Plain English Breakdown
The official text states diapers are covered if necessary to 'correct or ameliorate' a condition, which was simplified to 'fix or improve' for readability.
Medi-Cal Coverage for Diapers
This law adds diapers to Medi-Cal benefits for children over age 3 with specific incontinence conditions and people under 21 if needed to fix or improve a condition.
What This Bill Does
- Adds diapers as a covered benefit for children older than 3 who have been diagnosed with a specified condition that contributes to incontinence.
- Allows coverage for individuals under 21 years of age if necessary to correct or ameliorate a condition based on federal standards.
- Limits the number of diapers provided to an appropriate supply based on the person's diagnosed condition and age.
- Requires the state department to seek any necessary federal approvals before starting this benefit.
- Updates the Medi-Cal provider manual with new rules for these supplies.
Who It Names or Affects
- Medi-Cal beneficiaries who are children over 3 years old or individuals under 21 years old meeting specific medical criteria.
- The State Department of Health Care Services, which administers the program and must seek federal approvals.
Terms To Know
- Medi-Cal
- A state health care program for qualified low-income individuals that is partly governed by federal Medicaid rules.
- Incontinence medical supplies
- Items used to manage the inability to control bladder or bowel movements, which are already covered under existing law.
Limits and Unknowns
- The benefit only starts if federal approvals and funding become available.
- The state Legislature must approve spending money for this program before it begins.
- The exact list of medical conditions that qualify is not detailed in the summary text.