Bill > AB499

This bill modifies the Robert F. Kennedy Farm Workers Medical Plan by adjusting the state reimbursement mechanism for high-cost medical claims. Currently, the State Department of Health Care Services reimburses the nonprofit medical plan for claim payments over $70,000 per single episode of care, up to $3 million annually, with the program set to expire on January 1, 2031. The bill lowers the threshold for reimbursement from $70,000 to $50,000, meaning the state will now cover claim payments that exceed $50,000 for a single episode of care for an eligible employee or dependent, still maintaining the $3 million annual cap. To receive reimbursement, the medical plan must submit verified claims data annually to the department, covering the period from September 1 to August 31. The department will then analyze the data and reimburse the plan within 60 days, ensuring that farm workers have access to financial support for expensive medical treatments. The bill keeps the existing sunset date of January 1, 2031, preserving the temporary nature of the reimbursement program.

Budget and Finance, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260AB499