CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 1175Introduced by Assembly Member WoodFebruary 21, 2019 An act to amend Section 14715 of the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 1175, as introduced, Wood. Medi-Cal: specialty mental health services.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 and funded by federal Medicaid program provisions.Under existing law, specialty mental health services are covered under the Medi-Cal program. Existing law requires the department to implement managed mental health care for Medi-Cal beneficiaries through contracts with mental health plans. Existing law requires the department to require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with a Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan.This bill would make a technical, nonsubstantive change to a related provision.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NO Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 14715 of the Welfare and Institutions Code is amended to read:14715. (a) (1) The department shall require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with any Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan. The memorandum of understanding shall comply with applicable regulations.(2) For purposes of this section, a Medi-Cal managed care plan means any prepaid health plan or Medi-Cal managed care plan contracting with the department to provide services to enrolled Medi-Cal beneficiaries under Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200), or Part 4 (commencing with Section 101525) of Division 101 of the Health and Safety Code.(b) The department shall require the memorandum of understanding to include all of the following:(1) A process or entity to be designated by the local mental health plan to receive notice of actions, denials, or deferrals from the Medi-Cal managed care plan, and to provide any additional information requested in the deferral notice as necessary for a medical necessity determination.(2) A requirement that the local mental health plan respond by the close of the business day following the day the deferral notice is received.(c) The department may sanction a mental health plan pursuant to subdivision (e) of Section 14712 for failure to comply with this section.(d) This section shall apply applies to any contracts entered into, amended, modified, extended, or renewed on or after January 1, 2001.
CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 1175Introduced by Assembly Member WoodFebruary 21, 2019 An act to amend Section 14715 of the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 1175, as introduced, Wood. Medi-Cal: specialty mental health services.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 and funded by federal Medicaid program provisions.Under existing law, specialty mental health services are covered under the Medi-Cal program. Existing law requires the department to implement managed mental health care for Medi-Cal beneficiaries through contracts with mental health plans. Existing law requires the department to require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with a Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan.This bill would make a technical, nonsubstantive change to a related provision.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NO Local Program: NO
CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION
Assembly Bill No. 1175
Introduced by Assembly Member WoodFebruary 21, 2019
Introduced by Assembly Member Wood
February 21, 2019
An act to amend Section 14715 of the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 1175, as introduced, Wood. Medi-Cal: specialty mental health services.
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 and funded by federal Medicaid program provisions.Under existing law, specialty mental health services are covered under the Medi-Cal program. Existing law requires the department to implement managed mental health care for Medi-Cal beneficiaries through contracts with mental health plans. Existing law requires the department to require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with a Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan.This bill would make a technical, nonsubstantive change to a related provision.
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 and funded by federal Medicaid program provisions.
Under existing law, specialty mental health services are covered under the Medi-Cal program. Existing law requires the department to implement managed mental health care for Medi-Cal beneficiaries through contracts with mental health plans. Existing law requires the department to require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with a Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan.
This bill would make a technical, nonsubstantive change to a related provision.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 14715 of the Welfare and Institutions Code is amended to read:14715. (a) (1) The department shall require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with any Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan. The memorandum of understanding shall comply with applicable regulations.(2) For purposes of this section, a Medi-Cal managed care plan means any prepaid health plan or Medi-Cal managed care plan contracting with the department to provide services to enrolled Medi-Cal beneficiaries under Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200), or Part 4 (commencing with Section 101525) of Division 101 of the Health and Safety Code.(b) The department shall require the memorandum of understanding to include all of the following:(1) A process or entity to be designated by the local mental health plan to receive notice of actions, denials, or deferrals from the Medi-Cal managed care plan, and to provide any additional information requested in the deferral notice as necessary for a medical necessity determination.(2) A requirement that the local mental health plan respond by the close of the business day following the day the deferral notice is received.(c) The department may sanction a mental health plan pursuant to subdivision (e) of Section 14712 for failure to comply with this section.(d) This section shall apply applies to any contracts entered into, amended, modified, extended, or renewed on or after January 1, 2001.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 14715 of the Welfare and Institutions Code is amended to read:14715. (a) (1) The department shall require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with any Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan. The memorandum of understanding shall comply with applicable regulations.(2) For purposes of this section, a Medi-Cal managed care plan means any prepaid health plan or Medi-Cal managed care plan contracting with the department to provide services to enrolled Medi-Cal beneficiaries under Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200), or Part 4 (commencing with Section 101525) of Division 101 of the Health and Safety Code.(b) The department shall require the memorandum of understanding to include all of the following:(1) A process or entity to be designated by the local mental health plan to receive notice of actions, denials, or deferrals from the Medi-Cal managed care plan, and to provide any additional information requested in the deferral notice as necessary for a medical necessity determination.(2) A requirement that the local mental health plan respond by the close of the business day following the day the deferral notice is received.(c) The department may sanction a mental health plan pursuant to subdivision (e) of Section 14712 for failure to comply with this section.(d) This section shall apply applies to any contracts entered into, amended, modified, extended, or renewed on or after January 1, 2001.
SECTION 1. Section 14715 of the Welfare and Institutions Code is amended to read:
### SECTION 1.
14715. (a) (1) The department shall require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with any Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan. The memorandum of understanding shall comply with applicable regulations.(2) For purposes of this section, a Medi-Cal managed care plan means any prepaid health plan or Medi-Cal managed care plan contracting with the department to provide services to enrolled Medi-Cal beneficiaries under Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200), or Part 4 (commencing with Section 101525) of Division 101 of the Health and Safety Code.(b) The department shall require the memorandum of understanding to include all of the following:(1) A process or entity to be designated by the local mental health plan to receive notice of actions, denials, or deferrals from the Medi-Cal managed care plan, and to provide any additional information requested in the deferral notice as necessary for a medical necessity determination.(2) A requirement that the local mental health plan respond by the close of the business day following the day the deferral notice is received.(c) The department may sanction a mental health plan pursuant to subdivision (e) of Section 14712 for failure to comply with this section.(d) This section shall apply applies to any contracts entered into, amended, modified, extended, or renewed on or after January 1, 2001.
14715. (a) (1) The department shall require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with any Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan. The memorandum of understanding shall comply with applicable regulations.(2) For purposes of this section, a Medi-Cal managed care plan means any prepaid health plan or Medi-Cal managed care plan contracting with the department to provide services to enrolled Medi-Cal beneficiaries under Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200), or Part 4 (commencing with Section 101525) of Division 101 of the Health and Safety Code.(b) The department shall require the memorandum of understanding to include all of the following:(1) A process or entity to be designated by the local mental health plan to receive notice of actions, denials, or deferrals from the Medi-Cal managed care plan, and to provide any additional information requested in the deferral notice as necessary for a medical necessity determination.(2) A requirement that the local mental health plan respond by the close of the business day following the day the deferral notice is received.(c) The department may sanction a mental health plan pursuant to subdivision (e) of Section 14712 for failure to comply with this section.(d) This section shall apply applies to any contracts entered into, amended, modified, extended, or renewed on or after January 1, 2001.
14715. (a) (1) The department shall require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with any Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan. The memorandum of understanding shall comply with applicable regulations.(2) For purposes of this section, a Medi-Cal managed care plan means any prepaid health plan or Medi-Cal managed care plan contracting with the department to provide services to enrolled Medi-Cal beneficiaries under Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200), or Part 4 (commencing with Section 101525) of Division 101 of the Health and Safety Code.(b) The department shall require the memorandum of understanding to include all of the following:(1) A process or entity to be designated by the local mental health plan to receive notice of actions, denials, or deferrals from the Medi-Cal managed care plan, and to provide any additional information requested in the deferral notice as necessary for a medical necessity determination.(2) A requirement that the local mental health plan respond by the close of the business day following the day the deferral notice is received.(c) The department may sanction a mental health plan pursuant to subdivision (e) of Section 14712 for failure to comply with this section.(d) This section shall apply applies to any contracts entered into, amended, modified, extended, or renewed on or after January 1, 2001.
14715. (a) (1) The department shall require any mental health plan that provides Medi-Cal specialty mental health services to enter into a memorandum of understanding with any Medi-Cal managed care plan that provides Medi-Cal health services to some of the same Medi-Cal recipients served by the mental health plan. The memorandum of understanding shall comply with applicable regulations.
(2) For purposes of this section, a Medi-Cal managed care plan means any prepaid health plan or Medi-Cal managed care plan contracting with the department to provide services to enrolled Medi-Cal beneficiaries under Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200), or Part 4 (commencing with Section 101525) of Division 101 of the Health and Safety Code.
(b) The department shall require the memorandum of understanding to include all of the following:
(1) A process or entity to be designated by the local mental health plan to receive notice of actions, denials, or deferrals from the Medi-Cal managed care plan, and to provide any additional information requested in the deferral notice as necessary for a medical necessity determination.
(2) A requirement that the local mental health plan respond by the close of the business day following the day the deferral notice is received.
(c) The department may sanction a mental health plan pursuant to subdivision (e) of Section 14712 for failure to comply with this section.
(d) This section shall apply applies to any contracts entered into, amended, modified, extended, or renewed on or after January 1, 2001.