Medi-Cal: diapers.

Assembly Member Ortega's proposal to establish diapers as a covered Medi-Cal benefit targets support for children over age three with diagnosed incontinence-related conditions and individuals under 21 who require diapers to address specific health conditions. The measure would add diaper coverage to existing Medi-Cal incontinence medical supply benefits.

The bill establishes two primary eligibility categories: children older than three years who have been diagnosed with physical, mental, neurological, or behavioral health conditions contributing to incontinence, and individuals under 21 years of age when diapers are necessary to correct or ameliorate a condition under federal Early and Periodic Screening, Diagnostic, and Treatment standards. The Department of Health Care Services would determine appropriate supply quantities based on diagnosed conditions and beneficiary age.

Implementation depends on several prerequisites: federal approval to ensure compliance with Medicaid requirements, continued availability of federal financial participation, and a legislative appropriation of state funds. The Department of Health Care Services must update the Medi-Cal provider manual to incorporate the new coverage parameters once these conditions are met.