Amended IN Assembly March 29, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 1202Introduced by Assembly Member Lackey(Coauthor: Assembly Member Wallis)February 16, 2023 An act to add and repeal Section 14197.01 of the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 1202, as amended, Lackey. Medi-Cal: time or distance standards: childrens health care 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 through various health care delivery systems, including managed care pursuant to Medi-Cal managed care plan contracts. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law establishes, until January 1, 2026, certain time or distance and appointment time standards for specified Medi-Cal managed care covered services, consistent with federal regulations relating to network adequacy standards, to ensure that those services are available and accessible to enrollees of Medi-Cal managed care plans in a timely manner, as specified. Existing law sets forth various limits on the number of miles or minutes from the enrollees place of residence, depending on the type of service or specialty and, in some cases, on the county.Existing law authorizes a Medi-Cal managed care plan to use clinically appropriate video synchronous interaction as a means of demonstrating compliance with those standards. Existing law authorizes the department, upon request of a Medi-Cal managed care plan, to authorize alternative access standards for those standards under certain conditions, with the request being approved or denied on ZIP Code and provider type basis, as specified.This bill would require the department to conduct an analysis to identify the number of Medi-Cal providers needed to ensure adequate access to childrens health care services, through compliance by Medi-Cal managed care plans with the above-described time or distance and appointment time standards across all service areas or counties of the state. The bill would require the department to prepare a report of the analysis and to submit the report to the Legislature no later than January 1, 2026. The bill would repeal the analysis and reporting provisions on January 1, 2030.This bill would, no later than January 1, 2025, require each Medi-Cal managed care plan to conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the above-described time or distance and appointment time standards for pediatric primary care, across all service areas of the plan. The bill would, no later than January 1, 2026, require the department to prepare and submit a report to the Legislature that includes certain information, including a summary of the results reported by Medi-Cal managed care plans, specific steps for Medi-Cal managed care plan accountability, evidence of progress and compliance, and level of accuracy of provider directories, as specified.The bill would, no later than July 1, 2024, require the department to submit a report to the Legislature, and to make it publicly available, with certain information for the 2019, 2020, 2021, and 2022 calendar years, including (1) the number of children 0 to 5 years of age, inclusive, and the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of specified early childhood preventive or developmental services, and (2) the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of specified services. The bill would require that the report also include, for those populations, information about any disparities across racial or ethnic groups, primary languages spoken at home, service areas or counties, or age groups.The bill would repeal the analysis and reporting provisions on January 1, 2030.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 14197.01 is added to the Welfare and Institutions Code, immediately following Section 14197, to read:14197.01. (a) No later than January 1, 2025, each Medi-Cal managed care plan shall conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the time or distance and appointment time standards described in Section 14197 for pediatric primary care, across all service areas of the plan.(b) (1) No later than January 1, 2026, the department shall prepare and submit a report to the Legislature that includes all of the following:(A) A summary of the results reported by Medi-Cal managed care plans, as described in subdivision (a).(B) Specific steps that the department has taken to hold Medi-Cal managed care plans accountable for improving utilization of childrens preventive services, including, but not limited to, the following:(i) Monitoring the efficacy of Medi-Cal managed care plan activities through Healthcare Effectiveness Data and Information Set (HEDIS) measures.(ii) Medi-Cal managed care plan requirements related to the Population Health Management Program, as described in Section 14184.204, as specific to childrens preventive care.(C) Evidence of progress in reducing racial and ethnic disparities for well-child visits and immunizations for children served by the Medi-Cal program.(D) Evidence of Medi-Cal managed care plan compliance with contractual requirements to train providers on Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) requirements, and the number of providers trained.(E) Level of accuracy of Medi-Cal managed care plan provider directories, based on the most recent available results of provider directory validation.(2) No later than July 1, 2024, the department shall submit a report to the Legislature, and shall make the report publicly available by posting it on the departments internet website, with all of the following data:(A) For the 2019, 2020, and 2021, and 2022 calendar years, as one cohort, the number of children zero to five years of age, inclusive, and, as a separate cohort, the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of the following early childhood preventive or developmental services, disaggregated by age-related cohort and by service type:(i) Immunizations.(ii) Blood lead screenings.(iii) Physical examinations.(iv) Developmental screenings.(v) Nutrition screenings.(vi) Mental health screenings.(vii) Dental screenings.(viii) Vision screenings.(ix) Hearing screenings.(x) Autism spectrum disorder screenings.(xi) Developmental surveillance.(xii) Behavioral, social, or emotional screenings.(B) For each of the two cohorts of children described in subparagraph (A), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups within the cohort.(C) For the 2019, 2020, and 2021, and 2022 calendar years, the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of the following services, disaggregated by pregnancy or postpartum status and by service type:(i) Maternal depression screenings.(ii) Tobacco, alcohol, or drug use assessments.(iii) Depression or suicide risk screenings.(D) For the pregnant persons, and for the postpartum persons, described in subparagraph (C), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups.(3) The reports described in paragraphs (1) and (2) shall be submitted in accordance with Section 9795 of the Government Code.(c) Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.SECTION 1.Section 14197.01 is added to the Welfare and Institutions Code, immediately following Section 14197, to read:14197.01.(a)The department shall conduct an analysis to identify the number of Medi-Cal providers needed to ensure adequate access to childrens health care services, through compliance by Medi-Cal managed care plans with the time or distance and appointment time standards described in Section 14197, across all service areas or counties of the state.(b)(1)The department shall prepare a report of the analysis described in subdivision (a) and shall submit the report to the Legislature no later than January 1, 2026.(2)The report described in paragraph (1) shall be submitted in accordance with Section 9795 of the Government Code.(c)Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.
Amended IN Assembly March 29, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 1202Introduced by Assembly Member Lackey(Coauthor: Assembly Member Wallis)February 16, 2023 An act to add and repeal Section 14197.01 of the Welfare and Institutions Code, relating to Medi-Cal.LEGISLATIVE COUNSEL'S DIGESTAB 1202, as amended, Lackey. Medi-Cal: time or distance standards: childrens health care 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 through various health care delivery systems, including managed care pursuant to Medi-Cal managed care plan contracts. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law establishes, until January 1, 2026, certain time or distance and appointment time standards for specified Medi-Cal managed care covered services, consistent with federal regulations relating to network adequacy standards, to ensure that those services are available and accessible to enrollees of Medi-Cal managed care plans in a timely manner, as specified. Existing law sets forth various limits on the number of miles or minutes from the enrollees place of residence, depending on the type of service or specialty and, in some cases, on the county.Existing law authorizes a Medi-Cal managed care plan to use clinically appropriate video synchronous interaction as a means of demonstrating compliance with those standards. Existing law authorizes the department, upon request of a Medi-Cal managed care plan, to authorize alternative access standards for those standards under certain conditions, with the request being approved or denied on ZIP Code and provider type basis, as specified.This bill would require the department to conduct an analysis to identify the number of Medi-Cal providers needed to ensure adequate access to childrens health care services, through compliance by Medi-Cal managed care plans with the above-described time or distance and appointment time standards across all service areas or counties of the state. The bill would require the department to prepare a report of the analysis and to submit the report to the Legislature no later than January 1, 2026. The bill would repeal the analysis and reporting provisions on January 1, 2030.This bill would, no later than January 1, 2025, require each Medi-Cal managed care plan to conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the above-described time or distance and appointment time standards for pediatric primary care, across all service areas of the plan. The bill would, no later than January 1, 2026, require the department to prepare and submit a report to the Legislature that includes certain information, including a summary of the results reported by Medi-Cal managed care plans, specific steps for Medi-Cal managed care plan accountability, evidence of progress and compliance, and level of accuracy of provider directories, as specified.The bill would, no later than July 1, 2024, require the department to submit a report to the Legislature, and to make it publicly available, with certain information for the 2019, 2020, 2021, and 2022 calendar years, including (1) the number of children 0 to 5 years of age, inclusive, and the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of specified early childhood preventive or developmental services, and (2) the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of specified services. The bill would require that the report also include, for those populations, information about any disparities across racial or ethnic groups, primary languages spoken at home, service areas or counties, or age groups.The bill would repeal the analysis and reporting provisions on January 1, 2030.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
Amended IN Assembly March 29, 2023
Amended IN Assembly March 29, 2023
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
Assembly Bill
No. 1202
Introduced by Assembly Member Lackey(Coauthor: Assembly Member Wallis)February 16, 2023
Introduced by Assembly Member Lackey(Coauthor: Assembly Member Wallis)
February 16, 2023
An act to add and repeal Section 14197.01 of the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 1202, as amended, Lackey. Medi-Cal: time or distance standards: childrens health care 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 through various health care delivery systems, including managed care pursuant to Medi-Cal managed care plan contracts. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.Existing law establishes, until January 1, 2026, certain time or distance and appointment time standards for specified Medi-Cal managed care covered services, consistent with federal regulations relating to network adequacy standards, to ensure that those services are available and accessible to enrollees of Medi-Cal managed care plans in a timely manner, as specified. Existing law sets forth various limits on the number of miles or minutes from the enrollees place of residence, depending on the type of service or specialty and, in some cases, on the county.Existing law authorizes a Medi-Cal managed care plan to use clinically appropriate video synchronous interaction as a means of demonstrating compliance with those standards. Existing law authorizes the department, upon request of a Medi-Cal managed care plan, to authorize alternative access standards for those standards under certain conditions, with the request being approved or denied on ZIP Code and provider type basis, as specified.This bill would require the department to conduct an analysis to identify the number of Medi-Cal providers needed to ensure adequate access to childrens health care services, through compliance by Medi-Cal managed care plans with the above-described time or distance and appointment time standards across all service areas or counties of the state. The bill would require the department to prepare a report of the analysis and to submit the report to the Legislature no later than January 1, 2026. The bill would repeal the analysis and reporting provisions on January 1, 2030.This bill would, no later than January 1, 2025, require each Medi-Cal managed care plan to conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the above-described time or distance and appointment time standards for pediatric primary care, across all service areas of the plan. The bill would, no later than January 1, 2026, require the department to prepare and submit a report to the Legislature that includes certain information, including a summary of the results reported by Medi-Cal managed care plans, specific steps for Medi-Cal managed care plan accountability, evidence of progress and compliance, and level of accuracy of provider directories, as specified.The bill would, no later than July 1, 2024, require the department to submit a report to the Legislature, and to make it publicly available, with certain information for the 2019, 2020, 2021, and 2022 calendar years, including (1) the number of children 0 to 5 years of age, inclusive, and the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of specified early childhood preventive or developmental services, and (2) the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of specified services. The bill would require that the report also include, for those populations, information about any disparities across racial or ethnic groups, primary languages spoken at home, service areas or counties, or age groups.The bill would repeal the analysis and reporting provisions on January 1, 2030.
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 through various health care delivery systems, including managed care pursuant to Medi-Cal managed care plan contracts. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Existing law establishes, until January 1, 2026, certain time or distance and appointment time standards for specified Medi-Cal managed care covered services, consistent with federal regulations relating to network adequacy standards, to ensure that those services are available and accessible to enrollees of Medi-Cal managed care plans in a timely manner, as specified. Existing law sets forth various limits on the number of miles or minutes from the enrollees place of residence, depending on the type of service or specialty and, in some cases, on the county.
Existing law authorizes a Medi-Cal managed care plan to use clinically appropriate video synchronous interaction as a means of demonstrating compliance with those standards. Existing law authorizes the department, upon request of a Medi-Cal managed care plan, to authorize alternative access standards for those standards under certain conditions, with the request being approved or denied on ZIP Code and provider type basis, as specified.
This bill would require the department to conduct an analysis to identify the number of Medi-Cal providers needed to ensure adequate access to childrens health care services, through compliance by Medi-Cal managed care plans with the above-described time or distance and appointment time standards across all service areas or counties of the state. The bill would require the department to prepare a report of the analysis and to submit the report to the Legislature no later than January 1, 2026. The bill would repeal the analysis and reporting provisions on January 1, 2030.
This bill would, no later than January 1, 2025, require each Medi-Cal managed care plan to conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the above-described time or distance and appointment time standards for pediatric primary care, across all service areas of the plan. The bill would, no later than January 1, 2026, require the department to prepare and submit a report to the Legislature that includes certain information, including a summary of the results reported by Medi-Cal managed care plans, specific steps for Medi-Cal managed care plan accountability, evidence of progress and compliance, and level of accuracy of provider directories, as specified.
The bill would, no later than July 1, 2024, require the department to submit a report to the Legislature, and to make it publicly available, with certain information for the 2019, 2020, 2021, and 2022 calendar years, including (1) the number of children 0 to 5 years of age, inclusive, and the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of specified early childhood preventive or developmental services, and (2) the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of specified services. The bill would require that the report also include, for those populations, information about any disparities across racial or ethnic groups, primary languages spoken at home, service areas or counties, or age groups.
The bill would repeal the analysis and reporting provisions on January 1, 2030.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 14197.01 is added to the Welfare and Institutions Code, immediately following Section 14197, to read:14197.01. (a) No later than January 1, 2025, each Medi-Cal managed care plan shall conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the time or distance and appointment time standards described in Section 14197 for pediatric primary care, across all service areas of the plan.(b) (1) No later than January 1, 2026, the department shall prepare and submit a report to the Legislature that includes all of the following:(A) A summary of the results reported by Medi-Cal managed care plans, as described in subdivision (a).(B) Specific steps that the department has taken to hold Medi-Cal managed care plans accountable for improving utilization of childrens preventive services, including, but not limited to, the following:(i) Monitoring the efficacy of Medi-Cal managed care plan activities through Healthcare Effectiveness Data and Information Set (HEDIS) measures.(ii) Medi-Cal managed care plan requirements related to the Population Health Management Program, as described in Section 14184.204, as specific to childrens preventive care.(C) Evidence of progress in reducing racial and ethnic disparities for well-child visits and immunizations for children served by the Medi-Cal program.(D) Evidence of Medi-Cal managed care plan compliance with contractual requirements to train providers on Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) requirements, and the number of providers trained.(E) Level of accuracy of Medi-Cal managed care plan provider directories, based on the most recent available results of provider directory validation.(2) No later than July 1, 2024, the department shall submit a report to the Legislature, and shall make the report publicly available by posting it on the departments internet website, with all of the following data:(A) For the 2019, 2020, and 2021, and 2022 calendar years, as one cohort, the number of children zero to five years of age, inclusive, and, as a separate cohort, the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of the following early childhood preventive or developmental services, disaggregated by age-related cohort and by service type:(i) Immunizations.(ii) Blood lead screenings.(iii) Physical examinations.(iv) Developmental screenings.(v) Nutrition screenings.(vi) Mental health screenings.(vii) Dental screenings.(viii) Vision screenings.(ix) Hearing screenings.(x) Autism spectrum disorder screenings.(xi) Developmental surveillance.(xii) Behavioral, social, or emotional screenings.(B) For each of the two cohorts of children described in subparagraph (A), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups within the cohort.(C) For the 2019, 2020, and 2021, and 2022 calendar years, the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of the following services, disaggregated by pregnancy or postpartum status and by service type:(i) Maternal depression screenings.(ii) Tobacco, alcohol, or drug use assessments.(iii) Depression or suicide risk screenings.(D) For the pregnant persons, and for the postpartum persons, described in subparagraph (C), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups.(3) The reports described in paragraphs (1) and (2) shall be submitted in accordance with Section 9795 of the Government Code.(c) Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.SECTION 1.Section 14197.01 is added to the Welfare and Institutions Code, immediately following Section 14197, to read:14197.01.(a)The department shall conduct an analysis to identify the number of Medi-Cal providers needed to ensure adequate access to childrens health care services, through compliance by Medi-Cal managed care plans with the time or distance and appointment time standards described in Section 14197, across all service areas or counties of the state.(b)(1)The department shall prepare a report of the analysis described in subdivision (a) and shall submit the report to the Legislature no later than January 1, 2026.(2)The report described in paragraph (1) shall be submitted in accordance with Section 9795 of the Government Code.(c)Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.
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 14197.01 is added to the Welfare and Institutions Code, immediately following Section 14197, to read:14197.01. (a) No later than January 1, 2025, each Medi-Cal managed care plan shall conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the time or distance and appointment time standards described in Section 14197 for pediatric primary care, across all service areas of the plan.(b) (1) No later than January 1, 2026, the department shall prepare and submit a report to the Legislature that includes all of the following:(A) A summary of the results reported by Medi-Cal managed care plans, as described in subdivision (a).(B) Specific steps that the department has taken to hold Medi-Cal managed care plans accountable for improving utilization of childrens preventive services, including, but not limited to, the following:(i) Monitoring the efficacy of Medi-Cal managed care plan activities through Healthcare Effectiveness Data and Information Set (HEDIS) measures.(ii) Medi-Cal managed care plan requirements related to the Population Health Management Program, as described in Section 14184.204, as specific to childrens preventive care.(C) Evidence of progress in reducing racial and ethnic disparities for well-child visits and immunizations for children served by the Medi-Cal program.(D) Evidence of Medi-Cal managed care plan compliance with contractual requirements to train providers on Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) requirements, and the number of providers trained.(E) Level of accuracy of Medi-Cal managed care plan provider directories, based on the most recent available results of provider directory validation.(2) No later than July 1, 2024, the department shall submit a report to the Legislature, and shall make the report publicly available by posting it on the departments internet website, with all of the following data:(A) For the 2019, 2020, and 2021, and 2022 calendar years, as one cohort, the number of children zero to five years of age, inclusive, and, as a separate cohort, the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of the following early childhood preventive or developmental services, disaggregated by age-related cohort and by service type:(i) Immunizations.(ii) Blood lead screenings.(iii) Physical examinations.(iv) Developmental screenings.(v) Nutrition screenings.(vi) Mental health screenings.(vii) Dental screenings.(viii) Vision screenings.(ix) Hearing screenings.(x) Autism spectrum disorder screenings.(xi) Developmental surveillance.(xii) Behavioral, social, or emotional screenings.(B) For each of the two cohorts of children described in subparagraph (A), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups within the cohort.(C) For the 2019, 2020, and 2021, and 2022 calendar years, the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of the following services, disaggregated by pregnancy or postpartum status and by service type:(i) Maternal depression screenings.(ii) Tobacco, alcohol, or drug use assessments.(iii) Depression or suicide risk screenings.(D) For the pregnant persons, and for the postpartum persons, described in subparagraph (C), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups.(3) The reports described in paragraphs (1) and (2) shall be submitted in accordance with Section 9795 of the Government Code.(c) Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.
SECTION 1. Section 14197.01 is added to the Welfare and Institutions Code, immediately following Section 14197, to read:
### SECTION 1.
14197.01. (a) No later than January 1, 2025, each Medi-Cal managed care plan shall conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the time or distance and appointment time standards described in Section 14197 for pediatric primary care, across all service areas of the plan.(b) (1) No later than January 1, 2026, the department shall prepare and submit a report to the Legislature that includes all of the following:(A) A summary of the results reported by Medi-Cal managed care plans, as described in subdivision (a).(B) Specific steps that the department has taken to hold Medi-Cal managed care plans accountable for improving utilization of childrens preventive services, including, but not limited to, the following:(i) Monitoring the efficacy of Medi-Cal managed care plan activities through Healthcare Effectiveness Data and Information Set (HEDIS) measures.(ii) Medi-Cal managed care plan requirements related to the Population Health Management Program, as described in Section 14184.204, as specific to childrens preventive care.(C) Evidence of progress in reducing racial and ethnic disparities for well-child visits and immunizations for children served by the Medi-Cal program.(D) Evidence of Medi-Cal managed care plan compliance with contractual requirements to train providers on Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) requirements, and the number of providers trained.(E) Level of accuracy of Medi-Cal managed care plan provider directories, based on the most recent available results of provider directory validation.(2) No later than July 1, 2024, the department shall submit a report to the Legislature, and shall make the report publicly available by posting it on the departments internet website, with all of the following data:(A) For the 2019, 2020, and 2021, and 2022 calendar years, as one cohort, the number of children zero to five years of age, inclusive, and, as a separate cohort, the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of the following early childhood preventive or developmental services, disaggregated by age-related cohort and by service type:(i) Immunizations.(ii) Blood lead screenings.(iii) Physical examinations.(iv) Developmental screenings.(v) Nutrition screenings.(vi) Mental health screenings.(vii) Dental screenings.(viii) Vision screenings.(ix) Hearing screenings.(x) Autism spectrum disorder screenings.(xi) Developmental surveillance.(xii) Behavioral, social, or emotional screenings.(B) For each of the two cohorts of children described in subparagraph (A), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups within the cohort.(C) For the 2019, 2020, and 2021, and 2022 calendar years, the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of the following services, disaggregated by pregnancy or postpartum status and by service type:(i) Maternal depression screenings.(ii) Tobacco, alcohol, or drug use assessments.(iii) Depression or suicide risk screenings.(D) For the pregnant persons, and for the postpartum persons, described in subparagraph (C), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups.(3) The reports described in paragraphs (1) and (2) shall be submitted in accordance with Section 9795 of the Government Code.(c) Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.
14197.01. (a) No later than January 1, 2025, each Medi-Cal managed care plan shall conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the time or distance and appointment time standards described in Section 14197 for pediatric primary care, across all service areas of the plan.(b) (1) No later than January 1, 2026, the department shall prepare and submit a report to the Legislature that includes all of the following:(A) A summary of the results reported by Medi-Cal managed care plans, as described in subdivision (a).(B) Specific steps that the department has taken to hold Medi-Cal managed care plans accountable for improving utilization of childrens preventive services, including, but not limited to, the following:(i) Monitoring the efficacy of Medi-Cal managed care plan activities through Healthcare Effectiveness Data and Information Set (HEDIS) measures.(ii) Medi-Cal managed care plan requirements related to the Population Health Management Program, as described in Section 14184.204, as specific to childrens preventive care.(C) Evidence of progress in reducing racial and ethnic disparities for well-child visits and immunizations for children served by the Medi-Cal program.(D) Evidence of Medi-Cal managed care plan compliance with contractual requirements to train providers on Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) requirements, and the number of providers trained.(E) Level of accuracy of Medi-Cal managed care plan provider directories, based on the most recent available results of provider directory validation.(2) No later than July 1, 2024, the department shall submit a report to the Legislature, and shall make the report publicly available by posting it on the departments internet website, with all of the following data:(A) For the 2019, 2020, and 2021, and 2022 calendar years, as one cohort, the number of children zero to five years of age, inclusive, and, as a separate cohort, the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of the following early childhood preventive or developmental services, disaggregated by age-related cohort and by service type:(i) Immunizations.(ii) Blood lead screenings.(iii) Physical examinations.(iv) Developmental screenings.(v) Nutrition screenings.(vi) Mental health screenings.(vii) Dental screenings.(viii) Vision screenings.(ix) Hearing screenings.(x) Autism spectrum disorder screenings.(xi) Developmental surveillance.(xii) Behavioral, social, or emotional screenings.(B) For each of the two cohorts of children described in subparagraph (A), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups within the cohort.(C) For the 2019, 2020, and 2021, and 2022 calendar years, the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of the following services, disaggregated by pregnancy or postpartum status and by service type:(i) Maternal depression screenings.(ii) Tobacco, alcohol, or drug use assessments.(iii) Depression or suicide risk screenings.(D) For the pregnant persons, and for the postpartum persons, described in subparagraph (C), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups.(3) The reports described in paragraphs (1) and (2) shall be submitted in accordance with Section 9795 of the Government Code.(c) Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.
14197.01. (a) No later than January 1, 2025, each Medi-Cal managed care plan shall conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the time or distance and appointment time standards described in Section 14197 for pediatric primary care, across all service areas of the plan.(b) (1) No later than January 1, 2026, the department shall prepare and submit a report to the Legislature that includes all of the following:(A) A summary of the results reported by Medi-Cal managed care plans, as described in subdivision (a).(B) Specific steps that the department has taken to hold Medi-Cal managed care plans accountable for improving utilization of childrens preventive services, including, but not limited to, the following:(i) Monitoring the efficacy of Medi-Cal managed care plan activities through Healthcare Effectiveness Data and Information Set (HEDIS) measures.(ii) Medi-Cal managed care plan requirements related to the Population Health Management Program, as described in Section 14184.204, as specific to childrens preventive care.(C) Evidence of progress in reducing racial and ethnic disparities for well-child visits and immunizations for children served by the Medi-Cal program.(D) Evidence of Medi-Cal managed care plan compliance with contractual requirements to train providers on Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) requirements, and the number of providers trained.(E) Level of accuracy of Medi-Cal managed care plan provider directories, based on the most recent available results of provider directory validation.(2) No later than July 1, 2024, the department shall submit a report to the Legislature, and shall make the report publicly available by posting it on the departments internet website, with all of the following data:(A) For the 2019, 2020, and 2021, and 2022 calendar years, as one cohort, the number of children zero to five years of age, inclusive, and, as a separate cohort, the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of the following early childhood preventive or developmental services, disaggregated by age-related cohort and by service type:(i) Immunizations.(ii) Blood lead screenings.(iii) Physical examinations.(iv) Developmental screenings.(v) Nutrition screenings.(vi) Mental health screenings.(vii) Dental screenings.(viii) Vision screenings.(ix) Hearing screenings.(x) Autism spectrum disorder screenings.(xi) Developmental surveillance.(xii) Behavioral, social, or emotional screenings.(B) For each of the two cohorts of children described in subparagraph (A), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups within the cohort.(C) For the 2019, 2020, and 2021, and 2022 calendar years, the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of the following services, disaggregated by pregnancy or postpartum status and by service type:(i) Maternal depression screenings.(ii) Tobacco, alcohol, or drug use assessments.(iii) Depression or suicide risk screenings.(D) For the pregnant persons, and for the postpartum persons, described in subparagraph (C), information about any disparities across the following:(i) Racial or ethnic groups.(ii) Primary languages spoken at home.(iii) Service areas or counties of the state.(iv) Age groups.(3) The reports described in paragraphs (1) and (2) shall be submitted in accordance with Section 9795 of the Government Code.(c) Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.
14197.01. (a) No later than January 1, 2025, each Medi-Cal managed care plan shall conduct, and report to the department the results of, an analysis to identify the number and, as appropriate, the geographic distribution of Medi-Cal providers needed to ensure the Medi-Cal managed care plans compliance with the time or distance and appointment time standards described in Section 14197 for pediatric primary care, across all service areas of the plan.
(b) (1) No later than January 1, 2026, the department shall prepare and submit a report to the Legislature that includes all of the following:
(A) A summary of the results reported by Medi-Cal managed care plans, as described in subdivision (a).
(B) Specific steps that the department has taken to hold Medi-Cal managed care plans accountable for improving utilization of childrens preventive services, including, but not limited to, the following:
(i) Monitoring the efficacy of Medi-Cal managed care plan activities through Healthcare Effectiveness Data and Information Set (HEDIS) measures.
(ii) Medi-Cal managed care plan requirements related to the Population Health Management Program, as described in Section 14184.204, as specific to childrens preventive care.
(C) Evidence of progress in reducing racial and ethnic disparities for well-child visits and immunizations for children served by the Medi-Cal program.
(D) Evidence of Medi-Cal managed care plan compliance with contractual requirements to train providers on Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) requirements, and the number of providers trained.
(E) Level of accuracy of Medi-Cal managed care plan provider directories, based on the most recent available results of provider directory validation.
(2) No later than July 1, 2024, the department shall submit a report to the Legislature, and shall make the report publicly available by posting it on the departments internet website, with all of the following data:
(A) For the 2019, 2020, and 2021, and 2022 calendar years, as one cohort, the number of children zero to five years of age, inclusive, and, as a separate cohort, the number of children 6 to 18 years of age, inclusive, who are Medi-Cal beneficiaries receiving any of the following early childhood preventive or developmental services, disaggregated by age-related cohort and by service type:
(i) Immunizations.
(ii) Blood lead screenings.
(iii) Physical examinations.
(iv) Developmental screenings.
(v) Nutrition screenings.
(vi) Mental health screenings.
(vii) Dental screenings.
(viii) Vision screenings.
(ix) Hearing screenings.
(x) Autism spectrum disorder screenings.
(xi) Developmental surveillance.
(xii) Behavioral, social, or emotional screenings.
(B) For each of the two cohorts of children described in subparagraph (A), information about any disparities across the following:
(i) Racial or ethnic groups.
(ii) Primary languages spoken at home.
(iii) Service areas or counties of the state.
(iv) Age groups within the cohort.
(C) For the 2019, 2020, and 2021, and 2022 calendar years, the number of pregnant persons, and the number of postpartum persons, who are Medi-Cal beneficiaries receiving any of the following services, disaggregated by pregnancy or postpartum status and by service type:
(i) Maternal depression screenings.
(ii) Tobacco, alcohol, or drug use assessments.
(iii) Depression or suicide risk screenings.
(D) For the pregnant persons, and for the postpartum persons, described in subparagraph (C), information about any disparities across the following:
(i) Racial or ethnic groups.
(ii) Primary languages spoken at home.
(iii) Service areas or counties of the state.
(iv) Age groups.
(3) The reports described in paragraphs (1) and (2) shall be submitted in accordance with Section 9795 of the Government Code.
(c) Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.
(a)The department shall conduct an analysis to identify the number of Medi-Cal providers needed to ensure adequate access to childrens health care services, through compliance by Medi-Cal managed care plans with the time or distance and appointment time standards described in Section 14197, across all service areas or counties of the state.
(b)(1)The department shall prepare a report of the analysis described in subdivision (a) and shall submit the report to the Legislature no later than January 1, 2026.
(2)The report described in paragraph (1) shall be submitted in accordance with Section 9795 of the Government Code.
(c)Pursuant to Section 10231.5 of the Government Code, this section shall remain in effect only until January 1, 2030, and as of that date is repealed.