





Gavin Newsom