California 2023-2024 Regular Session

California Assembly Bill AB160 Compare Versions

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1-Assembly Bill No. 160 CHAPTER 39An act to amend Section 14199.85 of the Welfare and Institutions Code, relating to Medi-Cal, and making an appropriation therefor, to take effect immediately, bill related to the budget. [ Approved by Governor June 29, 2024. Filed with Secretary of State June 29, 2024. ] LEGISLATIVE COUNSEL'S DIGESTAB 160, Committee on Budget. Medi-Cal managed care organization provider tax.Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and 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.Existing law imposes a managed care organization (MCO) provider tax, administered and assessed by the department, on licensed health care service plans and managed care plans contracted with the department. Under existing law, all revenues, less refunds, derived from the MCO provider tax are available to the department, upon appropriation, for the purpose of funding specified subcomponents to support the Medi-Cal program. Existing law sets forth certain taxing tiers and tax amounts, and sets the Medi-Cal per enrollee tax amount for Medi-Cal taxing tier II, as defined, at $205 for the 2024, 2025, and 2026 calendar years.This bill would raise the MCO provider tax amount for that tier to $274 for all 3 of those calendar years.The bill would also reappropriate specified funds from the Budget Act of 2023 related to the State Department of Health Care Services.This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.Digest Key Vote: 2/3 Appropriation: YES Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 14199.85 of the Welfare and Institutions Code is amended to read:14199.85. (a) For each tax period, the Medi-Cal taxing tiers shall be as follows:(1) Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.(2) Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.(b) For each tax period, the other taxing tiers shall be as follows:(1) Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.(2) Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.(c) For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(d) For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(e) For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(f) For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(g) For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(h) For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars ($2).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(i) For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(j) For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(k) (1) The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.(2) If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.(3) In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.(l) The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.(m) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.SEC. 2. Notwithstanding any other provision of law, the balances as of June 30, 2023, of the appropriations made by Item 4260-101-0001 of the Budget Act of 2023 (Chs. 12, 38, and 189, Stats. 2023) related to Provision 26 of that item are reappropriated and shall be available for encumbrance or expenditure until June 30, 2025, for the same programs and purposes.SEC. 3. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
1+Enrolled June 27, 2024 Passed IN Senate June 26, 2024 Passed IN Assembly June 26, 2024 Amended IN Senate June 22, 2024 Amended IN Assembly February 01, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 160Introduced by Committee on Budget (Assembly Members Gabriel (Chair), Alvarez, Bennett, Bonta, Connolly, Mike Fong, Jackson, Lee, McCarty, Muratsuchi, Ortega, Petrie-Norris, Quirk-Silva, Ramos, Valencia, Ward, Weber, Wilson, and Zbur)January 09, 2023An act to amend Section 14199.85 of the Welfare and Institutions Code, relating to Medi-Cal, and making an appropriation therefor, to take effect immediately, bill related to the budget.LEGISLATIVE COUNSEL'S DIGESTAB 160, Committee on Budget. Medi-Cal managed care organization provider tax.Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and 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.Existing law imposes a managed care organization (MCO) provider tax, administered and assessed by the department, on licensed health care service plans and managed care plans contracted with the department. Under existing law, all revenues, less refunds, derived from the MCO provider tax are available to the department, upon appropriation, for the purpose of funding specified subcomponents to support the Medi-Cal program. Existing law sets forth certain taxing tiers and tax amounts, and sets the Medi-Cal per enrollee tax amount for Medi-Cal taxing tier II, as defined, at $205 for the 2024, 2025, and 2026 calendar years.This bill would raise the MCO provider tax amount for that tier to $274 for all 3 of those calendar years.The bill would also reappropriate specified funds from the Budget Act of 2023 related to the State Department of Health Care Services.This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.Digest Key Vote: 2/3 Appropriation: YES Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 14199.85 of the Welfare and Institutions Code is amended to read:14199.85. (a) For each tax period, the Medi-Cal taxing tiers shall be as follows:(1) Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.(2) Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.(b) For each tax period, the other taxing tiers shall be as follows:(1) Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.(2) Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.(c) For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(d) For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(e) For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(f) For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(g) For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(h) For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars ($2).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(i) For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(j) For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(k) (1) The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.(2) If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.(3) In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.(l) The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.(m) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.SEC. 2. Notwithstanding any other provision of law, the balances as of June 30, 2023, of the appropriations made by Item 4260-101-0001 of the Budget Act of 2023 (Chs. 12, 38, and 189, Stats. 2023) related to Provision 26 of that item are reappropriated and shall be available for encumbrance or expenditure until June 30, 2025, for the same programs and purposes.SEC. 3. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
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3- Assembly Bill No. 160 CHAPTER 39An act to amend Section 14199.85 of the Welfare and Institutions Code, relating to Medi-Cal, and making an appropriation therefor, to take effect immediately, bill related to the budget. [ Approved by Governor June 29, 2024. Filed with Secretary of State June 29, 2024. ] LEGISLATIVE COUNSEL'S DIGESTAB 160, Committee on Budget. Medi-Cal managed care organization provider tax.Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and 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.Existing law imposes a managed care organization (MCO) provider tax, administered and assessed by the department, on licensed health care service plans and managed care plans contracted with the department. Under existing law, all revenues, less refunds, derived from the MCO provider tax are available to the department, upon appropriation, for the purpose of funding specified subcomponents to support the Medi-Cal program. Existing law sets forth certain taxing tiers and tax amounts, and sets the Medi-Cal per enrollee tax amount for Medi-Cal taxing tier II, as defined, at $205 for the 2024, 2025, and 2026 calendar years.This bill would raise the MCO provider tax amount for that tier to $274 for all 3 of those calendar years.The bill would also reappropriate specified funds from the Budget Act of 2023 related to the State Department of Health Care Services.This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.Digest Key Vote: 2/3 Appropriation: YES Fiscal Committee: YES Local Program: NO
3+ Enrolled June 27, 2024 Passed IN Senate June 26, 2024 Passed IN Assembly June 26, 2024 Amended IN Senate June 22, 2024 Amended IN Assembly February 01, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 160Introduced by Committee on Budget (Assembly Members Gabriel (Chair), Alvarez, Bennett, Bonta, Connolly, Mike Fong, Jackson, Lee, McCarty, Muratsuchi, Ortega, Petrie-Norris, Quirk-Silva, Ramos, Valencia, Ward, Weber, Wilson, and Zbur)January 09, 2023An act to amend Section 14199.85 of the Welfare and Institutions Code, relating to Medi-Cal, and making an appropriation therefor, to take effect immediately, bill related to the budget.LEGISLATIVE COUNSEL'S DIGESTAB 160, Committee on Budget. Medi-Cal managed care organization provider tax.Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and 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.Existing law imposes a managed care organization (MCO) provider tax, administered and assessed by the department, on licensed health care service plans and managed care plans contracted with the department. Under existing law, all revenues, less refunds, derived from the MCO provider tax are available to the department, upon appropriation, for the purpose of funding specified subcomponents to support the Medi-Cal program. Existing law sets forth certain taxing tiers and tax amounts, and sets the Medi-Cal per enrollee tax amount for Medi-Cal taxing tier II, as defined, at $205 for the 2024, 2025, and 2026 calendar years.This bill would raise the MCO provider tax amount for that tier to $274 for all 3 of those calendar years.The bill would also reappropriate specified funds from the Budget Act of 2023 related to the State Department of Health Care Services.This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.Digest Key Vote: 2/3 Appropriation: YES Fiscal Committee: YES Local Program: NO
44
5- Assembly Bill No. 160 CHAPTER 39
5+ Enrolled June 27, 2024 Passed IN Senate June 26, 2024 Passed IN Assembly June 26, 2024 Amended IN Senate June 22, 2024 Amended IN Assembly February 01, 2023
66
7- Assembly Bill No. 160
7+Enrolled June 27, 2024
8+Passed IN Senate June 26, 2024
9+Passed IN Assembly June 26, 2024
10+Amended IN Senate June 22, 2024
11+Amended IN Assembly February 01, 2023
812
9- CHAPTER 39
13+ CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
14+
15+ Assembly Bill
16+
17+No. 160
18+
19+Introduced by Committee on Budget (Assembly Members Gabriel (Chair), Alvarez, Bennett, Bonta, Connolly, Mike Fong, Jackson, Lee, McCarty, Muratsuchi, Ortega, Petrie-Norris, Quirk-Silva, Ramos, Valencia, Ward, Weber, Wilson, and Zbur)January 09, 2023
20+
21+Introduced by Committee on Budget (Assembly Members Gabriel (Chair), Alvarez, Bennett, Bonta, Connolly, Mike Fong, Jackson, Lee, McCarty, Muratsuchi, Ortega, Petrie-Norris, Quirk-Silva, Ramos, Valencia, Ward, Weber, Wilson, and Zbur)
22+January 09, 2023
1023
1124 An act to amend Section 14199.85 of the Welfare and Institutions Code, relating to Medi-Cal, and making an appropriation therefor, to take effect immediately, bill related to the budget.
12-
13- [ Approved by Governor June 29, 2024. Filed with Secretary of State June 29, 2024. ]
1425
1526 LEGISLATIVE COUNSEL'S DIGEST
1627
1728 ## LEGISLATIVE COUNSEL'S DIGEST
1829
1930 AB 160, Committee on Budget. Medi-Cal managed care organization provider tax.
2031
2132 Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and 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.Existing law imposes a managed care organization (MCO) provider tax, administered and assessed by the department, on licensed health care service plans and managed care plans contracted with the department. Under existing law, all revenues, less refunds, derived from the MCO provider tax are available to the department, upon appropriation, for the purpose of funding specified subcomponents to support the Medi-Cal program. Existing law sets forth certain taxing tiers and tax amounts, and sets the Medi-Cal per enrollee tax amount for Medi-Cal taxing tier II, as defined, at $205 for the 2024, 2025, and 2026 calendar years.This bill would raise the MCO provider tax amount for that tier to $274 for all 3 of those calendar years.The bill would also reappropriate specified funds from the Budget Act of 2023 related to the State Department of Health Care Services.This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.
2233
2334 Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and 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.
2435
2536 Existing law imposes a managed care organization (MCO) provider tax, administered and assessed by the department, on licensed health care service plans and managed care plans contracted with the department. Under existing law, all revenues, less refunds, derived from the MCO provider tax are available to the department, upon appropriation, for the purpose of funding specified subcomponents to support the Medi-Cal program. Existing law sets forth certain taxing tiers and tax amounts, and sets the Medi-Cal per enrollee tax amount for Medi-Cal taxing tier II, as defined, at $205 for the 2024, 2025, and 2026 calendar years.
2637
2738 This bill would raise the MCO provider tax amount for that tier to $274 for all 3 of those calendar years.
2839
2940 The bill would also reappropriate specified funds from the Budget Act of 2023 related to the State Department of Health Care Services.
3041
3142 This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.
3243
3344 This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.
3445
3546 ## Digest Key
3647
3748 ## Bill Text
3849
3950 The people of the State of California do enact as follows:SECTION 1. Section 14199.85 of the Welfare and Institutions Code is amended to read:14199.85. (a) For each tax period, the Medi-Cal taxing tiers shall be as follows:(1) Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.(2) Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.(b) For each tax period, the other taxing tiers shall be as follows:(1) Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.(2) Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.(c) For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(d) For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(e) For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(f) For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(g) For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(h) For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars ($2).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(i) For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(j) For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(k) (1) The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.(2) If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.(3) In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.(l) The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.(m) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.SEC. 2. Notwithstanding any other provision of law, the balances as of June 30, 2023, of the appropriations made by Item 4260-101-0001 of the Budget Act of 2023 (Chs. 12, 38, and 189, Stats. 2023) related to Provision 26 of that item are reappropriated and shall be available for encumbrance or expenditure until June 30, 2025, for the same programs and purposes.SEC. 3. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
4051
4152 The people of the State of California do enact as follows:
4253
4354 ## The people of the State of California do enact as follows:
4455
4556 SECTION 1. Section 14199.85 of the Welfare and Institutions Code is amended to read:14199.85. (a) For each tax period, the Medi-Cal taxing tiers shall be as follows:(1) Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.(2) Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.(b) For each tax period, the other taxing tiers shall be as follows:(1) Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.(2) Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.(c) For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(d) For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(e) For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(f) For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(g) For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(h) For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars ($2).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(i) For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(j) For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(k) (1) The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.(2) If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.(3) In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.(l) The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.(m) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.
4657
4758 SECTION 1. Section 14199.85 of the Welfare and Institutions Code is amended to read:
4859
4960 ### SECTION 1.
5061
5162 14199.85. (a) For each tax period, the Medi-Cal taxing tiers shall be as follows:(1) Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.(2) Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.(b) For each tax period, the other taxing tiers shall be as follows:(1) Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.(2) Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.(c) For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(d) For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(e) For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(f) For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(g) For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(h) For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars ($2).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(i) For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(j) For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(k) (1) The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.(2) If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.(3) In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.(l) The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.(m) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.
5263
5364 14199.85. (a) For each tax period, the Medi-Cal taxing tiers shall be as follows:(1) Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.(2) Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.(b) For each tax period, the other taxing tiers shall be as follows:(1) Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.(2) Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.(c) For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(d) For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(e) For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(f) For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(g) For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(h) For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars ($2).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(i) For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(j) For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(k) (1) The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.(2) If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.(3) In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.(l) The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.(m) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.
5465
5566 14199.85. (a) For each tax period, the Medi-Cal taxing tiers shall be as follows:(1) Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.(2) Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.(b) For each tax period, the other taxing tiers shall be as follows:(1) Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.(2) Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.(3) Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.(c) For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(d) For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(e) For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(f) For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(g) For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(h) For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars ($2).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(i) For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:(1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).(2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).(3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).(j) For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:(1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).(2) The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).(3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).(k) (1) The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.(2) If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.(3) In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.(l) The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.(m) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.
5667
5768
5869
5970 14199.85. (a) For each tax period, the Medi-Cal taxing tiers shall be as follows:
6071
6172 (1) Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.
6273
6374 (2) Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.
6475
6576 (3) Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.
6677
6778 (b) For each tax period, the other taxing tiers shall be as follows:
6879
6980 (1) Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.
7081
7182 (2) Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.
7283
7384 (3) Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.
7485
7586 (c) For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
7687
7788 (1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
7889
7990 (2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).
8091
8192 (3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
8293
8394 (d) For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:
8495
8596 (1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
8697
8798 (2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).
8899
89100 (3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
90101
91102 (e) For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
92103
93104 (1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
94105
95106 (2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).
96107
97108 (3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
98109
99110 (f) For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
100111
101112 (1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
102113
103114 (2) The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).
104115
105116 (3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
106117
107118 (g) For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
108119
109120 (1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
110121
111122 (2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).
112123
113124 (3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
114125
115126 (h) For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
116127
117128 (1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
118129
119130 (2) The other per enrollee tax for the other taxing tier II shall be two dollars ($2).
120131
121132 (3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
122133
123134 (i) For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
124135
125136 (1) The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
126137
127138 (2) The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).
128139
129140 (3) The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
130141
131142 (j) For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
132143
133144 (1) The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
134145
135146 (2) The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).
136147
137148 (3) The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
138149
139150 (k) (1) The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.
140151
141152 (2) If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.
142153
143154 (3) In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.
144155
145156 (l) The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.
146157
147158 (m) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.
148159
149160 SEC. 2. Notwithstanding any other provision of law, the balances as of June 30, 2023, of the appropriations made by Item 4260-101-0001 of the Budget Act of 2023 (Chs. 12, 38, and 189, Stats. 2023) related to Provision 26 of that item are reappropriated and shall be available for encumbrance or expenditure until June 30, 2025, for the same programs and purposes.
150161
151162 SEC. 2. Notwithstanding any other provision of law, the balances as of June 30, 2023, of the appropriations made by Item 4260-101-0001 of the Budget Act of 2023 (Chs. 12, 38, and 189, Stats. 2023) related to Provision 26 of that item are reappropriated and shall be available for encumbrance or expenditure until June 30, 2025, for the same programs and purposes.
152163
153164 SEC. 2. Notwithstanding any other provision of law, the balances as of June 30, 2023, of the appropriations made by Item 4260-101-0001 of the Budget Act of 2023 (Chs. 12, 38, and 189, Stats. 2023) related to Provision 26 of that item are reappropriated and shall be available for encumbrance or expenditure until June 30, 2025, for the same programs and purposes.
154165
155166 ### SEC. 2.
156167
157168 SEC. 3. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
158169
159170 SEC. 3. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
160171
161172 SEC. 3. This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
162173
163174 ### SEC. 3.