(1) Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which health care services are provided to qualified, low-income persons through various health care delivery systems, including managed care pursuant to Medi-Cal managed care plan contracts. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing federal regulations require a state that contracts with specified Medicaid managed care plans to develop and enforce network adequacy standards, to ensure that services covered under the Medicaid state plan are available and accessible to enrollees of specified Medicaid managed care plans in a timely manner, and to contract with a qualified external quality review organization (EQRO) to produce annually an external quality review technical report that summarizes findings on access and quality of care. Existing state law establishes, until January 1, 2022, certain time and distance and appointment time standards for specified services consistent with those federal regulations to ensure that Medi-Cal managed care covered services are available and accessible to enrollees of Medi-Cal managed care plans in a timely manner, and authorizes a Medi-Cal managed care plan to request approval from the department to use alternative access standards for the time and distance standards if specified conditions are met, including that the Medi-Cal managed care plan has exhausted all reasonable options to obtain providers to meet the applicable standard. Existing state law requires a Medi-Cal managed care plan to provide annually to the department, or upon the department's request, a report that demonstrates the Medi-Cal managed care plan's compliance with time and distance standards, and requires the EQRO to compile various data, by plan and by county, related to time and distance standards, including the number of requests for alternative access standards in the plan service area for time and distance.
California AB 1642 (20192020) — Medi-Cal: managed care plans.
(1) Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which health care services are provided to qualified, low-income persons through various health care delivery systems, including managed care pursuant to Medi-Cal managed care plan contracts. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing federal regulations require a state that contracts with specified Medicaid managed care plans to develop and enforce network adequacy standards, to ensure that services covered under the Medicaid state plan are available and accessible to enrollees of specified Medicaid managed care plans in a timely manner, and to contract with a qualified external quality review organization (EQRO) to produce annually an external quality review technical report that summarizes findings on access and quality of care. Existing state law establishes, until January 1, 2022, certain time and distance and appointment time standards for specified services consistent with those federal regulations to ensure that Medi-Cal managed care covered services are available and accessible to enrollees of Medi-Cal managed care plans in a timely manner, and authorizes a Medi-Cal managed care plan to request approval from the department to use alternative access standards for the time and distance standards if specified conditions are met, including that the Medi-Cal managed care plan has exhausted all reasonable options to obtain providers to meet the applicable standard. Existing state law requires a Medi-Cal managed care plan to provide annually to the department, or upon the department's request, a report that demonstrates the Medi-Cal managed care plan's compliance with time and distance standards, and requires the EQRO to compile various data, by plan and by county, related to time and distance standards, including the number of requests for alternative access standards in the plan service area for time and distance.
Version chain
The bill's text revisions, in order — the diff chain from filing to enrollment.
Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations] — 7–1 (pass) · upper
Do pass as amended. — 13–1 (pass) · lower
Do pass as amended and be re-referred to the Committee on [Appropriations] — 12–0 (pass) · lower
3rd Reading AB1642 Wood By Pan — 39–1 (pass) · upper
Placed on suspense file — 7–0 (pass) · upper
AB 1642 Wood Concurrence in Senate Amendments — 76–0 (pass) · lower
AB 1642 Wood Assembly Third Reading — 67–2 (pass) · lower
With recommendation: That Senate amendments be concurred in. — 12–0 (pass) · lower
Sponsors
Wood — primary (person)
Timeline
The legislative action history — every referral, reading, and vote.
2019-02-22 Introduced. To print. introduction
2019-02-23 From printer. May be heard in committee March 25.
2019-02-25 Read first time. reading-1
2019-03-18 Referred to Com. on HEALTH. referral-committee
2019-03-18 From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended. reading-1, reading-2, amendment-passage, amendment-introduction
2019-03-19 Re-referred to Com. on HEALTH. referral-committee
2019-04-01 From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended. reading-1, reading-2, amendment-passage, amendment-introduction
2019-04-02 Re-referred to Com. on HEALTH. referral-committee
2019-04-22 From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 12. Noes 0.) (April 9). amendment-passage, committee-passage, amendment-introduction
2019-04-23 Read second time and amended. amendment-passage, reading-1, reading-2
2019-04-24 Re-referred to Com. on APPR. referral-committee
2019-05-16 From committee: Amend, and do pass as amended. (Ayes 13. Noes 1.) (May 16). amendment-passage, committee-passage, amendment-introduction
2019-05-16 Read second time and amended. Ordered returned to second reading. amendment-passage, reading-1, reading-2
2019-05-20 Read second time. Ordered to third reading. reading-1, reading-2
2019-05-29 Read third time. Passed. Ordered to the Senate. (Ayes 67. Noes 2. Page 2101.) passage, reading-3, reading-1
2019-05-30 In Senate. Read first time. To Com. on RLS. for assignment. reading-1
2019-06-12 Referred to Com. on HEALTH. referral-committee
2019-07-01 From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on HEALTH. reading-1, reading-2, amendment-passage, referral-committee, amendment-introduction
2019-07-11 From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 7. Noes 1.) (July 10). amendment-passage, committee-passage, amendment-introduction
2019-07-11 Read second time and amended. Re-referred to Com. on APPR. reading-1, reading-2, amendment-passage, referral-committee
2019-08-12 In committee: Referred to APPR. suspense file. referral-committee
2019-08-30 From committee: Amend, and do pass as amended. (Ayes 5. Noes 2.) (August 30). amendment-passage, committee-passage, amendment-introduction
2019-08-30 Read second time and amended. Ordered returned to second reading. amendment-passage, reading-1, reading-2
2019-09-03 Read second time. Ordered to third reading. reading-1, reading-2
2019-09-04 Read third time. Passed. Ordered to the Assembly. (Ayes 39. Noes 1. Page 2523.). passage, reading-3, reading-1
2019-09-05 In Assembly. Concurrence in Senate amendments pending. May be considered on or after September 7 pursuant to Assembly Rule 77.
2019-09-05 Re-referred to Com. on HEALTH. pursuant to Assembly Rule 77.2. referral-committee
Fabio