What’s happening: Effective Jan. 1, 2025, Medi-Cal managed care plans (MCPs) must implement presumptive authorization arrangement with select providers of enhanced care management (ECM).
What else to know: The Department of Health Care Services (DHCS) is releasing updates to the ECM presumptive authorization policy parallel to the ECM Referral Standards that, together, are designed to ease the administrative burden of the referral and authorization process on ECM providers and community referral partners.
The ECM presumptive authorization policy enables a subset of ECM providers to directly authorize ECM for 30 calendar days, so they can more rapidly initiate ECM services and ensure members receive the care they need.
Additional information is available on page 107 of the updated ECM Policy Guide and will be addressed in an upcoming webinar in early October.
