CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Senate Bill No. 1492Introduced by Senator MenjivarFebruary 16, 2024 An act to add Section 14105.205 to the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTSB 1492, as introduced, Menjivar. Medi-Cal reimbursement rates: private duty nursing. 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 sets forth requirements for private duty nursing and home health care under the Medi-Cal program.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 to provide full-scope Medi-Cal services. Under existing law, proceeds from the MCO provider tax may be used, upon appropriation by the Legislature, for the increased costs incurred as a result of reimbursement requirements, among other things.This bill would provide that, for the above-described reimbursement purposes, private duty nursing services provided to a child under 21 years of age by a home health agency are considered specialty care services.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 14105.205 is added to the Welfare and Institutions Code, to read:14105.205. Notwithstanding any other law, private duty nursing services, as defined in Section 1743.2 of Health and Safety Code, provided to a child under 21 years of age by a home health agency, as defined in Section 1725 of the Health and Safety Code, shall be considered specialty care for purposes of Medi-Cal reimbursement under Sections 14105.200, 14105.201, 14105.202, and 14199.82.
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Senate Bill No. 1492Introduced by Senator MenjivarFebruary 16, 2024 An act to add Section 14105.205 to the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTSB 1492, as introduced, Menjivar. Medi-Cal reimbursement rates: private duty nursing. 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 sets forth requirements for private duty nursing and home health care under the Medi-Cal program.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 to provide full-scope Medi-Cal services. Under existing law, proceeds from the MCO provider tax may be used, upon appropriation by the Legislature, for the increased costs incurred as a result of reimbursement requirements, among other things.This bill would provide that, for the above-described reimbursement purposes, private duty nursing services provided to a child under 21 years of age by a home health agency are considered specialty care services.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
Senate Bill
No. 1492
Introduced by Senator MenjivarFebruary 16, 2024
Introduced by Senator Menjivar
February 16, 2024
An act to add Section 14105.205 to the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
SB 1492, as introduced, Menjivar. Medi-Cal reimbursement rates: private duty nursing.
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 sets forth requirements for private duty nursing and home health care under the Medi-Cal program.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 to provide full-scope Medi-Cal services. Under existing law, proceeds from the MCO provider tax may be used, upon appropriation by the Legislature, for the increased costs incurred as a result of reimbursement requirements, among other things.This bill would provide that, for the above-described reimbursement purposes, private duty nursing services provided to a child under 21 years of age by a home health agency are considered specialty care services.
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 sets forth requirements for private duty nursing and home health care under the Medi-Cal program.
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 to provide full-scope Medi-Cal services. Under existing law, proceeds from the MCO provider tax may be used, upon appropriation by the Legislature, for the increased costs incurred as a result of reimbursement requirements, among other things.
This bill would provide that, for the above-described reimbursement purposes, private duty nursing services provided to a child under 21 years of age by a home health agency are considered specialty care services.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 14105.205 is added to the Welfare and Institutions Code, to read:14105.205. Notwithstanding any other law, private duty nursing services, as defined in Section 1743.2 of Health and Safety Code, provided to a child under 21 years of age by a home health agency, as defined in Section 1725 of the Health and Safety Code, shall be considered specialty care for purposes of Medi-Cal reimbursement under Sections 14105.200, 14105.201, 14105.202, and 14199.82.
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 14105.205 is added to the Welfare and Institutions Code, to read:14105.205. Notwithstanding any other law, private duty nursing services, as defined in Section 1743.2 of Health and Safety Code, provided to a child under 21 years of age by a home health agency, as defined in Section 1725 of the Health and Safety Code, shall be considered specialty care for purposes of Medi-Cal reimbursement under Sections 14105.200, 14105.201, 14105.202, and 14199.82.
SECTION 1. Section 14105.205 is added to the Welfare and Institutions Code, to read:
### SECTION 1.
14105.205. Notwithstanding any other law, private duty nursing services, as defined in Section 1743.2 of Health and Safety Code, provided to a child under 21 years of age by a home health agency, as defined in Section 1725 of the Health and Safety Code, shall be considered specialty care for purposes of Medi-Cal reimbursement under Sections 14105.200, 14105.201, 14105.202, and 14199.82.
14105.205. Notwithstanding any other law, private duty nursing services, as defined in Section 1743.2 of Health and Safety Code, provided to a child under 21 years of age by a home health agency, as defined in Section 1725 of the Health and Safety Code, shall be considered specialty care for purposes of Medi-Cal reimbursement under Sections 14105.200, 14105.201, 14105.202, and 14199.82.
14105.205. Notwithstanding any other law, private duty nursing services, as defined in Section 1743.2 of Health and Safety Code, provided to a child under 21 years of age by a home health agency, as defined in Section 1725 of the Health and Safety Code, shall be considered specialty care for purposes of Medi-Cal reimbursement under Sections 14105.200, 14105.201, 14105.202, and 14199.82.
14105.205. Notwithstanding any other law, private duty nursing services, as defined in Section 1743.2 of Health and Safety Code, provided to a child under 21 years of age by a home health agency, as defined in Section 1725 of the Health and Safety Code, shall be considered specialty care for purposes of Medi-Cal reimbursement under Sections 14105.200, 14105.201, 14105.202, and 14199.82.