(a) In enacting this section, it is the intent of the Legislature that palliative care include, but not be limited to, all of the following:
(1) Specialized medical care and emotional and spiritual support for people with serious advanced illnesses.
(2) Relief of symptoms, pain, and stress of serious illness.
(3) Improvement of quality of life for both the patient and family.
(4) Appropriate care for any age and for any stage of serious illness, along with curative treatment.
(b) The department, in consultation with interested stakeholders, shall establish standards and provide technical assistance for Medi-Cal managed care plans to ensure delivery of palliative care services.
(c) Covered services shall include, but are not limited to, those types of services that are available through the Medi-Cal hospice benefit. These services shall include the following, regardless of whether these services are covered under the Medi-Cal hospice benefit:
(1) Hospice services that are provided at the same time that curative treatment is available, to the extent that the services are not duplicative.
(2) Hospice services provided to individuals whose conditions may result in death, regardless of the estimated length of the individual’s remaining period of life.
(3) Any other services that the department determines to be appropriate.
(d) The department, in consultation with interested stakeholders, shall establish guidance on the medical conditions and prognoses that render a beneficiary eligible for the palliative care services.
(e) Providers authorized to provide services shall include licensed hospice agencies and home health agencies licensed to provide hospice care that are contracted with Medi-Cal managed care plans to provide palliative care services.
(f) The department shall, to the extent practicable, ensure that the delivery of palliative care services under this section is provided in a manner that is cost neutral to the General Fund on an ongoing basis.
(g) 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 the provisions of this section by means of all plan letters or similar instructions, without the adoption of regulations. The department shall notify stakeholders and the fiscal and appropriate policy committees of the Legislature of its intent to issue all plan letters or other similar instructions prior to issuance.
(h) (1) Nothing in this section shall result in the elimination or reduction of any covered benefits or services under the Medi-Cal program.
(2) This section shall not affect an individual’s eligibility to receive, concurrently with the services provided for in this section, any services, including home health services, for which the individual would have been eligible in the absence of this section.
(Added by Stats. 2014, Ch. 574, Sec. 1. (SB 1004) Effective January 1, 2015.)