AB 349: Drug Medi-Cal Treatment Program: ratesetting process.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions.

Existing law also provides for the Drug Medi-Cal Treatment Program (Drug Medi-Cal), under which each county enters into contracts with the State Department of Health Care Services to provide various drug treatment services to Medi-Cal recipients, or the department directly arranges to provide these services if a county elects not to do so. Existing law specifies the method of determining the maximum allowable reimbursement rates for Drug Medi-Cal and group outpatient drug free services, and requires the department to adopt any necessary regulations to implement those provisions, including emergency regulations, as specified.

This bill would instead authorize the department to implement, interpret, or make specific those provisions until the time that necessary regulations are adopted. The bill would require the department to adopt regulations by July 1, 2020, and to provide semiannual status reports to the Legislature until the regulations are adopted, as specified. The bill would authorize the department to annually establish and update the statewide maximum allowable reimbursement rates described above by means of bulletins or similar instructions.