AB 160: Medi-Cal managed care organization provider tax.
- Session Year: 2023-2024
- House: Assembly
- Latest Version Date: 2024-06-29
Current Status:
Passed
(2024-06-29: Chaptered by Secretary of State - Chapter 39, Statutes of 2024.)
Introduced
In Committee
First Chamber
In Committee
Second Chamber
Enacted
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. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. 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.
Existing law imposes a managed care organization (MCO) provider tax, administered and assessed by the department, on licensed health care service plans and managed care plans contracted with the department. Under existing law, all revenues, less refunds, derived from the MCO provider tax are available to the department, upon appropriation, for the purpose of funding specified subcomponents to support the Medi-Cal program. Existing law sets forth certain taxing tiers and tax amounts, and sets the Medi-Cal per enrollee tax amount for Medi-Cal taxing tier II, as defined, at $205 for the 2024, 2025, and 2026 calendar years.
This bill would raise the MCO provider tax amount for that tier to $274 for all 3 of those calendar years.
The bill would also reappropriate specified funds from the Budget Act of 2023 related to the State Department of Health Care Services.
This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.
This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.
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. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. 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.
Existing law imposes a managed care organization (MCO) provider tax, administered and assessed by the department, on licensed health care service plans and managed care plans contracted with the department. Under existing law, all revenues, less refunds, derived from the MCO provider tax are available to the department, upon appropriation, for the purpose of funding specified subcomponents to support the Medi-Cal program. Existing law sets forth certain taxing tiers and tax amounts, and sets the Medi-Cal per enrollee tax amount for Medi-Cal taxing tier II, as defined, at $205 for the 2024, 2025, and 2026 calendar years.
This bill would raise the MCO provider tax amount for that tier to $274 for all 3 of those calendar years.
The bill would also reappropriate specified funds from the Budget Act of 2023 related to the State Department of Health Care Services.
This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.
This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.
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. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. 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.
Existing law imposes a managed care organization (MCO) provider tax, administered and assessed by the department, on licensed health care service plans and managed care plans contracted with the department. Under existing law, all revenues, less refunds, derived from the MCO provider tax are available to the department, upon appropriation, for the purpose of funding specified subcomponents to support the Medi-Cal program. Existing law sets forth certain taxing tiers and tax amounts, and sets the Medi-Cal per enrollee tax amount for Medi-Cal taxing tier II, as defined, at $205 for the 2024, 2025, and 2026 calendar years.
This bill would raise the MCO provider tax amount for that tier to $274 for all 3 of those calendar years.
The bill would also reappropriate specified funds from the Budget Act of 2023 related to the State Department of Health Care Services.
This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.
This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.
This bill would express the intent of the Legislature to enact statutory changes, relating to the Budget Act of 2023.This bill would express the intent of the Legislature to enact statutory changes changes, relating to the Budget Act of 2023.
This bill would express the intent of the Legislature to enact statutory changes relating to the Budget Act of 2023.
(a)For each tax period, the Medi-Cal taxing tiers shall be as follows:
(1)Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.
(2)Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.
(3)Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.
(b)For each tax period, the other taxing tiers shall be as follows:
(1)Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.
(2)Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.
(3)Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.
(c)For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(d)For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(e)For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(f)For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(g)For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(h)For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be two dollars ($2).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(i)For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(j)For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(k)(1)The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.
(2)If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.
(3)In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.
(l)The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.
(m)Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.
SEC. 2.Notwithstanding any other provision of law, the balances as of June 30, 2023, of the appropriations made by Item 4260-101-0001 of the Budget Act of 2023 (Chs. 12, 38, and 189, Stats. 2023) related to Provision 26 of that item are reappropriated and shall be available for encumbrance or expenditure until June 30, 2025, for the same programs and purposes.
SEC. 3.This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
(a)For each tax period, the Medi-Cal taxing tiers shall be as follows:
(1)Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.
(2)Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.
(3)Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.
(b)For each tax period, the other taxing tiers shall be as follows:
(1)Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.
(2)Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.
(3)Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.
(c)For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(d)For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(e)For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(f)For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(g)For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(h)For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be two dollars ($2).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(i)For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred seventy-four dollars ($274).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(j)For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(k)(1)The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.
(2)If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.
(3)In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.
(l)The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.
(m)Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.
SEC. 2.Notwithstanding any other provision of law, the balances as of June 30, 2023, of the appropriations made by Item 4260-101-0001 of the Budget Act of 2023 (Chs. 12, 38, and 189, Stats. 2023) related to Provision 26 of that item are reappropriated and shall be available for encumbrance or expenditure until June 30, 2025, for the same programs and purposes.
SEC. 3.This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
(a)For each tax period, the Medi-Cal taxing tiers shall be as follows:
(1)Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 1,250,000, inclusive.
(2)Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.
(3)Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.
(b)For each tax period, the other taxing tiers shall be as follows:
(1)Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 1,250,000, inclusive.
(2)Other taxing tier II shall consist of all countable other enrollees in a health plan from 1,250,001 to 4,000,000, inclusive.
(3)Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 4,000,000.
(c)For the period of April 1, 2023, through December 31, 2023, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be one hundred eighty-two dollars and fifty cents ($182.50).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(d)For the period of April 1, 2023, through December 31, 2023, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(e)For the 2024 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred five dollars ($205). seventy-four dollars ($274).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(f)For the 2024 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be one dollar and seventy-five cents ($1.75).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(g)For the 2025 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred five dollars ($205). seventy-four dollars ($274).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(h)For the 2025 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be two dollars ($2).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(i)For the 2026 calendar year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:
(1)The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be zero dollars ($0).
(2)The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be two hundred five dollars ($205). seventy-four dollars ($274).
(3)The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be zero dollars ($0).
(j)For the 2026 calendar year, the other per enrollee tax amount for each other taxing tier shall be as follows:
(1)The other per enrollee tax for the other taxing tier I shall be zero dollars ($0).
(2)The other per enrollee tax for the other taxing tier II shall be two dollars and twenty-five cents ($2.25).
(3)The other per enrollee tax for the other taxing tier III shall be zero dollars ($0).
(k)(1)The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other provision specified in this article to the extent that it deems necessary to meet the requirements of federal law or regulations, to obtain or maintain federal approval, or to ensure federal financial participation is available or is not otherwise jeopardized, provided the modification or adjustment does not otherwise conflict with the purposes of this article, or result in an increase in the aggregate tax amounts projected to be collected under this article that the department, in its sole discretion, determines is significant.
(2)If the department identifies that modification or adjustment is necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.
(3)In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.
(l)The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other federal law or regulation necessary to implement this article.
(m)Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking any further regulatory action. The department shall provide notification to the Department of Finance, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.
SEC. 2.Notwithstanding any other provision of law, the balances as of June 30, 2023, of the appropriations made by Item 4260-101-0001 of the Budget Act of 2023 (Chs. 12, 38, and 189, Stats. 2023) related to Provision 26 of that item are reappropriated and shall be available for encumbrance or expenditure until June 30, 2025, for the same programs and purposes.
SEC. 3.This act is a bill providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution, has been identified as related to the budget in the Budget Bill, and shall take effect immediately.
SECTION 1.It is the intent of the Legislature to enact statutory changes, relating to the Budget Act of 2023.It is the intent of the Legislature to enact statutory changes changes, relating to the Budget Act of 2023.
It is the intent of the Legislature to enact statutory changes relating to the Budget Act of 2023.
|
Date
|
Status
|
|---|---|
| Jun 29, 2024 | Chaptered by Secretary of State - Chapter 39, Statutes of 2024. |
| Jun 29, 2024 | Approved by the Governor. |
| Jun 27, 2024 | Enrolled and presented to the Governor at 4:30 p.m. |
| Jun 26, 2024 | Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 61. Noes 12.). |
| Jun 26, 2024 | In Assembly. Concurrence in Senate amendments pending. May be considered on or after June 28 pursuant to Assembly Rule 77. |
| Jun 26, 2024 | Assembly Rule 77 suspended. |
| Jun 26, 2024 | Assembly Rule 63 suspended. |
| Jun 26, 2024 | Read third time. Passed. Ordered to the Assembly. (Ayes 31. Noes 8. Page 4768.). |
| Jun 26, 2024 | Read second time. Ordered to third reading. |
| Jun 26, 2024 | From committee: Do pass. (Ayes 13. Noes 5.) (June 26). |
| Jun 22, 2024 | From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on B. & F.R. |
| Jun 20, 2024 | In committee: Hearing postponed by committee. |
| Jun 19, 2024 | In committee: Hearing postponed by committee. |
| Apr 12, 2023 | Referred to Com. on B. & F.R. |
| Mar 23, 2023 | In Senate. Read first time. To Com. on RLS. for assignment. |
| Mar 23, 2023 | Read third time. Passed. Ordered to the Senate. (Ayes 60. Noes 14. Page 858.) |
| Mar 21, 2023 | Read second time. Ordered to third reading. |
| Mar 20, 2023 | Withdrawn from committee. |
| Mar 20, 2023 | Ordered to second reading. |
| Mar 20, 2023 | Assembly Rule 96 suspended. (Ayes 61. Noes 17. Page 732.) |
| Feb 2, 2023 | Re-referred to Com. on BUDGET. |
| Feb 1, 2023 | From committee chair, with author's amendments: Amend, and re-refer to Com. on BUDGET. Read second time and amended. |
| Jan 26, 2023 | Referred to Com. on BUDGET. |
| Jan 10, 2023 | From printer. May be heard in committee February 9. |
| Jan 9, 2023 | Read first time. To print. |
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Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Jun 26, 2024 | AB 160 BUDGET Concurrence in Senate Amendments By GABRIEL | Assembly Floor |
Passed |
|
| Jun 26, 2024 | Assembly 3rd Reading AB160 BUDGET (Gabriel) By Wiener | Senate Floor |
Passed |
|
| Jun 26, 2024 | Do pass | Senate Standing Committee on Budget and Fiscal Review |
Passed |
|
| Mar 23, 2023 | AB 160 Budget Assembly Third Reading By TING | Assembly Floor |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
SENATE RULES COMMITTEE Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | AB 160 |
THIRD READING
Bill No: AB 160
Author: Committee on Budget
Amended: 6/22/24 in Senate
Vote: 27- Urgency
SENATE BUDGET & FISCAL REVIEW COMMITTEE: 13-5, 6/26/24
AYES: Wiener, Becker, Blakespear, Cortese, Durazo, Laird, Menjivar, Newman, Padilla, Roth, Skinner, Smallwood-Cuevas, Wahab
NOES: Niello, Dahle, Grove, Seyarto, Wilk
NO VOTE RECORDED: Eggman
ASSEMBLY FLOOR: Not relevant
SUBJECT: Medi-Cal managed care organization provider tax
SOURCE: Author
DIGEST:
This bill is a health trailer bill that assesses a tax on managed care organizations to: 1) support the General Fund shortfall and achieve a balanced budget; and 2) support Medi-Cal investments to ensure access, quality and equity.
ANALYSIS:
This bill modifies the tiered tax amounts for the tax imposed on managed care organizations authorized by AB 119 and modified by SB 136. Specifically, this bill:
- Increases, for the 2024 calendar year, the per enrollee tax for tier II of the Medi-Cal taxing tier, for Medi-Cal plans with annual enrollees between 1,250,001 and 4,000,000 from $205.00 to $274.00.
- Increases, for the 2025 calendar year, the per enrollee tax for tier II of the Medi-Cal taxing tier, for Medi-Cal plans with annual enrollees between 1,250,001 and 4,000,000 from $205.00 to $274.00.
- Increases, for the 2026 calendar year, the per enrollee tax for tier II of the Medi-Cal taxing tier, for Medi-Cal plans with annual enrollees between 1,250,001 and 4,000,000 from $205.00 to $274.00.
- Reappropriates General Fund expenditure authority, originally authorized in the 2023 Budget Act, until June 30, 2025, for DHCS to support the California Advancing and Innovating Medi-Cal (CalAIM) Providing Access and Transforming Health (PATH) program to build out Enhanced Care Management and Community Supports.
Background
Federal Medicaid regulations allow states to impose provider-related taxes on health care service providers as long as certain conditions are met. The revenue from these taxes may serve as the non-federal share of spending for health care services in a state’s Medicaid program, which allows the state to draw down additional federal funding for those services. State Medicaid programs may receive federal financial participation (FFP) for expenditures using health care-related taxes, as long as the taxes are broad-based, uniformly imposed, and contain no hold-harmless provisions.
AB 119 (Committee on Budget, Chapter 13, Statutes of 2023) reauthorized a tax on enrollment of managed care organizations licensed by the Department of Managed Health Care or contracted with the state’s Medi-Cal program. The tax is assessed per enrollee, and is tiered based on total enrollment in the plan during the base year, January 1, 2022 through December 31, 2022. There are two sets of taxing tiers for purposes of calculating each plan’s tax liability: one for Medi-Cal plans and one for other health plans. The amount of the per enrollee tax in each of the taxing tiers is adjusted during each calendar year, according to the provisions of AB 119. The tax was authorized effective April 1, 2023 through December 31, 2026.
SB 136 (Committee on Budget and Fiscal Review, Chapter 6, Statutes of 2024) increased the tax on the per enrollee tax for tier II of the Medi-Cal taxing tier to $205.00 for calendar years 2024, 2025, and 2026.
FISCAL EFFECT: Appropriation: Yes Fiscal Com.: Yes Local: No
According to the Senate Budget and Fiscal Review Committee,
1) Modification of the per enrollee tax would result in increased net General Fund benefit to the state of approximately $1.77 billion in 2024-25, $1.92 billion in 2025-26, and $1.44 billion in 2026-27.
2) This bill also reappropriates General Fund expenditure authority, originally authorized in the 2023 Budget Act, until June 30, 2025, for DHCS to support the California Advancing and Innovating Medi-Cal (CalAIM) Providing Access and Transforming Health (PATH) program to build out Enhanced Care Management and Community Supports.
FISCAL EFFECT: Appropriation: Yes Fiscal Com.: Yes Local: No
SUPPORT: (Verified 06/21/24)
None received
OPPOSITION: (Verified 06/21/24)
None received
Prepared by: Scott Ogus / B. & F.R. / (916) 651-4103
6/26/24 13:51:32
**** END ****
CONCURRENCE IN SENATE AMENDMENTS
CSA1 Bill Id:AB 160
Author:(Committee on Budget)
As Amended Ver:June 22, 2024
2/3 vote. Budget Bill Appropriation Takes Effect Immediately
SUMMARY
As part of the 2024 Budget Package, expands the Managed Care Organizational tax per Medi-Cal enrollees in health plans that have between 1.25 million and 4 million total enrollees, effective 2024-2026.
Senate Amendments
This bill also reappropriates any unspent funds provided in the 2023 Budget Act for the Providing Access and Transforming Health (PATH) Capacity and Infrastructure Transition, Expansion, and Development (CITED) Initiative. According to the Department of Finance, clinics eligible for these funds have been identified by the Department of Health Care Services, but the department will not be able to encumber the funds before the fiscal year ends.
COMMENTS
This bill expands the Managed Care Organization tax to allow the State to collection additional revenue to offset state health care costs. The existing tax was renewed as part of the 2023 budget package in AB 119 (Budget) Chapter 119, Statutes of 2023 and then further expanded earlier this year as a budget "early action" item in SB 136 (Budget and Fiscal Review) Chapter 6, Statutes of 2024. California is one of several states that uses a Managed Care Organization tax as part of its federal revenue claiming process.
The additional revenue generated from this tax offsets existing state health care costs by $689.9 million in 2024-25, $950 million in 2025-26, and $1.3 billion in 2026-27.
According to the Author
This bill enacts an essential budget solution that is key to the 2024 budget agreement.
Arguments in Support
None on file.
Arguments in Opposition
None on file.
FISCAL COMMENTS
This bill generates special fund and federal revenues which offsets state health care costs. The June 2024 budget package assumes General Fund savings of $689.9 million in 2024-25, $950 million in 2025-26, and $1.3 billion in 2026-27 from this measure.
VOTES:
ASSEMBLY FLOOR: 60-14-6
YES: Addis, Aguiar-Curry, Alvarez, Arambula, Bains, Bauer-Kahan, Bennett, Berman, Boerner Horvath, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Connolly, Mike Fong, Friedman, Gabriel, Garcia, Gipson, Grayson, Haney, Hart, Holden, Irwin, Jackson, Jones- Sawyer, Kalra, Lee, Low, Lowenthal, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Ortega, Pacheco, Papan, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Reyes, Luz Rivas, Robert Rivas, Rodriguez, Blanca Rubio, Santiago, Schiavo, Soria, Ting, Valencia, Villapudua, Ward, Weber, Wicks, Wilson, Wood, Zbur, Rendon
NO: Alanis, Megan Dahle, Davies, Dixon, Essayli, Flora, Vince Fong, Gallagher, Hoover, Lackey, Jim Patterson, Joe Patterson, Sanchez, Ta
ABS, ABST OR NV: Cervantes, Chen, Maienschein, Mathis, Waldron, Wallis
UPDATED
VERSION: June 22, 2024
CONSULTANT: Christian Griffith / BUDGET / (916) 319-2099 FN: 0003622
SENATE COMMITTEE ON BUDGET AND FISCAL REVIEW
Senator Scott Wiener, Chair
2023 - 2024 Regular
Bill No: AB 160 Hearing Date: June 26, 2024
Author: | |||
Version: | June 22, 2024 Amended | ||
Urgency: | No | Fiscal: | Yes |
Consultant: | Scott Ogus | ||
Subject: Medi-Cal managed care organization provider tax
Summary:
This bill is a health trailer bill that assesses a tax on managed care organizations to: 1) support the General Fund shortfall and achieve a balanced budget; and 2) support Medi-Cal investments to ensure access, quality and equity.
Background:
Federal Medicaid regulations allow states to impose provider-related taxes on health care service providers as long as certain conditions are met. The revenue from these taxes may serve as the non-federal share of spending for health care services in a state’s Medicaid program, which allows the state to draw down additional federal funding for those services. State Medicaid programs may receive federal financial participation (FFP) for expenditures using health care-related taxes, as long as the taxes are broad-based, uniformly imposed, and contain no hold-harmless provisions.
AB 119 (Committee on Budget), Chapter 13, Statutes of 2023, reauthorized a tax on enrollment of managed care organizations licensed by the Department of Managed Health Care or contracted with the state’s Medi-Cal program. The tax is assessed per enrollee, and is tiered based on total enrollment in the plan during the base year, January 1, 2022 through December 31, 2022. There are two sets of taxing tiers for purposes of calculating each plan’s tax liability: one for Medi-Cal plans and one for other health plans. The amount of the per enrollee tax in each of the taxing tiers is adjusted during each calendar year, according to the provisions of AB 119. The tax was authorized effective April 1, 2023 through December 31, 2026.
SB 136 (Committee on Budget and Fiscal Review), Chapter 6, Statutes of 2024, increased the tax on the per enrollee tax for tier II of the Medi-Cal taxing tier to $205.00 for calendar years 2024, 2025, and 2026.
Proposed Law:
This bill would modify the tiered tax amounts for the tax imposed on managed care organizations authorized by AB 119 and modified by SB 136. Specifically, the bill would:
- For the 2024 calendar year, increase the per enrollee tax for tier II of the Medi-Cal taxing tier, for Medi-Cal plans with annual enrollees between 1,250,001 and 4,000,000 from $205.00 to $274.00.
- For the 2025 calendar year, increase the per enrollee tax for tier II of the Medi-Cal taxing tier, for Medi-Cal plans with annual enrollees between 1,250,001 and 4,000,000 from $205.00 to $274.00.
- For the 2026 calendar year, increase the per enrollee tax for tier II of the Medi-Cal taxing tier, for Medi-Cal plans with annual enrollees between 1,250,001 and 4,000,000 from $205.00 to $274.00.
- Reappropriate General Fund expenditure authority, originally authorized in the 2023 Budget Act, until June 30, 2025, for DHCS to support the California Advancing and Innovating Medi-Cal (CalAIM) Providing Access and Transforming Health (PATH) program to build out Enhanced Care Management and Community Supports.
Fiscal Effect:
- 1) Modification of the per enrollee tax would result in increased net General Fund benefit to the state of approximately $1.77 billion in 2024-25, $1.92 billion in 2025-26, and $1.44 billion in 2026-27.
2) This bill also reappropriates General Fund expenditure authority, originally authorized in the 2023 Budget Act, until June 30, 2025, for DHCS to support the California Advancing and Innovating Medi-Cal (CalAIM) Providing Access and Transforming Health (PATH) program to build out Enhanced Care Management and Community Supports.
Support:
None on file.
Opposed:
None on file.
-- END --
ASSEMBLY THIRD READING
ATR Bill Id:AB 160
Author:(Committee on Budget)
As Amended Ver:February 1, 2023
Majority vote. Budget Bill Appropriation Takes Effect Immediately
SUMMARY
This bill expresses the intent of the Legislature to enact statutory changes relating to the Budget Act of 2023.
Major Provisions
COMMENTS
According to the Author
Arguments in Support
Arguments in Opposition
FISCAL COMMENTS
VOTES
UPDATED
VERSION: February 1, 2023
CONSULTANT: Christian Griffith / BUDGET / (916) 319-2099 FN: 0000094
Discussed in Hearing
View Older Hearings
Bill Author
Bill Co-Author(s):