Medi-Cal: diapers.

Plain English Breakdown

Checked against official source text during the last sync.

Medi-Cal: Diapers for Children with Certain Conditions

This law makes diapers a covered benefit under Medi-Cal for children over three years old who have certain conditions that cause incontinence, and for individuals under 21 if needed to correct or improve their condition.

What This Bill Does

• Adds diapers as a covered benefit for eligible Medi-Cal beneficiaries with specific medical needs.
• Limits the number of diapers provided based on the child's age and diagnosed condition.
• Requires the State Department of Health Care Services to seek federal approval before implementing this change.
• Conditions implementation on receiving federal financial support and state funding.
• Updates the Medi-Cal provider manual to reflect these changes.

Who It Names or Affects

• Children over three years old with certain medical conditions that cause incontinence.
• Individuals under 21 who need diapers to correct or improve their condition according to federal standards.
• The State Department of Health Care Services, which administers the Medi-Cal program.

Terms To Know

Medi-Cal

A health care program for low-income Californians funded by both state and federal governments.

Incontinence

The inability to control the release of urine or feces.

Limits and Unknowns

• Implementation depends on getting approval from the federal government.
• Federal financial support must be available for this program to start.
• State funding is needed before the program can begin.

Official Summary Text

AB 636, as amended, Ortega.
Medi-Cal: diapers.
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, incontinence medical supplies are covered by the Medi-Cal program.
This bill would establish diapers as a covered Medi-Cal benefit for a child greater than 3 years of age who has been diagnosed with a condition, as specified, that contributes to incontinence, and for an individual under 21 years of age if necessary to correct or ameliorate a condition pursuant to certain federal standards. The bill would limit the provided diapers to an appropriate supply based on the diagnosed condition and the age of the Medi-Cal
beneficiary.
The bill would require the department to seek any necessary federal approvals to implement these provisions. The bill would condition implementation of these provisions on receipt of any necessary federal approvals, the availability of federal financial participation, and an appropriation by the Legislature.
The bill would require the department to update the Medi-Cal provider manual, as applicable, in the course of implementing these provisions.

Current Bill Text

Download Bill PDF