AB 180: Medi-Cal.

(1)Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides that federally qualified health center (FQHC) services and rural health clinic (RHC) services are covered benefits under the Medi-Cal program to be reimbursed, to the extent that federal financial participation is obtained, to providers on a per-visit basis.

This bill would, on or before March 1, 2019, require the department to establish a stakeholder process to assist the department in developing guidance for a FQHC or RHC to determine whether a payment would constitute an incentive payment that is prohibited from being reimbursed. The bill would further require the department to issue the guidance developed pursuant to the stakeholder process on or before July 1, 2019, and apply the guidance only to all FQHC and RHC payments starting on and after that issuance date. The bill would authorize the department to seek necessary federal approvals and require the department to promulgate regulations to implement these provisions.

(2)This bill would declare that it is to take effect immediately as an urgency statute.