SB 173: Health.

Official summary

Legislative Counsel’s Digest (official, as of the latest version). Written by nonpartisan legislative staff; reproduced verbatim.

(1)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 by, and funded pursuant to, federal Medicaid program provisions.

Existing law sets forth qualifications and procedures for the enrollment of providers in the Medi-Cal program, including the completion of a provider agreement and disclosure of certain information as required in federal Medicaid regulations or by the department. Under existing law, failure to disclose the required information, or the disclosure of false information, results in denial of the application for enrollment or makes the provider subject to temporary suspension from the Medi-Cal program, as specified.

This bill would require the department, subject to receipt of necessary federal approvals, to deny an application for enrollment or to terminate the enrollment of a provider if the applicant or provider discloses an affiliation within the previous 5 years with any person or entity that has experienced a disclosable event, as defined, if the department determines that the affiliation poses an undue risk of fraud, waste, or abuse to the Medi‑Cal program. The bill would require the department to apply certain factors set forth in federal regulations for purposes of the risk determination. The bill would authorize the department to take action, regardless of a disclosure, if the affiliation poses the above-described undue risk.

Existing law sets forth various provisions relating to the termination of provisional provider status that is granted to an applicant or provider.

This bill would also apply those provisions to an applicant or provider that is granted preferred provisional provider status or full-enrollment status. The bill would make conforming changes to related provisions. The bill would change existing criteria, and would impose additional criteria, for compliance and grounds for denial, suspension, or termination.

Under existing law, if it is discovered that a provider is under investigation by the department or any state, local, or federal government law enforcement agency for fraud or abuse, the provider is subject to temporary suspension from the Medi-Cal program.

Sponsors

“Support” is shown only as formal sponsorship recorded by the legislature. Roll-call votes are available on the official bill page.

Recent official actions

1. August 30, 2026Ordered to third reading.
2. August 30, 2026(Ayes 56. Noes 19. Page 6855.)
3. August 30, 2026Withdrawn from committee pursuant to Assembly Rule 96.
4. August 28, 2026From committee with author's amendments. Read second time and amended. Re-referred to Com. on BUDGET.
5. March 24, 2025Referred to Com. on BUDGET.
6. March 20, 2025In Assembly. Read first time. Held at Desk.
7. March 20, 2025Read third time. Passed. (Ayes 28. Noes 10. Page 454.) Ordered to the Assembly.
8. March 18, 2025Read second time. Ordered to third reading.
9. March 17, 2025Ordered to second reading.
10. March 17, 2025Withdrawn from committee. (Ayes 27. Noes 10. Page 384.)
11. February 5, 2025Referred to Com. on B. & F. R.
12. January 24, 2025From printer. May be acted upon on or after February 23.