Medi-Cal: community supports.

Plain English Breakdown

The exact date when certain parts of the bill will end has not been specified.

Medi-Cal: Continuing Community Supports

This bill allows Medi-Cal managed care plans to keep covering certain community supports after December 31, 2026, and requires the state health department to provide more detailed information about these services.

What This Bill Does

• Allows Medi-Cal managed care plans to continue covering approved community supports that are cost-effective and medically appropriate starting January 1, 2027, subject to federal approval.
• Requires the State Department of Health Care Services to publish a quarterly report on community support usage data, populations served, and demographic information.
• Requires the department to provide ongoing technical assistance to Medi-Cal managed care plans and providers of community supports.
• Needs the department to create a model Evidence of Coverage document with clear instructions about eligibility and coverage policies for each type of community support.
• Requires Medi-Cal managed care plans to track how many of their providers are community providers and report this information.

Who It Names or Affects

• People who receive Medi-Cal benefits
• Medi-Cal managed care plans
• Providers of community supports

Terms To Know

Community Supports

Services that help people with health issues live independently, such as housing assistance and medically supportive food services.

Medi-Cal Managed Care Plans

Health insurance plans for low-income Californians funded by the state and federal government.

Limits and Unknowns

• The bill's requirements are dependent on getting approval from the federal government.
• It is not clear how much it will cost to implement these changes.
• The exact date when certain parts of the bill will end has not been specified.

Official Summary Text

AB 2348, as amended, Bonta.
Medi-Cal: community supports.
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, the California Advancing and Innovating Medi-Cal (CalAIM) Act, subject to any necessary federal approvals, establishes the CalAIM initiative in order to, among other things, improve quality outcomes, reduce health disparities, and transition and transform the Medi-Cal program to a more consistent and seamless system by reducing complexity and increasing flexibility. Under existing law, the CalAIM initiative ends on December 31, 2026. Existing law authorizes the department to seek to extend the payment methodologies or programs set
forth in CalAIM, as specified, consistent with applicable federal requirements.
Existing law, subject to CalAIM implementation, authorizes a Medi-Cal managed care plan to elect to cover community supports. Under existing law, community supports that the department is authorized to approve include, among others, housing transition navigation services and medically supportive food and nutrition services. Existing law requires the department to annually publish a public report on reported community supports utilization data, populations served, and demographic data, as specified.
This bill would authorize a Medi-Cal managed care plan to continue to cover those community supports approved by the department as cost effective and medically appropriate, as specified. Under the bill, this continued coverage would commence on January 1, 2027, would be conditioned on the availability of federal financial participation, and would be
set forth as part of a CalAIM successor program.
The bill would require the department to continue to publish the above-described public report, but on a quarterly basis. The bill would require the department to provide ongoing technical assistance to Medi-Cal managed care plans and providers of community supports to enhance their ability to effectively provide these services.
The bill would require the department to produce a model Evidence of Coverage document that contains comprehensive and detailed instructions on model eligibility and coverage policies, and to develop related policies for each community support provided, as specified. The bill would require the department to solicit and accept feedback in developing the Evidence of Coverage document, as specified. The bill would require the department to regularly review and update its policy as needed until a specified date. The bill would require the department to
publicly release written updates to its community supports policy guidance no later than 6 months prior to the effective date of the update, subject to limited exceptions. The bill would require Medi-Cal managed care plans to track and report to the department the number and percentage of their providers that are community providers, and would define “community provider” for these purposes. The bill would require the department to continue to convene the currently established CalAIM Implementation Advisory Group until a specified date.

Current Bill Text

Download Bill PDF