BILL NUMBER: SB 296AMENDED BILL TEXT AMENDED IN ASSEMBLY JULY 2, 2015 AMENDED IN SENATE APRIL 20, 2015 AMENDED IN SENATE APRIL 7, 2015 INTRODUCED BY Senator Cannella FEBRUARY 23, 2015 An act to add Section1472714728 to the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGEST SB 296, as amended, Cannella. Medi-Cal: specialty mental health services: documentation requirements. 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, including specialty mental health services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. In order to facilitate the receipt of medically necessary specialty mental health services by a foster child who is placed outside of his or her county of original jurisdiction, existing law requires the department to create a standardized set of documentation standards and forms. This bill would require the department, in consultation with specified stakeholders, to develop a single set of service billing documentation requirements for the provision of specialty mental health services by January 1, 2017, for use commencing July 1, 2017, and would require the department to update the billing documentation requirements no less than every 2 years. The bill would generally prohibit counties from requiring additional billing documentation requirements for Medi-Cal specialty mental health services that go beyond the billing documentation requirements developed by the department. 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. The Legislature finds and declares all of the following: (a) Counties and private providers that contract for service delivery estimate that over 40 cents out of every dollar spent on Medi-Cal mental health services goes to paperwork to document that the services meet federal billing standards and to avoid potential state audit disallowances. (b) A national expert reviewed what counties in California were requiring of providers and noted that it took 20 minutes of documentation to prepare progress notes for a single session of psychotherapy, as compared to an estimated five minutes in other states. (c) State guidelines on billing are not significantly different from the requirements of other states, however, counties have added other documentation requirements based on the fear that interpretations of the guidelines during audits may result in some services being disallowed if the additional documentation is not included. (d) In order to eliminate this pattern, it is necessary for the State Department of Health Care Services to develop a single set of documentation requirements, in consultation with counties and providers, that limits audit disallowances to circumstances clearly spelled out in the requirements. SEC. 2. Section1472714728 is added to the Welfare and Institutions Code,immediately following Section 14726, to read:14727.14728. (a) The State Department of Health Care Services shall consult with counties, providers, and other stakeholders to develop a single set of service billing documentation requirements for the provision of specialty mental health services. (b) The billing documentation requirements developed pursuant to this section shall do both of the following: (1) Minimize time and paperwork required of counties and providers, consistent with federal standards. (2) Eliminate duplicative or outdated requirements. (c) The billing documentation requirements shall be completed by January 1, 2017, for use commencing on July 1, 2017, and shall thereafter be updated no less than every two years through a stakeholder process, unless changes in the Medicaid state plan or other federal rules require that the billing requirements be updated more often. (d) After adoption of the standard billing requirements by the department, a county may not require additional billing documentation for Medi-Cal specialty mental health services that go beyond these requirements unless necessary for funding from other funding sources that are also used to pay for the services, or for purposes other than documentation for billing.