Medi-Cal: graduate medical education payments.

Plain English Breakdown

The official source does not specify if the Director of Health Care Services has explicit authority to modify requirements beyond meeting federal requirements or maximizing federal financial participation.

Medi-Cal: Graduate Medical Education Payments for Public Hospitals

This law requires Medi-Cal payments to be made to district and municipal public hospitals (DMPHs) and their affiliated government entities, similar to how payments are made to designated public hospitals (DPHs), in recognition of the costs associated with graduate medical education programs.

What This Bill Does

• Requires Medi-Cal payments for DMPHs and their affiliates to cover GME costs.
• Establishes a new fund called the DMPH GME Special Fund to support these payments.
• Allows the department to seek federal approval for different forms of GME payments.
• Ensures that no state General Fund money is used for nonfederal shares of payments.

Who It Names or Affects

• District and municipal public hospitals (DMPHs) and their affiliated government entities
• The State Department of Health Care Services

Terms To Know

Medi-Cal

A health care program for low-income individuals in California, funded partly by federal Medicaid funds.

Graduate Medical Education (GME)

Training programs for doctors after medical school that are often part of teaching hospitals.

Limits and Unknowns

• The law requires the department to seek necessary federal approvals before making these payments.
• It is not clear how much funding will be needed or available from DMPHs and their affiliates.
• The exact details of GME payment methods for DMPHs are yet to be determined.

Official Summary Text

SB 246, Grove.
Medi-Cal: graduate medical education payments.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Existing law requires the department, subject to any necessary federal approvals and the availability of federal financial participation, to make Medi-Cal payments to designated public hospitals (DPHs) and their affiliated government entities, as defined, in recognition of the Medi-Cal managed care share of graduate medical education (GME) costs. Existing law requires that the payments consist of direct and indirect GME payments made in recognition and support of the direct costs incurred in the operation of GME programs and the increased operating and patient
care costs associated with teaching programs, respectively.
Under existing law, the nonfederal share of these payments consists of voluntary intergovernmental transfers (IGTs) of funds provided by DPHs or their affiliated government entities, or other eligible public entities, as specified. Under existing law, the continuously appropriated DPH GME Special Fund is established for these purposes.
This bill would require the department, subject to any necessary federal approvals and the availability of federal financial participation, to make additional Medi-Cal payments to district and municipal public hospitals (DMPHs), defined as nondesignated public hospitals, and to their affiliated government entities, in recognition of the Medi-Cal managed care share of GME costs. Under the bill, these payments would be made in a manner consistent with the methodology for GME payments to DPHs and their affiliated government entities
and would consist of the above-described direct and indirect GME payment components. The bill would authorize the department to seek federal approval for other forms of GME payments to DMPHs and their affiliated government entities, as specified.
Under the bill, the nonfederal share of payments under these provisions would consist of voluntary IGTs of funds provided by DMPHs or their affiliated government entities, or other eligible public entities, to the extent permitted under certain federal regulations and other applicable federal Medicaid laws, and with no state General Fund moneys being used to fund the nonfederal share of payments. The bill would establish the DMPH GME Special Fund, with moneys deposited being continuously appropriated to the department for purposes of these provisions.
The bill would require the department to seek any necessary federal approvals for GME payments, effective no sooner than January 1,
2026. The bill would authorize the Director of Health Care Services to modify the requirements set forth in these provisions to the extent necessary to meet federal requirements or to maximize federal financial participation, as specified.

Current Bill Text

Download Bill PDF