Amended IN Senate March 23, 2017 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Senate Bill No. 456Introduced by Senator PanFebruary 16, 2017 An act to add Section 14087.326 to the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGESTSB 456, as amended, Pan. Medi-Cal managed care: federally qualified health centers and rural health clinics: services that follow the patient.Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides that federally qualified health center (FQHC) services and rural health clinic (RHC) services, as defined, are covered benefits under the Medi-Cal program. Existing law requires a managed care entity to offer subcontracts to FQHCs and RHCs in the relevant service area, as a condition of obtaining a contract with the department.This bill would authorize a federally qualified health center or rural health clinic contracting with a managed care entity to enter into a separate, additional agreement for the provision of to enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient. The bill would describe those entities eligible to contract with an FQHC or RHC under the bill, and would define services that follow the patient as services that promote continuity of care and contribute to overall patient wellness, as specified. The bill would specify that compensation paid to a federally qualified health center or rural health clinic pursuant to the agreement would be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate, and not subject to reconciliation or reduction, as specified.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 14087.326 is added to the Welfare and Institutions Code, to read:14087.326. (a) A federally qualified health center or rural health clinic contracting with a managed care entity of the type described in Section 14087.325 may enter into a separate and additional agreement with the managed care entity for the provision of may enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient, as described in this section. A public or private entity eligible to contract with a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall include, but not be limited to, any of the following:(1) A managed care health plan.(2) A county.(3) A health care district.(4) A community-based organization.(5) An individual health care or social services provider whose activities under this section comply with the individuals scope of practice or certification.(b) As used in this section, services that follow the patient means services that promote continuity of care and contribute to overall patient wellness. These services include, but are not limited to, all of the following:(1) Comprehensive care management.(2) Care coordination.(3) Health and wellness initiatives.(4) Comprehensive transitional care.(5) Individual and family support services.(6) Referral to community and social supports.(c) Compensation paid to a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate and shall not be subject to a reconciliation pursuant to Section 14087.325, or to any reduction.
Amended IN Senate March 23, 2017 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Senate Bill No. 456Introduced by Senator PanFebruary 16, 2017 An act to add Section 14087.326 to the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGESTSB 456, as amended, Pan. Medi-Cal managed care: federally qualified health centers and rural health clinics: services that follow the patient.Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides that federally qualified health center (FQHC) services and rural health clinic (RHC) services, as defined, are covered benefits under the Medi-Cal program. Existing law requires a managed care entity to offer subcontracts to FQHCs and RHCs in the relevant service area, as a condition of obtaining a contract with the department.This bill would authorize a federally qualified health center or rural health clinic contracting with a managed care entity to enter into a separate, additional agreement for the provision of to enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient. The bill would describe those entities eligible to contract with an FQHC or RHC under the bill, and would define services that follow the patient as services that promote continuity of care and contribute to overall patient wellness, as specified. The bill would specify that compensation paid to a federally qualified health center or rural health clinic pursuant to the agreement would be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate, and not subject to reconciliation or reduction, as specified.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
Amended IN Senate March 23, 2017
Amended IN Senate March 23, 2017
CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION
Senate Bill No. 456
Introduced by Senator PanFebruary 16, 2017
Introduced by Senator Pan
February 16, 2017
An act to add Section 14087.326 to the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
SB 456, as amended, Pan. Medi-Cal managed care: federally qualified health centers and rural health clinics: services that follow the patient.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides that federally qualified health center (FQHC) services and rural health clinic (RHC) services, as defined, are covered benefits under the Medi-Cal program. Existing law requires a managed care entity to offer subcontracts to FQHCs and RHCs in the relevant service area, as a condition of obtaining a contract with the department.This bill would authorize a federally qualified health center or rural health clinic contracting with a managed care entity to enter into a separate, additional agreement for the provision of to enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient. The bill would describe those entities eligible to contract with an FQHC or RHC under the bill, and would define services that follow the patient as services that promote continuity of care and contribute to overall patient wellness, as specified. The bill would specify that compensation paid to a federally qualified health center or rural health clinic pursuant to the agreement would be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate, and not subject to reconciliation or reduction, as specified.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides that federally qualified health center (FQHC) services and rural health clinic (RHC) services, as defined, are covered benefits under the Medi-Cal program. Existing law requires a managed care entity to offer subcontracts to FQHCs and RHCs in the relevant service area, as a condition of obtaining a contract with the department.
This bill would authorize a federally qualified health center or rural health clinic contracting with a managed care entity to enter into a separate, additional agreement for the provision of to enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient. The bill would describe those entities eligible to contract with an FQHC or RHC under the bill, and would define services that follow the patient as services that promote continuity of care and contribute to overall patient wellness, as specified. The bill would specify that compensation paid to a federally qualified health center or rural health clinic pursuant to the agreement would be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate, and not subject to reconciliation or reduction, as specified.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 14087.326 is added to the Welfare and Institutions Code, to read:14087.326. (a) A federally qualified health center or rural health clinic contracting with a managed care entity of the type described in Section 14087.325 may enter into a separate and additional agreement with the managed care entity for the provision of may enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient, as described in this section. A public or private entity eligible to contract with a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall include, but not be limited to, any of the following:(1) A managed care health plan.(2) A county.(3) A health care district.(4) A community-based organization.(5) An individual health care or social services provider whose activities under this section comply with the individuals scope of practice or certification.(b) As used in this section, services that follow the patient means services that promote continuity of care and contribute to overall patient wellness. These services include, but are not limited to, all of the following:(1) Comprehensive care management.(2) Care coordination.(3) Health and wellness initiatives.(4) Comprehensive transitional care.(5) Individual and family support services.(6) Referral to community and social supports.(c) Compensation paid to a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate and shall not be subject to a reconciliation pursuant to Section 14087.325, or to any reduction.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 14087.326 is added to the Welfare and Institutions Code, to read:14087.326. (a) A federally qualified health center or rural health clinic contracting with a managed care entity of the type described in Section 14087.325 may enter into a separate and additional agreement with the managed care entity for the provision of may enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient, as described in this section. A public or private entity eligible to contract with a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall include, but not be limited to, any of the following:(1) A managed care health plan.(2) A county.(3) A health care district.(4) A community-based organization.(5) An individual health care or social services provider whose activities under this section comply with the individuals scope of practice or certification.(b) As used in this section, services that follow the patient means services that promote continuity of care and contribute to overall patient wellness. These services include, but are not limited to, all of the following:(1) Comprehensive care management.(2) Care coordination.(3) Health and wellness initiatives.(4) Comprehensive transitional care.(5) Individual and family support services.(6) Referral to community and social supports.(c) Compensation paid to a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate and shall not be subject to a reconciliation pursuant to Section 14087.325, or to any reduction.
SECTION 1. Section 14087.326 is added to the Welfare and Institutions Code, to read:
### SECTION 1.
14087.326. (a) A federally qualified health center or rural health clinic contracting with a managed care entity of the type described in Section 14087.325 may enter into a separate and additional agreement with the managed care entity for the provision of may enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient, as described in this section. A public or private entity eligible to contract with a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall include, but not be limited to, any of the following:(1) A managed care health plan.(2) A county.(3) A health care district.(4) A community-based organization.(5) An individual health care or social services provider whose activities under this section comply with the individuals scope of practice or certification.(b) As used in this section, services that follow the patient means services that promote continuity of care and contribute to overall patient wellness. These services include, but are not limited to, all of the following:(1) Comprehensive care management.(2) Care coordination.(3) Health and wellness initiatives.(4) Comprehensive transitional care.(5) Individual and family support services.(6) Referral to community and social supports.(c) Compensation paid to a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate and shall not be subject to a reconciliation pursuant to Section 14087.325, or to any reduction.
14087.326. (a) A federally qualified health center or rural health clinic contracting with a managed care entity of the type described in Section 14087.325 may enter into a separate and additional agreement with the managed care entity for the provision of may enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient, as described in this section. A public or private entity eligible to contract with a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall include, but not be limited to, any of the following:(1) A managed care health plan.(2) A county.(3) A health care district.(4) A community-based organization.(5) An individual health care or social services provider whose activities under this section comply with the individuals scope of practice or certification.(b) As used in this section, services that follow the patient means services that promote continuity of care and contribute to overall patient wellness. These services include, but are not limited to, all of the following:(1) Comprehensive care management.(2) Care coordination.(3) Health and wellness initiatives.(4) Comprehensive transitional care.(5) Individual and family support services.(6) Referral to community and social supports.(c) Compensation paid to a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate and shall not be subject to a reconciliation pursuant to Section 14087.325, or to any reduction.
14087.326. (a) A federally qualified health center or rural health clinic contracting with a managed care entity of the type described in Section 14087.325 may enter into a separate and additional agreement with the managed care entity for the provision of may enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient, as described in this section. A public or private entity eligible to contract with a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall include, but not be limited to, any of the following:(1) A managed care health plan.(2) A county.(3) A health care district.(4) A community-based organization.(5) An individual health care or social services provider whose activities under this section comply with the individuals scope of practice or certification.(b) As used in this section, services that follow the patient means services that promote continuity of care and contribute to overall patient wellness. These services include, but are not limited to, all of the following:(1) Comprehensive care management.(2) Care coordination.(3) Health and wellness initiatives.(4) Comprehensive transitional care.(5) Individual and family support services.(6) Referral to community and social supports.(c) Compensation paid to a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate and shall not be subject to a reconciliation pursuant to Section 14087.325, or to any reduction.
14087.326. (a) A federally qualified health center or rural health clinic contracting with a managed care entity of the type described in Section 14087.325 may enter into a separate and additional agreement with the managed care entity for the provision of may enter into an agreement with a public or private entity willing and qualified to provide services that follow the patient, as described in this section. A public or private entity eligible to contract with a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall include, but not be limited to, any of the following:
(1) A managed care health plan.
(2) A county.
(3) A health care district.
(4) A community-based organization.
(5) An individual health care or social services provider whose activities under this section comply with the individuals scope of practice or certification.
(b) As used in this section, services that follow the patient means services that promote continuity of care and contribute to overall patient wellness. These services include, but are not limited to, all of the following:
(1) Comprehensive care management.
(2) Care coordination.
(3) Health and wellness initiatives.
(4) Comprehensive transitional care.
(5) Individual and family support services.
(6) Referral to community and social supports.
(c) Compensation paid to a federally qualified health center or rural health clinic pursuant to an agreement described in this section shall be supplemental to, and separate from, the federally qualified health centers or rural health clinics prospective payment rate and shall not be subject to a reconciliation pursuant to Section 14087.325, or to any reduction.