Medi-Cal: vision services: performance measures.

Plain English Breakdown

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Medi-Cal Vision Services: Quality Measures

This bill requires the State Department of Health Care Services to establish performance measures for Medi-Cal vision services to ensure quality and access, and to report on these measures annually.

What This Bill Does

• Requires the department to create a list of ways to check if Medi-Cal vision care is good and easy to get.
• Includes information about doctors who provide eye care, how often people use these services, and any complaints.
• Sets up goals for each measure and reports on them every year.
• Posts performance measures and data online so everyone can see it.

Who It Names or Affects

• People who get Medi-Cal vision care benefits
• Doctors and clinics that provide eye care under Medi-Cal

Terms To Know

Medi-Cal

A health insurance program for low-income people in California, funded partly by the federal government.

Performance measures

Ways to check if a service is working well and meeting goals.

Limits and Unknowns

• The bill does not specify how much it will cost or where the money will come from.
• It's unclear what specific data sources the department must use for reporting.

Official Summary Text

AB 2756, as amended, Ahrens.
Medi-Cal: vision services: performance measures.
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.
Under existing law, certain vision care benefits are covered under the Medi-Cal program, relating to, among other things, optometric and optician services and eyeglasses, as specified.
This bill would require the department to establish a list of performance measures to ensure that the vision services under the Medi-Cal program meet quality and access criteria. The bill would require that the performance measures be designed to evaluate utilization, access, and availability of Medi-Cal vision
services.
The bill would require certain information within the performance measures, relating to
providers, examinations, and complaints,
providers and examinations,
among other factors. The bill would require the department, when evaluating performance measures, to consider certain criteria, including trended data and other state performance and quality measures.
The bill would require the department to report on each performance measure only to the extent that the department has existing data sources from which to calculate the applicable measure, as specified.
The bill would specify
a timeline for the posting of performance measures and data on the department’s internet website. The bill would also require the department to establish benchmarks for each performance measure and to annually prepare a summary report on complaints and grievances, as specified.

Current Bill Text

Download Bill PDF