Robert F. Kennedy Farm Workers Medical Plan.

Assembly Member Ortega's proposal to modify the Robert F. Kennedy Farm Workers Medical Plan would lower the threshold at which the State Department of Health Care Services reimburses medical claims from $70,000 to $50,000 per episode of care. The annual reimbursement cap would remain at $3 million, with the program continuing through January 1, 2031.

Under the revised framework, the Farm Workers Medical Plan must submit annual claims data, verified by an independent certified public accountant, covering services provided from September through August of the preceding year. The Department then has 60 days to analyze the data and process reimbursements for claims exceeding the new $50,000 threshold. This verification and reimbursement process applies to care provided on or after September 1, 2016.

The Robert F. Kennedy Farm Workers Medical Plan operates as a nonprofit voluntary employees' beneficiary association under federal law, providing health care and other benefits to member farm workers and their dependents. The state reimbursement program supplements this coverage by partially offsetting the plan's costs for high-value medical claims.