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April 12, 2010
Honorable Brian Nestande
California State Assembly
Capitol Building, Room 4153
Sacramento, CA 95814
RE: AB 2127 (Nestande)
Dear Assembly Member Nestande:
Disability Rights California, a non-profit advocacy organization mandated to advance the human and legal rights of people with disabilities, opposes AB 2127. This bill is set to be heard in the Assembly Health Committee on April 13, 2010.
Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which basic health care services, including nonemergency medical transportation services, are provided to qualified low-income persons.
AB 2127 would require DHCS to establish a 2-year pilot program in at least 3 consenting counties to evaluate a nonemergency medical transportation model. The state would contract with a broker to manage the provision of nonemergency medical transportation services to Medi-Cal beneficiaries. DHCS would monitor the pilot program, evaluate the outcomes and savings, and provide the fiscal committees of the Legislature with a report on its findings and recommendations. If the department determines the pilot program to be cost effective, the bill would authorize the department to implement the program statewide at any time and continue operation of the program indefinitely.
Medical transportation includes emergency and non-emergency services. Currently, a beneficiary seeking Medi-Cal funded non-emergency medical transportation must submit a Treatment Authorization Request (TAR) through a provider to the Medi-Cal Field Office. Medi-Cal staff review the TAR for medical necessity and either approve or disapprove the request.
AB 2127 would replace the Medi-Cal Field Office review process with a private broker under state contract. The broker would have the power to manage the administrative tasks including screening transportation requests to managing the full scope of the service.
AB 2127 would put financially motivated brokers in charge of weather or not a person would be able to get medical treatment. When financial motivation and the possibility of large ongoing contracts is inserted into the decision making process, the pressure to create cost savings would be immense. The end result would undoubtedly cause some treatment requests to be unreasonably denied and create additional health issues for people with disabilities who use these services.
For these reasons, we oppose this bill. Please contact me if you have any questions about our position on this bill.
Disability Rights California
CC: Honorable Members of the Assembly Health Committee
CC: Honorable Bill Monning, Chair, Assembly Health Committee
CC: Marjorie Swartz, Consultant, Assembly Health Committee
CC: Madhavi Knickerbocker, Legislative Director, Office of Assembly Member Nestande