CA AB1327

Deletes the 80% Medicare standard from Medi-Cal reimbursement rate calculations for clinical laboratory services, allowing rates to be based on comparable payment amounts from other payers and state Medicaid programs instead.

Requires clinical laboratory providers to submit confidential data reports showing the lowest amounts other payers are paying for similar services, with initial data for 2018 calendar year and then every third year thereafter.

Establishes reimbursement rates as the lowest of: amount billed, charge to general public, or average of lowest amounts other payers are paying for similar services, excluding significant deviations in cost or volume factors.

Allows the Department of Health Care Services to contract with a vendor to collect payment data, analyze information, and calculate proposed reimbursement rates based on submissions from providers.

Effective July 1, 2020, and every third year thereafter, with implementation requiring federal Medicaid approval and compliance with federal law.