Bill Text: CA AB651 | 2019-2020 | Regular Session | Amended
Bill Title: Air ambulance services.
Spectrum: Bipartisan Bill
Status: (Passed) 2019-10-07 - Chaptered by Secretary of State - Chapter 537, Statutes of 2019. [AB651 Detail]
Download: California-2019-AB651-Amended.html
Amended
IN
Senate
September 09, 2019 |
Amended
IN
Senate
September 06, 2019 |
Amended
IN
Senate
August 30, 2019 |
Amended
IN
Senate
July 01, 2019 |
Amended
IN
Assembly
April 08, 2019 |
Introduced by Assembly Member Grayson (Coauthors: Assembly Members Aguiar-Curry, Boerner Horvath, Brough, Carrillo, Choi, Cooper, Flora, Eduardo Garcia, Lackey, Mathis, Mayes, Patterson, Rodriguez, Blanca Rubio, Weber, and Wood) (Coauthors: Senators Borgeas, Caballero, Dahle, Dodd, Glazer, Hurtado, Jones, McGuire, Nielsen, Stone, and Wiener) |
February 15, 2019 |
LEGISLATIVE COUNSEL'S DIGEST
(2)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, including medical transportation services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes the Director of Health Care Services to limit rates of payment for health care services, and requires the director to adopt regulations as are necessary for carrying out these provisions. Existing regulations provide for the maximum reimbursement rates for medical transportation services, including air ambulance services. Existing federal law provides for the federal Medicare Program, which is a public health insurance program for persons 65 years of age and older and specified persons with disabilities who are under 65 years of age.
This bill would, subject to an appropriation by the Legislature,
require the department to set and maintain, commencing January 1, 2020, supplemental Medi-Cal payments for air ambulance services provided by fixed or rotary wing aircraft, and would require the amount of these payments to be the difference between the Medicare Program’s lowest rural rates in California and the Medi-Cal fee-for-service program rates as these rates are in effect on January 1, 2020. The bill would provide, commencing January 1, 2020, the amounts a noncontract emergency medical transport provider may collect if the beneficiary received medical assistance other than through enrollment in a Medi-Cal managed care health plan pursuant to a specified federal law would be the sum of the supplemental payments and the existing fee-for-service payment schedule amounts.
(3)
(4)
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 76000.10 of the Government Code is amended to read:76000.10.
(a) This section shall be known, and may be cited, as the Emergency Medical Air Transportation Act.(II)A payment augmentation made pursuant to subclause (I) shall apply only to emergency medical air transportation services that were provided on a date of service that predates the implementation of the supplemental Medi-Cal payments for air ambulance services, as specified in subdivision (a) of Section 14124.15 of the Welfare and Institutions Code.
SEC. 2.
Section 1371.55 is added to the Health and Safety Code, to read:1371.55.
(a) (1) Notwithstanding Section 1367.11, a health care service plan contract issued, amended, or renewed on or after January 1, 2020, shall provide that if an enrollee receives covered services from a noncontracting air ambulance provider, the enrollee shall pay no more than the same cost-sharing amount that the enrollee would pay for the same covered services received from a contracting air ambulance provider. This amount shall be referred to as the “in-network cost-sharing amount.”SEC. 3.
Section 10126.65 is added to the Insurance Code, to read:10126.65.
(a) (1) Notwithstanding Section 10352, a health insurance policy issued, amended, or renewed on or after January 1, 2020, shall provide that if an insured or subscriber receives covered services from a noncontracting air ambulance provider, the insured or subscriber shall pay no more than the same cost sharing that the insured or subscriber would pay for the same covered services received from a contracting air ambulance provider. This amount shall be referred to as the “in-network cost-sharing amount.”(a)The department shall set and maintain supplemental Medi-Cal payments for air ambulance services provided by fixed or rotary wing aircraft in accordance with subdivision (b).
(b)The supplemental Medi-Cal payment amount shall be the difference between the Medicare Program’s lowest rural rates in California and the Medi-Cal fee-for-service program rates as these rates are in effect on January 1, 2020.
(c)Each applicable Medi-Cal managed care health plan shall satisfy its obligation under Section 438.114(c) of Title 42 of the Code of Federal Regulations for emergency medical transports and
shall provide payment to noncontract emergency medical transport providers consistent with Section 1396u-2(b)(2)(D) of Title 42 of the United States Code. Commencing January 1, 2020, and for each state fiscal year thereafter for which this section is operative, the amounts a noncontract emergency medical transport provider may collect, if the beneficiary received medical assistance other than through enrollment in a Medi-Cal managed care health plan pursuant to Section 1396u-2(b)(2)(D) of Title 42 of the United States Code, shall be the sum of the supplemental payments and existing fee-for-service payment schedule amounts after the application of this section.
(d)This section shall become operative January 1, 2020.
(e)Implementation of this section shall be subject to an appropriation
in the annual Budget Act or an appropriation in any other act approved by the Legislature.