Medi-Cal

About Medi-Cal

More than 15 million Californians rely on Medi-Cal, the state’s health care coverage safety net, for health insurance. Two-thirds of those on Medi-Cal are people of color and often live in communities with a lack of adequate health care providers. Without significant investments to support providers that deliver health care to California’s most vulnerable, millions living in rural and underserved areas are in jeopardy.

Children’s Behavioral Health Services Lack Timely Access

What’s happening: The California State Auditor recently investigated children’s access to Medi-Cal-covered behavioral health services.  

What else to know: The auditor concluded that many Medi-Cal health plans were out of compliance with state requirements for timely care and that the Department of Health Care Services (DHCS) is not adequately disciplining health plans.

DHCS Authorizes Doulas Without Physician Approval for Any Medi-Cal Member

What’s happening: A new update on doula regulations from the Department of Health Care Services (DHCS) removes the need for physician approval to allow doulas to be present during deliveries in hospitals.  

What else to know: DHCS Medical Director, Karen Mark, MD, has authorized doula services for any Medi-Cal member who is pregnant or was pregnant within the past year and wishes to receive services from a doula while pregnant or within one year of pregnancy.  

Continuing Resolution Averts Government Shutdown and Delays DSH Cuts

What’s happening: The House voted 336-95 on a two-tiered stopgap measure that funds the federal government past the Nov. 17 deadline and delays Medicaid disproportionate share hospital cuts until Jan. 19. The Senate passed the measure on Nov. 15 and President Biden has indicated he will sign it.  

What else to know: Funding expires for certain federal agencies on Jan. 19 and other agencies on Feb. 2.  

Area Wage Index Litigation

This page contains important, members-only information related to the Centers for Medicare & Medicaid Services’ recently finalized area wage index policy. To continue, please log in to your member account. 

Updated MCO Tax Ballot Language Reflects Compromise

Last week, the Coalition to Protect Access to Care submitted final revised ballot initiative language for the Protect Access to Healthcare Act of 2024. It would permanently authorize the managed care organization (MCO) tax in state law and dedicate the majority of associated revenues to improving Medi-Cal provider payments in targeted service categories.  

The language was amended to address concerns related to the state budget, as well as other stakeholder concerns. If approved by voters, the final language will:  

Minimum Wage Advocacy Stretches into Final Hours of Signing Deadline   

The gubernatorial signing deadline for bills passed in California’s 2023 legislative session is a little more than 48 hours away. One piece of legislation still awaiting action is SB 525, a bill that would raise the minimum wage for health care workers and is critical for hospitals to create a stable and predictable path for these increases.