AB 1494 Summary

• Transitions Healthy Families Program enrollees to Medi-Cal beginning January 1, 2013, in four phases based on plan type and county managed care availability.

• Expands Medi-Cal eligibility to optional targeted low-income children ages 6-18 with family incomes up to 200 percent of federal poverty level, with premiums imposed only for families above 150 percent of poverty level.

• Modifies clinical laboratory service reimbursement rates by reducing payments up to 10 percent until federal approval of a new rate methodology based on lowest amounts paid by other payers and state Medicaid programs.

• Requires county eligibility workers to perform Medi-Cal determinations for transitioned enrollees with specific performance standards and reporting requirements, and imposes state-mandated local program costs on counties.

• Appropriates $400,000 from the Managed Care Fund to the Department of Managed Health Care for transition call center and health plan coordination activities.