Medi-Cal reimbursements: nonemergency ambulance transportation.

Assembly Member Michelle Rodriguez's Medi-Cal reimbursement legislation establishes new payment rates for nonemergency ambulance transportation services, setting fee-for-service compensation at 80 percent of Medicare ambulance fee schedule rates beginning January 2026. The reimbursement rates would be adjusted using the Geographic Practice Cost Index to account for regional cost variations across California.

The Department of Health Care Services would create a directed payment program for Medi-Cal managed care plans to implement comparable reimbursement rates for nonemergency ambulance services. The department must pursue federal funding to support these payment changes while maintaining the option to use state funds if federal participation proves insufficient. Implementation requires legislative appropriation but allows the department to proceed through administrative guidance rather than formal rulemaking.

The measure defines nonemergency ambulance transportation as ground ambulance services for non-urgent medical transportation, explicitly excluding emergency medical transport services. This definition aligns with existing regulations in the California Code of Regulations while creating a distinct reimbursement framework for this category of service within the Medi-Cal program.