2011 California Code
Penal Code
PART 3. OF IMPRISONMENT AND THE DEATH PENALTY [2000 - 10007]
ARTICLE 1. Miscellaneous Powers and Duties of Department and Director of Corrections
Section 2065

(a) The Department of Corrections and Rehabilitation shall complete all of the tasks associated with inmates granted medical parole pursuant to Section 3550 that are specified in this section. Subdivisions (c) and (d) shall apply only to the period of time that inmates are on medical parole.

(b) The department shall seek to enter into memoranda of understanding with the Social Security Administration and the State Department of Health Care Services, in addition to other federal, state, or county entities necessary to facilitate prerelease agreements to help inmates initiate benefits claims.

(c) This subdivision shall be implemented in a manner that is consistent with federal Medicaid law and regulations. The Director of Health Care Services shall seek any necessary federal approvals for the implementation of this subdivision. Claiming of federal Medicaid funds shall be implemented only to the extent that federal approval, if necessary, is obtained. If an inmate is granted medical parole and found to be eligible for Medi-Cal, all of the following shall apply:

(1) The hospital shall first bill Medi-Cal to obtain any available reimbursement.

(2) Upon providing an acceptable invoice, the department shall reimburse county public hospitals on a quarterly basis for all of the following:

(A) The nonfederal share of Medi-Cal costs incurred by the county for individuals who have been granted medical parole.

(B) An amount equal to the county costs for providing health care services that are not allowable under Medi-Cal but are required by the state to be furnished to eligible individuals who have been granted medical parole, including public guardianship health care services.

(3) The department shall directly provide, or provide reimbursement on a quarterly basis, after invoicing, for allowable costs that cannot be claimed as Medi-Cal expenditures under targeted case management and the nonfederal share of services associated with public guardianship that can be claimed as Medi-Cal expenditures.

(4) The department may provide supplemental reimbursements to providers amounting to a total reimbursement that is allowable pursuant to Section 5023.5. These supplemental reimbursements may only be paid to the extent they comply with federal and state law and regulations. The Director of Health Care Services may work with the department to modify these supplemental reimbursements to the extent necessary to comply with federal and state law and regulations.

(5) The department and the State Department of Health Care Services shall work together to do all of the following:

(A) Maximize federal financial participation for service costs, administrative costs, and targeted case management costs incurred pursuant to this section.

(B) Determine whether medical parolees shall be exempt from mandatory enrollment in managed health care, including county organized health plans, and determine the proper prior authorization process for individuals who have been granted medical parole.

(6) The department may submit retroactive Medi-Cal claims to the State Department of Health Care Services for allowable certified public expenditures that have been reimbursed by the department. The department shall work with the Director of Health Care Services to ensure that any process established regarding the submission of retroactive claims shall be in compliance with state and federal law and regulations.

(d) If an inmate is granted medical parole and found to be ineligible for Medi-Cal, all of the following shall apply:

(1) The department shall consider the income and assets of a medical parolee to determine whether the individual has the ability to pay for the cost of his or her medical care.

(2) If the individual is unable to pay the cost of their medical care, the department shall establish contracts with appropriate medical providers and pay costs that are allowable pursuant to Section 5023.5.

(3) The department shall retain the responsibility to perform utilization review and cost management functions that it currently performs under existing contracts with health care facilities.

(4) The department shall directly provide, or provide reimbursement for, services associated with public guardianship.

(e) Notwithstanding the rulemaking provisions of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 2 of the Government Code, the department and the State Department of Health Care Services may implement this section by means of all-facility letters, all-county letters, or similar instructions, in addition to adopting regulations, as necessary.

(Added by Stats. 2010, Ch. 405, Sec. 1. Effective January 1, 2011.)