Ab 4

     

Abstract

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. Federal law prohibits payment khổng lồ a state for medical assistance furnished to lớn an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under màu sắc of law.Existing law requires individuals under 19 years of age enrolled in restricted-scope Medi-Cal at the time the Director of Health Care Services makes a determination that systems have been programmed for implementation of these provisions to be enrolled in the full scope of Medi-Cal benefits, if otherwise eligible, pursuant lớn an eligibility và enrollment plan, which includes outreach strategies. Existing law makes the effective date of enrollment for those individuals the same day that systems are operational lớn begin processing new applications pursuant khổng lồ the director"s determination, và requires the department to lớn seek any necessary federal approvals khổng lồ obtain federal financial participation for purposes of implementing the requirements. Existing law requires that benefits for services under these provisions be provided with state-only funds only if federal financial participation is not available for those services.


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Existing law requires the department, until the director makes the above-described determination, lớn provide monthly updates lớn specified legislative committees on the status of the implementation of these provisions.This bill would extend eligibility for full-scope Medi-Cal benefits to lớn individuals of all ages, if otherwise eligible for those benefits, but for their immigration status, và would delete provisions delaying eligibility and enrollment until the director makes the determination described above. The bill would require the department to provide, indefinitely, the above-described monthly updates to the legislative committees. The bill would expand the requirements of the eligibility và enrollment plan, such as ensuring that an individual maintains their primary care provider without disruption, as specified. The bill would require the department to collaborate with the counties & designated public hospitals to maximize federal financial participation và to work with designated public hospitals to lớn mitigate any financial losses related to the implementation of these requirements. The bill would condition the implementation of its provisions on an appropriation by the Legislature in the annual Budget Act or other measure for that purpose.Because counties are required to make Medi-Cal eligibility determinations và this bill would expand Medi-Cal eligibility, the bill would impose a state-mandated local program.The California Constitution requires the state khổng lồ reimburse local agencies & school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to lớn the statutory provisions noted above.