1. Legislative Update 2016 Legislative Session
CCLA Annual Conference
Sacramento Public Policy Report
Arnold and Associates, Inc.
Kristian Foy
Michael Arnold

2. What We Will Cover Sacramento Environment Key Legislation for 2016
State Budget
Second Extraordinary Session on Health Care
Medi-Cal Reimbursement Issues
November Election
Outlook for 2017 Legislation

3. Sacramento Environment
2016 legislative year was the second year of the Session

5. Infrastructure for Tracking Legislation
Box in bill room
Bill tracking system
Daily committee hearing calendars
Legislative status reports

6. Legislative Status Report
Periodic listing of all bills being followed by CCLA.
Shows bill, author, summary, location, hearing date, etc.
Available to any CCLA member, anytime
Click on the bill number and it takes one to a copy of the bill, analyses, and other information.

7. CCLA Legislative Highlights

8. Key Bills for 2016

9. AB 1732 (Ting) Single-user Restrooms
Requires, commencing on March 1, 2017, businesses or places of public accommodation that offer a single-user toilet facility to be designated as an all-gender toilet facility.
The Governor signed the bill as Chapter 818, Statutes of 2016.

10. Repeal of Clinical Lab Licensure Law
AB 1774 (Bonilla)
Repeal of Clinical Lab Licensure Law
Existing law provides for the licensure, registration, and regulation of clinical laboratories and various clinical laboratory personnel by the State Department of Public Health. Under existing law the department inspects clinical laboratories and assesses a fee for licensure of those facilities.
This bill would repeal the laws requiring a clinical laboratory to be licensed, registered, or inspected by the department, including the licensing and registration fee.
Died in the Assembly Appropriations Committee

11. AB 2179 (Gipson) Hepatitis C Testing
Existing law authorizes an HIV counselor who receives specified training and works in specified counseling and testing sites to perform HIV, hepatitis C virus (HCV), or combined HIV/HCV tests, including performing skin punctures for purposes of withdrawing blood for purposes of these tests.
This bill authorizes a hepatitis C counselor, who meets specified requirements comparable to the requirements specified for an HIV counselor, to perform HCV tests in the manner described above with respect to an HIV counselor.
Vetoed by the Governor.
..”Department of Public Health works with local health agencies to train HIV counselors who test for both HIV and hepatitis C. National health guidelines recommend people at risk for either of these diseases be tested for both. As such, I believe the existing counselor classification is more protective of public health.”

12. SB 622 (Hernandez) Optometrist Scope of Practice
Proposed to amend ten sections of the Business and Professions Code to delete current requirements under the Optometry Practice Act that specify circumstances under which optometrists must refer patients to an ophthalmologist or a physician and surgeon.
Would have expanded the scope of practice of Optometrists, allowing them to become more involved in clinical laboratory issues.
Bill died during consideration in the Legislature.

13. 2016-2017 State Budget Proposition 25 is working – On Time Budget
Governor Advised Fiscal Restraint
Billions in deficit now in the past
Surplus going forward
The Governor pointed out that the economy has finished its 7th year of expansion, 2 years longer than the average recovery.
Budget increased Rainy Day Fund to $6.7 billion by June 2017.
2013

14. Two Extraordinary Sessions
Infrastructure
Health Care

15. Extraordinary Session on Health Care
In June of 2015, the Governor issued proclamations calling for two special extra-ordinary sessions of the Legislature. One on transportation and one on health care.
Managed Care Organization (MCO) Tax
Groups asked for funding to provide additional rate increases for providers of Medi-Cal and developmental disabilities services
Importantly, the proclamation stated that the legislation must “Establish mechanisms so that any additional rate increases expand access to services.”
Developmental disabilities providers were only ones to get a rate increase
Tobacco bills passed

16. Medi-Cal Reimbursement
2011 budget crisis
AB 97 10% cut in provider payments under Medi-Cal fee-for-service
80% of enrollees in Medi-Cal managed care
13.5 million in CA Medi-Cal program m

17. Medi-Cal Rates for Laboratory services 2012 – AB 1494
requires DHCS to produce a new rate development methodology with data submission
Methodology compares rates of other payers
Information on website:
Delayed implementation

18. Recoupments 1) July 1, 2012 – June 30, 2015 =
3 Retroactive Recoupments
1) July 1, 2012 – June 30, 2015 =
10% of total reimbursement
2) July 1, 2015 – February 1, 2016 =
difference between old and new rate per test
3) July 1, 2016 – November (??) =

19. CCLA joins lawsuit
Lawsuit challenges the application of the AB % reimbursement cut
Arguing that DHCS does not have the statutory authority to apply AB 97 after adoption of the AB 1494 new rate methodology
Hearing was on October 28th in Sacramento

20. November 8, 2016

21. 2016 Election is Key to Next Decade
Election of monumental importance in the state Assembly, where 16 of 80 members will be termed out.
Then, no members term out for the next three cycles=
Members elected in 2016 do not term out until 2028

22. 17 Propositions on Ballot
Prop 56 – Tobacco Tax Increase.
Dedicated to Medi-Cal program
Prop 55 – Taxes.
Extends the temporary personal income tax increases on higher incomes
Possibility for elimination of the AB 97 10% cut

23. November Election
Will the Democrats get a 2/3 majority in both houses???
Current Make-up
Senate: D=26; R=14
2/3 = 27
Assembly: D=52; R=28
2/3 = 54

24. Outlook for 2017
The new Legislative Session starts December 5, 2016.
Get to know your new Legislators! Invite them to your lab for a visit.

25. Lab Issues for 2017
Direct access testing for any test – possible legislation like Arizona
Rate Methodology implementation and recoupments
Problems in processing laboratory applications for Medi-Cal provider status—now that the moratorium has been lifted
Laboratory Field Services – oversight, fees, overcharges
Medi-Cal Frequency Limits—still an issue
Staffing requirements and standards
Licensure regulations and fees
PAMA implementation for Medicare