California Assembly Bill AB411 Amended / Bill

 BILL NUMBER: AB 411AMENDED BILL TEXT AMENDED IN ASSEMBLY APRIL 9, 2013 INTRODUCED BY Assembly Member Pan FEBRUARY 15, 2013 An act to add Section 14029.91 to the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGEST AB 411, as amended, Pan. Medi-Cal: performance measures. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. 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. This bill would require all Medi-Cal managed care plans to analyze their Healthcare Effectiveness Data and Information Set (HEDIS) measures, or their External Accountability Set (EAS) performance measure equivalent, by  geographic region,  race, ethnicity, and primary language, and to implement strategies to reduce identified disparities between members  from different   regions,  of different races and  ethnicities   ethnicities,  and with different primary languages. The bill would also require that these analyses be reported to the State Department of Health Care Services annually and be made available to the public via the department's Internet Web site. This bill would further require all Medi-Cal managed care plans to link individual level data collected as a part of analyzing their HEDIS measures, or their EAS performance measure equivalent, to personal identifiers and to submit that data to the department annually. The department would be required to make the individual level data available for research purposes, as specified. 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 14029.91 is added to the Welfare and Institutions Code, to read: 14029.91. (a) (1) The department shall require all Medi-Cal managed care plans, including county organized health systems and plans contracting with the department to provide services pursuant to two-plan and geographic managed care models, to analyze their Healthcare Effectiveness Data and Information Set (HEDIS) measures, or their External Accountability Set (EAS) performance measure equivalent, by  race   geographic region, race,  and ethnicity in order to identify disparities in medical treatment between Medi-Cal managed care members  from different regions and  of different races and ethnicities and to implement strategies to reduce those disparities. (2) The department shall require the plans described in paragraph (1) to analyze their HEDIS measures, or their EAS performance measure equivalent, by primary language in order to identify disparities in medical treatment between Medi-Cal managed care members with different primary languages and to implement strategies to reduce those disparities. (3) The results of the analyses prepared in accordance with this subdivision shall be reported to the department annually. The department shall make such analyses available to the public through the department's Internet Web site. (b) The department shall require the plans described in paragraph (1) of subdivision (a) to link all individual level data collected as a part of analyzing their HEDIS measures, or their EAS performance measure equivalent, to patient identifiers in a manner that allows for an analysis of disparities in medical treatment by  geographic region,  race, ethnicity, and primary language, and to provide that information to the department annually. The department shall make this data available, in a format that complies with the Health Insurance Portability and Accountability Act of 1996, for research purposes through a data use or business associate agreement.