Medi-Cal: hospice providers: forms.

Plain English Breakdown

The candidate explanation included a claim about changing the type of counseling available for gambling disorder treatment, which is not directly related to the main purpose of the bill and was removed.

Medi-Cal Hospice Provider Forms

This law requires hospice providers in Medi-Cal fee-for-service to use an online form within five days after someone chooses to receive hospice care, along with counseling and informed consent.

What This Bill Does

• Requires hospice providers to fill out a specific online form within five days after a person decides to receive hospice services through the Medi-Cal fee-for-service program.
• Specifies that this form must be completed along with counseling, receipt of informed consent, and another election notice form.
• Does not apply to Medi-Cal managed care plans; instead, providers must follow their assigned plan's rules for submitting information.

Who It Names or Affects

• Hospice providers who work within the Medi-Cal fee-for-service system
• People receiving hospice care through Medi-Cal fee-for-service

Terms To Know

Medi-Cal

A health insurance program for low-income people in California, funded by both state and federal governments.

Hospice care

Care provided to patients who are nearing the end of their life due to a terminal illness.

Limits and Unknowns

• The bill does not specify what happens if hospice providers do not follow these new rules.
• It is unclear how this change will affect people using Medi-Cal managed care plans for hospice services.

Official Summary Text

AB 2538, as amended, Macedo.
Gambling disorder prevention.
Medi-Cal: hospice providers: forms.
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 fee-for-service or managed care delivery systems. The Medi-Cal program is in part governed by, and funded pursuant to, federal Medicaid program provisions.
Existing law provides for the licensure of hospice agencies by the State Department of Public Health to provide hospice services to an individual who is experiencing the last phase of life due to a terminal illness, as defined. Under existing law, hospice services are covered under the Medi-Cal program,
subject to utilization controls and the availability of federal financial participation, as specified.
The State Department of Health Care Services administratively requires, effective March 2, 2026, a hospice provider to use a certain online attestation form to notify the department when a Medi-Cal fee-for-service member has elected to receive hospice services, as specified.
This bill would codify and recast those departmental procedures relating to the online form. The bill would require the hospice provider to submit the online form within 5 calendar days after the member’s election to receive hospice services, and to submit the form in conjunction with counseling, receipt of informed consent, and completion of a separate election notice form, as specified.
The bill would make these provisions applicable only to the Medi-Cal fee-for-service delivery system. In the case of Medi-Cal managed care, the bill would require a hospice provider to instead follow its assigned Medi-Cal managed care plan’s submission requirements, as specified.
Existing law establishes the Office of Problem Gambling in the State Department of Public Health and requires the office to develop a gambling disorder prevention program that includes, among other components, a toll-free telephone service for immediate crisis management, public awareness campaigns, and training of gambling industry personnel in identifying customers who are at risk for gambling disorders. Existing law also requires the office to develop a treatment program for those purposes, which may include, among other things, state-funded treatment services in the form of telephone counseling. Existing law requires the office to make information available regarding this program as requested by the Governor and the Legislature.
This bill would delete the authorization for telephone counseling treatment services and instead authorize
telehealth counseling. The bill would also require the office to make the information available if it is requested by a county health officer.

Current Bill Text

Download Bill PDF