SB 1477: Health.

(1)Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms that took effect January 1, 2014. Among other things, PPACA requires each state, by January 1, 2014, to establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans by qualified individuals and qualified small employers. Existing state law establishes the California Health Benefit Exchange (the Exchange) within state government, specifies the powers and duties of the board governing the Exchange, and requires the board to facilitate the purchase of qualified health plans by qualified individuals and qualified small employers.

This bill would state that the California Health Benefit Exchange is also known as Covered California and would deem any reference to the California Health Benefit Exchange or the Exchange to refer to Covered California.

(2)Under existing law, the Robert W. Crown California Childrens Services Act, the State Department of Health Care Services and each county administers the California Childrens Services Program (CCS program) for treatment services for physically defective or handicapped persons under 21 years of age, as specified. Existing law authorizes, if a person is enrolled in the Healthy Families Program or the AIM-Linked Infants Program, the financial documentation required to establish eligibility for those programs to be used to establish financial eligibility for treatment services under the CCS program. Existing law transitions enrollees of the Healthy Families Program to the Medi-Cal program and renamed the AIM-Linked Infants Program as the Medi-Cal Access Program.

This bill would change references to the Healthy Families Program to the Medi-Cal program, and the AIM-Linked Infants Program to the Medi-Cal Access Program.

(3)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. The Medi-Cal program is, in part, governed and funded by the federal Medicaid program. 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. Under the Medi-Cal program, existing law provides for the provision of health, dental, and vision benefits to eligible children pursuant to the federal Childrens Health Insurance Program (CHIP). Existing federal regulations, published on May 6, 2016, revise regulations governing Medicaid managed care plans to, among other things, align, where feasible, those rules with those of other major sources of coverage, including coverage through qualified health plans offered through an American Health Benefit Exchange, such as the Exchange, and promote quality of care and strengthen efforts to reform delivery systems that serve Medicaid and CHIP beneficiaries.

This bill, until January 1, 2020, would authorize the department to enter into contracts for the purposes of undertaking certain administrative activities concerning those revised federal regulations published on May 6, 2016. The bill would exempt contracts entered into or amended under this authority from specified provisions of the State Contract Act, specified provisions governing personal services contracts, and the provisions governing the requirement of advertising in the California State Contracts Register. The bill would require contracts entered into pursuant to these provisions to be publicly available pursuant to the California Public Records Act.

(4)This bill would correct an erroneous cross-reference and would also make other technical, nonsubstantive changes.