Medi-Cal: subacute care services.
- Standardizes the Medi-Cal authorization process for subacute care services through required state forms.
- Prohibits managed care plans from creating their own medical necessity criteria for subacute care.
- Eliminates the need for new authorizations when patients return from acute hospital stays.
- Authorizes state sanctions against managed care plans that violate these requirements.
Assembly Member Jackson's Medi-Cal legislation establishes standardized authorization procedures for subacute care services, requiring healthcare providers to submit specific state forms when requesting approval for both pediatric and adult care. The measure addresses authorization processes within California's Medi-Cal program, which provides health coverage for low-income residents.
Under the new requirements, providers must include form DHCS 6200 for pediatric subacute care requests and form DHCS 6200A for adult services. The legislation prohibits Medi-Cal managed care plans from developing or applying medical necessity criteria beyond those enumerated in these standardized forms. Additionally, plans cannot require new authorization requests when patients return from acute hospitalization bed holds.
The Department of Health Care Services maintains authority to impose sanctions on managed care plans that violate these provisions. These changes apply to the existing Medi-Cal subacute care program, which serves patients who meet specific medical criteria and receive care in designated health facilities.
 Corey JacksonD Assemblymember | Bill Author |  Not Contacted | |
 Caroline MenjivarD Senator | Bill Author | Not Contacted |
Email the authors or create an email template to send to all relevant legislators.
Introduced By
Latest Voting History
| Ayes | Noes | NVR | Total | Result |
|---|---|---|---|---|
| 39 | 0 | 1 | 40 | PASS |
- Standardizes the Medi-Cal authorization process for subacute care services through required state forms.
- Prohibits managed care plans from creating their own medical necessity criteria for subacute care.
- Eliminates the need for new authorizations when patients return from acute hospital stays.
- Authorizes state sanctions against managed care plans that violate these requirements.
Email the authors or create an email template to send to all relevant legislators.
Introduced By
Assembly Member Jackson's Medi-Cal legislation establishes standardized authorization procedures for subacute care services, requiring healthcare providers to submit specific state forms when requesting approval for both pediatric and adult care. The measure addresses authorization processes within California's Medi-Cal program, which provides health coverage for low-income residents.
Under the new requirements, providers must include form DHCS 6200 for pediatric subacute care requests and form DHCS 6200A for adult services. The legislation prohibits Medi-Cal managed care plans from developing or applying medical necessity criteria beyond those enumerated in these standardized forms. Additionally, plans cannot require new authorization requests when patients return from acute hospitalization bed holds.
The Department of Health Care Services maintains authority to impose sanctions on managed care plans that violate these provisions. These changes apply to the existing Medi-Cal subacute care program, which serves patients who meet specific medical criteria and receive care in designated health facilities.
Latest Voting History
| Ayes | Noes | NVR | Total | Result |
|---|---|---|---|---|
| 39 | 0 | 1 | 40 | PASS |
Corey JacksonD Assemblymember | Bill Author | Not Contacted | |
Caroline MenjivarD Senator | Bill Author | Not Contacted |