AB 1202: Medi-Cal: health care services data: children and pregnant or postpartum persons.

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 through various health care delivery systems, including managed care pursuant to Medi-Cal managed care plan contracts. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.

Existing law establishes, until January 1, 2026, certain time or distance and appointment time standards for specified Medi-Cal managed care covered services, consistent with federal regulations relating to network adequacy standards, to ensure that those services are available and accessible to enrollees of Medi-Cal managed care plans in a timely manner, as specified. Existing law sets forth various limits on the number of miles or minutes from the enrollees place of residence, depending on the type of service or specialty and, in some cases, on the county.

This bill would require the department, no later than January 1, 2025, to prepare and submit a report to the Legislature that includes certain information, including an analysis of the adequacy of each Medi-Cal managed care plans network for pediatric primary care, including the number and geographic distribution of providers and the plans compliance with the above-described time or distance and appointment time standards.

Under the bill, the report would also include data, disaggregated as specified, on the number of children and pregnant or postpartum persons who are Medi-Cal beneficiaries receiving certain health care services during the 202122, 202223, and 202324 fiscal years. The report would also include additional information regarding the departments efforts to improve access to pediatric preventive care, as specified. The bill would require that the report be made publicly available through its posting on the departments internet website.

The bill would repeal these reporting provisions on January 1, 2029.