CA Welf & Inst Code Section 14199.55

(a)

For each fiscal year, the Medi-Cal taxing tiers shall be as follows:

(1)

Medi-Cal taxing tier I shall consist of all countable Medi-Cal enrollees in a health plan from zero to 2,000,000, inclusive.

(2)

Medi-Cal taxing tier II shall consist of all countable Medi-Cal enrollees in a health plan from 2,000,001 to 4,000,000, inclusive.

(3)

Medi-Cal taxing tier III shall consist of all countable Medi-Cal enrollees in a health plan greater than 4,000,000.

(b)

For each fiscal year, the other taxing tiers shall be as follows:

(1)

Other taxing tier I shall consist of all countable other enrollees in a health plan from zero to 4,000,000, inclusive.

(2)

Other taxing tier II shall consist of all countable other enrollees in a health plan from 4,000,001 to 8,000,000, inclusive.

(3)

Other taxing tier III shall consist of all countable other enrollees in a health plan greater than 8,000,000.

(c)

For each fiscal year, the AHCSP taxing tier shall consist of all countable AHCSP enrollees in a health plan from zero to 8,000,000, inclusive.

(d)

For the 2016–17 fiscal year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:

(1)

The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be forty dollars ($40).

(2)

The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be nineteen dollars ($19).

(3)

The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be one dollar ($1).

(e)

For the 2016–17 fiscal year, the other per enrollee tax amount for each other taxing tier shall be as follows:

(1)

The other per enrollee tax for the other taxing tier I shall be seven dollars and fifty cents ($7.50).

(2)

The other per enrollee tax for the other taxing tier II shall be two dollars and fifty cents ($2.50).

(3)

The other per enrollee tax for the other taxing tier III shall be one dollar ($1).

(f)

For the 2016–17 fiscal year, the AHCSP per enrollee tax for the AHCSP taxing tier shall be two dollars ($2).

(g)

For the 2017–18 fiscal year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:

(1)

The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be forty-two dollars and fifty cents ($42.50).

(2)

The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be twenty dollars and twenty-five cents ($20.25).

(3)

The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be one dollar ($1).

(h)

For the 2017–18 fiscal year, the other per enrollee tax amount for each other taxing tier shall be as follows:

(1)

The other per enrollee tax for the other taxing tier I shall be eight dollars ($8).

(2)

The other per enrollee tax for the other taxing tier II shall be three dollars ($3).

(3)

The other per enrollee tax for the other taxing tier III shall be one dollar ($1).

(i)

For the 2017–18 fiscal year, the AHCSP per enrollee tax for the AHCSP taxing tier shall be two dollars and twenty-five cents ($2.25).

(j)

For the 2018–19 fiscal year, the Medi-Cal per enrollee tax amount for each Medi-Cal taxing tier shall be as follows:

(1)

The Medi-Cal per enrollee tax for Medi-Cal taxing tier I shall be forty-five dollars ($45).

(2)

The Medi-Cal per enrollee tax for Medi-Cal taxing tier II shall be twenty-one dollars ($21).

(3)

The Medi-Cal per enrollee tax for Medi-Cal taxing tier III shall be one dollar ($1).

(k)

For the 2018–19 fiscal year, the other per enrollee tax amount for each other taxing tier shall be as follows:

(1)

The other per enrollee tax for the other taxing tier I shall be eight dollars and fifty cents ($8.50).

(2)

The other per enrollee tax for the other taxing tier II shall be three dollars and fifty cents ($3.50).

(3)

The other per enrollee tax for the other taxing tier III shall be one dollar ($1).

(l)

For the 2018–19 fiscal year, the AHCSP per enrollee tax for the AHCSP taxing tier shall be two dollars and fifty cents ($2.50).

(m)

(1)The department may modify or make adjustments to any methodology, tax amount, taxing tier, or other similar provision specified in this article to the extent necessary to meet the requirements of federal law or regulations, obtain federal approval, or to ensure federal financial participation is available provided the modification or adjustment does not otherwise conflict with the purposes of this article. Any modification or adjustment that would result in more than the following aggregate tax amounts for the other enrollees and AHCSP enrollees, combined, shall be considered to conflict with the purposes of this article:

(A)

Two hundred sixty-six million dollars ($266,000,000) in the 2016–17 fiscal year.

(B)

Two hundred eighty-seven million dollars ($287,000,000) in the 2017–18 fiscal year.

(C)

Three hundred nine million dollars ($309,000,000) in the 2018–19 fiscal year.

(2)

In implementing any modification or adjustment, the department may only make an adjustment that would result in lowering the amounts in subparagraph (A), (B), or (C) of paragraph (1). Nothing in this subdivision shall limit the authority of the department to make an adjustment that does not impact the amounts in subparagraph (A), (B), or (C) of paragraph (1).

(3)

If the department identifies that a modification or adjustment may be necessary in accordance with paragraph (1), the department shall consult with affected health plans, to the extent practicable, to implement that modification or adjustment.

(4)

In the event of a modification or adjustment made pursuant to this subdivision, the department shall notify affected health plans, the Joint Legislative Budget Committee, the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days of that modification or adjustment.

(n)

The department shall request approval from the federal Centers for Medicare and Medicaid Services as is necessary to implement this article. In making that request, the department may seek, as it deems necessary, a request for waiver of the broad-based requirement, waiver of the uniformity requirement, or both, pursuant to Section 433.68(e)(1) and (2) of Title 42 of the Code of Federal Regulations, or a request for waiver of any other provision of federal law or regulation necessary to implement this article.

(o)

Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this article by means of provider bulletins, all-plan letters, or other similar instructions, without taking regulatory action. The department shall provide notification to the Joint Legislative Budget Committee and to the Senate Committees on Appropriations, Budget and Fiscal Review, and Health, and the Assembly Committees on Appropriations, Budget, and Health within 10 business days after the above-described action is taken.