Bill Text: CA AB1868 | 2013-2014 | Regular Session | Amended

California Assembly Bill 1868 (Prior Session Legislation)

Bill Title: Medi-Cal: optional benefits: podiatric medicine.

Spectrum: Slight Partisan Bill (Democrat 2-1)

Status: (Engrossed - Dead) 2014-08-14 - In committee: Held under submission. [AB1868 Detail]

Download: California-2013-AB1868-Amended.html

BILL NUMBER: AB 1868	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JUNE 10, 2014

INTRODUCED BY   Assembly Member Gomez
    (   Coauthors:   Assembly Members 
 Brown   and Wilk   ) 

                        FEBRUARY 19, 2014

   An act to amend Section 14131.10 of the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1868, as amended, Gomez. Medi-Cal: optional benefits: podiatric
medicine.
   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 optional
podiatric services are excluded from coverage under the Medi-Cal
program.
   This bill would cover medical and surgical services provided by a
doctor of podiatric medicine  within his or her scope of practice
 that, if provided by a physician, would be considered
physician services, and which services may be provided by either a
physician or a podiatrist in the state.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 14131.10 of the Welfare and Institutions Code
is amended to read:
   14131.10.  (a) Notwithstanding any other provision of this
chapter, Chapter 8 (commencing with Section 14200), or Chapter 8.75
(commencing with Section 14591), in order to implement changes in the
level of funding for health care services, specific optional
benefits are excluded from coverage under the Medi-Cal program.
   (b) (1) The following optional benefits are excluded from coverage
under the Medi-Cal program:
   (A) Adult dental services, except as specified in paragraph (2).
   (B) Acupuncture services.
   (C) Audiology services and speech therapy services.
   (D) Chiropractic services.
   (E) Optometric and optician services, including services provided
by a fabricating optical laboratory.
   (F) Podiatric services, except as specified in paragraph (2).
   (G) Psychology services.
   (H) Incontinence creams and washes.
   (2) (A) (i) Medical and surgical services provided by a doctor of
dental medicine or dental surgery  ,  that, if
provided by a physician, would be considered physician services, and
which services may be provided by either a physician or a dentist in
this state, are covered.
   (ii) Medical and surgical services provided by a doctor of
podiatric medicine  ,   within his or her scope
of practice  that, if provided by a physician, would be
considered physician services, and which services may be provided by
either a physician or a doctor of podiatric medicine in this state,
are covered.
   (B) Emergency procedures are also covered in the categories of
service specified in subparagraph (A). The director may adopt
regulations for any of the services specified in subparagraph (A).
   (C) Effective May 1, 2014, or the effective date of any necessary
federal approvals as required by subdivision (f), whichever is later,
for persons 21 years of age or older, adult dental benefits, subject
to utilization controls, are limited to all the following medically
necessary services:
   (i) Examinations, radiographs/photographic images, prophylaxis,
and fluoride treatments.
   (ii) Amalgam and composite restorations.
   (iii) Stainless steel, resin, and resin window crowns.
   (iv) Anterior root canal therapy.
   (v) Complete dentures, including immediate dentures.
   (vi) Complete denture adjustments, repairs, and relines.
   (D) Services specified in this paragraph shall be included as a
covered medical benefit under the Medi-Cal program pursuant to
Section 14132.89.
   (3) Pregnancy-related services and services for the treatment of
other conditions that might complicate the pregnancy are not excluded
from coverage under this section.
   (c) The optional benefit exclusions do not apply to either of the
following:
   (1) Beneficiaries under the Early and Periodic Screening Diagnosis
and Treatment Program.
   (2) Beneficiaries receiving long-term care in a nursing facility
that is both:
   (A) A skilled nursing facility or intermediate care facility as
defined in subdivisions (c) and (d) of Section 1250 of the Health and
Safety Code.
   (B) Licensed pursuant to subdivision (k) of Section 1250 of the
Health and Safety Code.
   (d) This section shall only be implemented to the extent permitted
by federal law.
   (e) 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 the provisions of this section by means of
all-county letters, provider bulletins, or similar instructions,
without taking further regulatory action.
   (f) The department shall seek approval for federal financial
participation and coverage of services specified in subparagraph (C)
of paragraph (2) of subdivision (b) under the Medi-Cal program.
   (g) This section, except as specified in subparagraph (C) of
paragraph (2) of subdivision (b), shall be implemented on the first
day of the month following 90 days after the operative date of this
section.