JurisdictionCaliforniaCode WICWelfare and Institutions Code - WIC
Div. 9.DIVISION 9. PUBLIC SOCIAL SERVICES
Part 3.PART 3. AID AND MEDICAL ASSISTANCE
Ch. 7.CHAPTER 7. Basic Health Care
Art. 5.2.ARTICLE 5.2. Medi-Cal Hospital Care/Uninsured Hospital Care Demonstration Project Act
This text of California § 14166.23. (14166.23. (Amended by Stats. 2009, 4th Ex. Sess., Ch. 5, Sec. 49.)) is published on Counsel Stack Legal Research, covering California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
(a)For purposes of this section, “distressed hospitals” are hospitals that participate in selective providers contracting under Article 2.6 (commencing with Section 14081) and that meet all of the following requirements, as determined by the California Medical Assistance Commission in its discretion:
(1)The hospital serves a substantial volume of Medi-Cal patients measured either as a percentage of the hospital’s overall
volume or by the total volume of Medi-Cal services furnished by the hospital.
(2)The hospital is a critical component of the Medi-Cal program’s health care delivery system, such that the Medi-Cal health care delivery system would be significantly disrupted if the hospital reduced its Medi-Cal services or no longer participated in the Medi-Cal program.
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(a)
For purposes of this section, “distressed hospitals” are hospitals that participate in selective providers contracting under Article 2.6 (commencing with Section 14081) and that meet all of the following requirements, as determined by the California Medical Assistance Commission in its discretion:
(1)
The hospital serves a substantial volume of Medi-Cal patients measured either as a percentage of the hospital’s overall
volume or by the total volume of Medi-Cal services furnished by the hospital.
(2)
The hospital is a critical component of the Medi-Cal program’s health care delivery system, such that the Medi-Cal health care delivery system would be significantly disrupted if the hospital reduced its Medi-Cal services or no longer participated in the Medi-Cal program.
(3)
The hospital is facing a significant financial hardship that may impair its ability to continue its range of services for the Medi-Cal program.
(b)
The Distressed Hospital Fund is hereby created in the State Treasury.
(c)
Notwithstanding Section 13340 of the Government Code, the fund shall be continuously appropriated to the department for the purposes specified in this section.
(d)
Except as otherwise limited by this section, the fund shall consist of all of the following:
(1)
The amounts transferred to the fund pursuant to subdivision (e).
(2)
Any additional amounts appropriated to the fund by the Legislature.
(3)
Any interest that accrues on amounts in the fund.
(e)
The following amounts shall be transferred to the fund from the prior supplemental funds at the beginning of each project year.
(1)
Twenty percent of the amount in the prior supplemental funds on the effective date of this article, less any and all payments for services rendered prior to July 1, 2005, but paid after July 1, 2005.
(2)
Interest that accrued on the prior supplemental funds during the prior project year.
(3)
Notwithstanding paragraph (1), solely for the 2009–10 fiscal year, the amount of funds transferred shall be reduced by six million one hundred and ninety-one thousand dollars ($6,191,000). The funds generated from this reduction shall be transferred to the General Fund.
(f)
No distributions, payments, transfers, or disbursements shall be made from the prior supplemental funds except as set forth in this section.
(g)
Moneys in the fund shall be used as the source for the nonfederal share of payments to hospitals under this section.
(h)
Except as otherwise provided in subdivision (j), moneys shall be
applied to obtain federal financial participation to the extent available in accordance with customary Medi-Cal accounting procedures for purposes of payments under this section. Distributions from the fund shall be supplemental to any other Medi-Cal reimbursement received by the hospitals, including amounts that hospitals receive under the selective provider contracting program, and shall not affect provider rates paid under the selective provider contracting program.
(i)
Subject to subdivision (j), all amounts that are in the fund shall be available for negotiation by the California Medical Assistance Commission, along with corresponding federal financial participation, for additional payments to distressed hospitals. These amounts shall be paid under contracts entered into by the department and negotiated by the California Medical Assistance Commission pursuant to Article 2.6 (commencing with Section 14081), provided that any amounts payable
to a designated public hospital shall be paid in the form of a direct grant of state general funds pursuant to a contract negotiated by the California Medical Assistance Commission. The commission shall not consider the lack of federal financial participation in direct grants to designated public hospitals in determining which hospital may receive funding under this section.
(j)
After April 1, 2007, and each April 1 thereafter, in the event that funding under this article is insufficient to meet the adjusted aggregate baseline funding amounts for a particular project year, as determined in subdivision (d) of Section 14166.5, and in Sections 14166.13 and 14166.18, funds under this section shall first be available for use under contracts negotiated by the California Medical Assistance Commission for hospitals contracting under the selective provider contracting program under Article 2.6 (commencing with Section 14081) in an effort to address the
insufficiency, to the extent funds under this section are available on or after April 1 for the particular project year.
(k)
Any funds remaining in the fund at the end of a fiscal year shall be carried forward for use in the following fiscal year.