Bills We’re Watching: 2015 Legislation

The California Legislature has begun hearing bills that are up for consideration this term. Below is a list of key bills related to California’s school-based Medicaid billing programs, Medi-Cal Administrative Activities (MAA) and Local Educational Agency (LEA) Medi-Cal Billing.


SB 123 – Superintendent of Public Instruction: Report: School-Based Medi-Cal Administrative Activities Program

Impacts: School-Based MAA Program

Introduced by Senator Liu, Senate Bill (SB) No. 123 relates to the internal state audit that is currently evaluating several aspects of the California Department of Health Care Services’ (DHCS) administration of the school-based MAA program. This bill would require the Superintendent of Public Instruction to prepare specific recommendations to be shared with the state legislature in 2016 based on the audit findings which are expected sometime this year.

Recommendations would include: the appropriate state agency to administer the MAA program (for example, moving oversight and administration from DHCS to the California Department of Education (CDE), the best structure of the program and role of various supporting entities (including an evaluation of regional LECs and LGAs), and more which are highlighted in the bill text.

Read SB 123…

Read details of the State Auditor Request…

SB 276 – Medi-Cal: Local Educational Agencies

Impacts: LEA Medi-Cal Billing Program

Introduced by Senator Wolk, SB 276 touches on both the free care and Third Party Liability (TPL) billing issues for schools. This bill would address the recent free care win by requiring California’s DHCS to submit claims for all eligible health services provided to Medi-Cal students, regardless of whether an Individualized Education Plan (IEP) is in place.

For those students who have both Medi-Cal and Other Health Coverage (OHC), this bill would require legally liable third parties to issue denial notices to schools that would in turn allow the school district to bill that service to Medi-Cal. This provision seeks to address the TPL barrier faced by many schools when OHC agencies refuse to issue payment or an appropriate denial, leaving the district unable to bill Medi-Cal for the service.

Read SB 276…

SB 118 – School-Based Health and Education Partnership Program

Impacts: School Based Health Centers

Introduced by Senator Liu, SB 118 would provide funding for the expansion and renovation of school based health centers. This bill would also create a new Population Health grant to fund interventions to implement population health outcomes and target specific health or education risk factors in amounts between $50,000 and $125,000 for a three year funding period.

Read SB 118…