BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     AB 344


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          Date of Hearing:  April 29, 2015


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                                 Jimmy Gomez, Chair


          AB  
          344 (Chávez) - As Introduced February 13, 2015


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          Urgency:  No  State Mandated Local Program:  NoReimbursable:  No


          SUMMARY:


          This bill, as proposed to be amended, provides that if a payment  
          is made to a non-designated public hospital (NDPH), as  
          specified, the payment is not be subject to a peer group  
          inpatient reimbursement limitation established by the Department  








                                                                     AB 344


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          of Health Care Services (DHCS), unless otherwise required under  
          federal law.


          FISCAL EFFECT:


          Negligible state fiscal effect. 


          COMMENTS:


          1)Purpose. According to the sponsor, the District Hospital  
            Leadership Forum, this bill addresses a technical issue  
            related to the Peer Grouping Inpatient Reimbursement  
            Limitation (PIRL) that non-contract district/municipal  
            hospitals (otherwise known as NDPHs) were subject to prior to  
            January 1, 2014.  The PIRL is a reimbursement limitation that  
            in certain circumstances could restrict Medi-Cal payment to  
            hospitals.  The sponsor states that this bill seeks to prevent  
            application of an existing statutory or regulatory rate  
            limitation on a NDPH with the conversion to a new Medi-Cal  
            inpatient reimbursement methodology called Diagnosis-Related  
            Group (DRG).



          2)Necessity of this bill? As the reimbursement methodology for  
            NDPHs has recently changed, this bill does not appear  
            necessary. The PIRL applied to the prior reimbursement  
            methodology.  DHCS does not plan to apply this to the new  
            methodology.  The PIRL is defined in regulations, not in  
            statute, so a statutory clarification does not appear  
            necessary when this could be clarified in regulation.  The  
            transition to DRG payments occurred July 1, 2014 and the PIRL  
            does not appear to be an issue. 
          
          3)Amendments are technical and correct a code reference.








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          Analysis Prepared by:Lisa Murawski / APPR. / (916)  
          319-2081