AB 1512
Version: Introduced
Author: Garrick
BILL NUMBER: AB 1512 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Garrick
JANUARY 12, 2012
An act to amend Section 14016.55 of the Welfare and Institutions Code, relating
to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 1512, as introduced, Garrick. Medi-Cal.
Existing law provides for the Medi-Cal program, which is administered by the
State Department of Health Care Services under which qualified low-income
individuals receive health care benefits. Under existing law, the Director of
Health Care Services is required to enter into contracts with managed care
plans to provide services under the Medi-Cal program. A Medi-Cal participant is
given 30 days following the determination of eligibility to indicate his or her
choice of health care options. Under existing law, in counties where the
conversion to managed care plan enrollment has occurred, and where the default
rate, as defined, is 20% or higher in 2 consecutive months occurring after the
conversion, the department is required to conduct a survey of beneficiaries, as
specified, and to report the results to the appropriate legislative policy and
budget committees.
This bill would make technical, nonsubstantive changes to the survey and
reporting provisions.
Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local
program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14016.55 of the Welfare and Institutions Code is amended to
read:
14016.55. (a) It is the intent of the Legislature that Medi-Cal beneficiaries
who are required to enroll in a Medi-Cal managed care health plan make an
informed choice that is not the result of confusion, lack of information, or
understandingmisunderstanding of the choices available to
them.
(b) It is the intent of the Legislature that the department strive to increase
the level of choice of Medi-Cal beneficiaries required to enroll in a Medi-Cal
managed care health plan and that default rates be no greater than 20 percent
in any participating county.
(c) In any county in which conversion to managed care
health plan
enrollment has taken place and where the default rate, as defined in
subdivision (e), is 20 percent or higher in two consecutive months occurring
after conversion upon the effective date of this section, the department shall
conduct a one-time survey of beneficiaries aimed at determining the reasons why
beneficiaries fail to enroll into a managed care
health plan when
required to do so by the department or its health care options contractor.
(d) The department shall submit the results of the survey to the appropriate
legislative policy and budget committees within six months of completion, and
implement a plan of correction intended to reduce the rate of beneficiary
default. The plan of correction may include, but not be limited to, culturally
appropriate outreach and education activities, including the use of community
based organization.
(e) For purposes of this section, "default rate" refers to the rate of Medi-Cal
beneficiaries defaulting into managed care health plan enrollment by virtue of
their failure to make an election, as provided for in Section 14016.5.