SB 1124 - California’s Medi-Cal Recovery System
SB 1124 (Hernandez) will be heard in the Senate Appropriations Committee on April 28, 2014. SB 1124 includes the most important Medi-Cal Recovery changes since 1993, when the current law was passed via Governor Wilson’s budget proposal.
Responding to consumer concerns and consumer outrage at being forced to apply for Medi-Cal Expansion if their income is too low for Covered California; being forced to obtain coverage via a Medi-Cal managed care program; being denied information as to what the monthly capitated managed care rate might be; and then having their estates subject to Medi-Cal recovery because they are aged 55 or older, regardless of what health care services they use – SB 1124 addresses many of these concerns.
SB 1124 would eliminate most of the optional recovery provisions and allow thousands of older, low-income Medi-Cal beneficiaries to be relieved of the worry about losing their family homes. SB 1124:
Limits recovery for those 55+ to what is required by federal law – e.g. nursing facility, home and community based services and related hospital and prescription drug services – eliminates optional recovery.
Eliminates recovery from the estate of a surviving spouse of a deceased Medi-Cal beneficiary.
Restricts recovery amount to benefits paid for services actually received or capitated monthly rate, whichever is less.
Requires DHCS to provide claims detail information free of charge to Medi-Cal beneficiaries or their representatives via phone, internet, mail, in person or other means, and requires the Department to post information on their web site the methods by which a consumer or his/her representative can request claims detail information.
The Appropriations hearing on SB 1124 is set for April 28 in the Senate Appropriations Committee – send letters of support to Senator Kevin de Leon, Chair, Senate Appropriations Committee via FAX: (916) 327-8817.
(The following information was reprinted with the permission of California Advocates of Nursing Home Reform, a co-sponsor of the bill).
Update - This Bill was vetoed by Governor Brown.