California Senate Bill SB1236 Amended / Bill

 BILL NUMBER: SB 1236AMENDED BILL TEXT AMENDED IN SENATE APRIL 21, 2010 INTRODUCED BY Senator Alquist FEBRUARY 19, 2010 An act to add and repeal Section 14133.55 of the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGEST SB 1236, as amended, Alquist. Medi-Cal: utilization controls. Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which basic health care services are provided to qualified low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law establishes a program in Alameda County in which utilization controls shall not be required when, pursuant to federal law under the Medicare Program, a county hospital based utilization review committee has been established to determine the level of authorization for payment under Medi-Cal and a utilization plan has been filed with the department and approved by it. This bill would establish a program, whereby state utilization controls shall not be required for inpatient hospitalization at designated public hospitals, as defined  , in Santa Clara County  . The bill would require the nonfederal share of expenditures for inpatient hospitalization at designated public hospitals  in Santa Clara County  submitted to the federal Centers for Medicare and Medicaid Services for purposes of claiming federal financial participation to be comprised of only those funds that are paid by  Santa Clara County   designated public hospitals  and certified by  the county   counties  in accordance with applicable state and federal requirements. This bill would provide that the above-described provisions shall become inoperative on the date the Director of Health Care Services executes a declaration specifying that the nonfederal share of expenditures for inpatient hospitalization at designated public hospitals  in Santa Clara County  used for purposes of claiming federal financial participation is not comprised of funds that are paid by  Santa Clara County   designated public hospitals  and certified by  the county   counties  in accordance with applicable state and federal requirements. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 14133.55 is added to the Welfare and Institutions Code, to read: 14133.55. (a) There shall be established a program whereby state utilization controls shall not be required for inpatient hospitalization at designated public hospitals, as defined in subdivision (d) of Section 14166.1  , in Santa Clara County  . (b) The nonfederal share of expenditures for inpatient hospitalization at designated public hospitals  in Santa Clara County  submitted to the federal Centers for Medicare and Medicaid Services for purposes of claiming federal financial participation shall be comprised of only those funds that are paid by  Santa Clara County   designated public hospitals  and certified by  the county   counties  in accordance with applicable state and federal requirements. (c) This section shall become inoperative on the date the Director of Health Care Services executes a declaration specifying that the nonfederal share of expenditures for inpatient hospitalization at designated public hospitals  in Santa Clara County  used for purposes of claiming federal financial participation is not comprised of funds that are paid by  Santa Clara County   designated public hospitals  and certified by  the county   counties  in accordance with applicable state and federal requirements, and as of that date is repealed. (d) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department shall implement this section by means of policy letters or similar instructions, without taking further regulatory action.