Monday, February 19, 2024 is Presidents’ Day, our offices will be closed. Have a safe holiday.

Home 9 Providers 9 Forms Manuals Policies 9 All Plan Letters

All Plan Letters

From time to time, the Department of Health Care Services (DHCS) posts All Plan Letters (APLs) informing CenCal Health of new guidelines and standards required by the state of California for Medi-Cal services.  APLs provide instruction to CenCal Health’s contracted providers (if applicable) on how to implement these changes on an operational basis.

Please share these details with your staff and practitioners within your organization, or reference our Provider News Flash section of our website for published notifications.

The latest legislative updates are available from the Department of Health Care Services (DHCS).

APL

Relevant Provider Takeaways

APL 24-002
Date: Feb. 8, 2024

Medi-Cal Managed Care Plan Responsibilities for Indian Health Care Providers and American Indian Members (Supersedes APL 09-009)

The purpose of this All Plan Letter (APL) is to summarize and clarify existing federal and state protections and alternative health coverage options for American Indian Members enrolled in Medi-Cal managed care plans (MCPs). Additionally, this APL consolidates various MCP requirements pertaining to protections for Indian Health Care Providers (IHCPs), including requirements related to contracting with IHCPs and reimbursing claims from IHCPs in a timely and expeditious manner. This APL also provides guidance regarding MCP tribal liaison requirements and expectations in relation to their role and responsibilities.

Effective January 1, 2024, MCPs are required to have an identified tribal liaison dedicated to working with each contracted and non-contracted IHCP in its service area. The tribal liaison is responsible for coordinating referrals and payment for services provided to American Indian MCP Members who are qualified to receive services from an IHCP.

To learn more, please contact the Provider Relations Supervisor at dlopez@cencalhealth.org.

APL 24-001
Date: Jan. 12, 2024
Street Medicine Provider: Definitions and Participation in Managed Care (Supersedes APL 22-023)
Resources Available Soon.
APL 23-035
Date: Dec. 28, 2023

Student Behavioral Health Incentive Program

The purpose of this APL is to provide Medi-Cal MCPs with guidance on the incentive payments provided by the Student Behavioral Health Incentive Program (SBHIP).​  SBHIP is a part of California’s Children and Youth Behavioral Health Initiative (CYBHI) and is being implemented by the Department of Health Care Services (DHCS).  Participating MCPs must comply with the policy requirements outlined throughout this APL to earn incentive payments for submitting deliverables and meeting predefined goals and metrics.​  Incentive payments provided through SBHIP must supplement and not supplant existing payments to MCPs. ​

MCP Eligibility and Participation​: MCP participation in this incentive program is voluntary, but strongly encouraged. ​To earn incentive payments, MCPs that elect to participate will be required to engage with County Offices of Education (COEs) and/or partner with Local Educational Agencies (LEAs) to submit required deliverables, Memorandum of Understanding (MOUs) and to meet predefined goals and metrics. ​MCPs are also encouraged, but not required, to partner with County Behavioral Health Departments.

APL 23-034
Date: Dec. 27. 2023
California Children’s Services Whole Child Model Program (Supersedes APL 21-005)
Resources Available Soon.
APL 23-033
Date: Dec. 26, 2023

2024-2025 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Process Schedule

The purpose of this All Plan Letter (APL) is to provide Medi-Cal managed care health plans (MCPs) with the 2024-2025 Medi-Cal Eligibility Data System (MEDS)/834 cutoff and processing schedule. The MEDS/834 cutoff and processing schedule covers the period of December 2023 through January 2025. These cutoff dates and timelines are established by the Department of Health Care Services (DHCS), Enterprise Technology Services Division and are critical to ensuring timely processing of eligibility files and data.

When applicable, it is important for DHCS to receive all enrollments and disenrollments on a daily basis. MCPs must adhere to the enclosed cutoff dates and timelines to allow adequate processing time and to ensure timely payments. In addition to the MEDS/834 cutoff and processing schedule, enclosed is the updated outline of MCP 834 responsibilities and the Health Care Options (HCO) Secure Data Exchange Services (SDES) file posting schedule for 2024.

APL 23-032
Date: Dec. 22, 2023

Enhanced Care Management Requirements (Supersedes APL 21-012)

The Department of Health Care Services (DHCS) released its California Advancing and Innovating Medi-Cal (CalAIM) proposal on October 29, 2019, in anticipation of the expiration of its Medi-Cal 2020 1115 Demonstration and 1915(b) Specialty Mental Health Services Waiver authorities. DHCS postponed the planned implementation of the CalAIM initiative, which was originally scheduled for January 1, 2021, due to the COVID-19 public health emergency, and released a revised CalAIM proposal on January 8, 2021.

DHCS also submitted its CalAIM Section 1115 Demonstration and 1915(b) Waiver applications to the Centers for Medicare and Medicaid Services on June 30, 2021.1 DHCS obtained statutory authority to establish the CalAIM initiative to support the stated goals of identifying and managing the risks and needs of Medi-Cal beneficiaries, transitioning and transforming the Medi-Cal program to a more consistent and seamless system, and improving quality outcomes.

Effective upon the DHCS determined ECM implementation date for each MCP in its respective county of operation, the MCP must administer ECM and provide the following seven core ECM services to eligible Members in applicable ECM Populations of Focus: 1) Outreach and Engagement; 2) Comprehensive Assessment and Care Management Plan; 3) Enhanced Coordination of Care; 4) Health Promotion; 5) Comprehensive Transitional Care; 6) Member and Family Supports; and 7) Coordination of and Referral to Community and Social Support Services.

APL 23-031
Date: Dec. 20, 2023

Medi-Cal Managed Care Plan Implementation of Primary Care Provider Assignment for the Age 26-49 Adult Expansion Transition

The purpose of this APL is to provide CenCal Health with guidance on the Age 26-49 Adult Expansion to ensure individuals transitioning from restricted scope Medi-Cal or are otherwise uninsured to full-scope Medi-Cal maintain their existing PCP assignments to the maximum extent possible to minimize disruptions in services.

CenCal Health will coordinate with county uninsured programs and public health care systems to share data for the Adult Expansion Population ad use that data to effectuate PCP assignment.

APL 23-030
Date: Oct. 24, 2023

Medi-Cal Justice-Involved Reentry Initiative-Related State Guidance

The goal of the demonstration’s Medi-Cal Justice-Involved Reentry Initiative, is to build a bridge to community-based care for justice-involved Medi-Cal members, offering them services up to 90 days prior to their release to stabilize their health conditions and establish a plan for their community-based care (collectively referred to as “pre-release services”).

The Guide is intended to delineate for implementing stakeholders – correctional facilities (CFs), county behavioral health agencies, providers, CBOs, County Social Services Departments (SSD) and Medi-Cal managed care plans (MCPs), among others – the policy design and operational processes that will serve as the foundation for implementing this important initiative.

Effective 1/1/2024 ECM Population of Focus (POF) 4 continues to go live, however the Pre-Release Enrollment policy for POF 4 will go live 10/1/2024.

APL 23-029
Date: Oct. 11, 2023

Memorandum of Understanding (MOU) Requirements for Medi-Cal Managed Care Plans and Third Party Entities

The MCP Contract requires CenCal Health to build partnerships with the following Third Party Entities: local health departments; local educational and governmental agencies, such as county behavioral health departments for specialty mental health care and Substance Use Disorder (SUD) services; other local programs and services, including social services; child welfare departments; Continuum of Care programs; First 5 programs and providers; Regional Centers; Area Agencies on Aging; Caregiver Resource Centers; Women, Infants and Children Supplemental Nutrition Programs (WIC); Home and Community-Based Services (HCBS) waiver agencies and providers; and justice departments to ensure Member care is coordinated and Members have access to community-based resources in order to support whole-person care.

The MOUs are intended to be effective vehicles to clarify roles and responsibilities among parties, support local engagement, and facilitate care coordination and the exchange of information necessary to enable care coordination and improve the referral processes between the parties. The MOUs are also intended to improve transparency and accountability by setting forth certain existing requirements for each party as it relates to service or care delivery and coordination so that the parties are aware of each other’s obligations.

APL 23-028
Date: Oct. 03, 2023

Dental Services – Intravenous Moderate Sedation and Deep Sedation/General Anesthesia Coverage (Supersedes APL 15-012)

This APL describes the requirements for CenCal Health to cover intravenous (IV) moderate sedation and deep sedation/general anesthesia services provided by a physician in conjunction with dental services for Members in hospitals, ambulatory surgical settings, or dental offices. This APL identifies information that MCPs must review and consider during the prior authorization process as described and detailed in the guidelines for IV moderate sedation and deep sedation/general anesthesia for dental procedures.

APL 23-027
Date: Sept. 26, 2023

Subacute Care Facilities – Long Term Care Benefit Standardization and Transition of Members to Managed Care

Within this APL, CenCal Health must determine Medically Necessity consistent with definitions in 22 Code of California Regulations (CCR) sections 51124.5 and 51124.6, Welfare and Institutions Code section 14132.25, and the Medi-Cal Manual of Criteria.

Effective January 1, 2024 CenCal Health will ensure that Members in need of adult or pediatric subacute are services are placed in a health care facility that provides the level of care most appropriate to the Member’s medical needs.  In addition to if a Member needs adult or pediatric subacute care services, they are placed in a health care facility that is under contract for subacute care with DHCS’s Subacute Contracting Unit (SCU) or is actively in the process of applying for a contract with DHCS’ SCU.

APL 23-026
Date: Sept. 25, 2023

Federal Drug Utilization Review Requirements Designed to Reduce Opioid Related Fraud, Misuse & Abuse

This APL supersedes APL 19-012 Federal Drug Utilization Review Requirements Designed to Reduce Opioid Related Fraud, Misuse and Abuse.  CenCal Health is required to operate a DUR program that complies with the Medicaid-related DUR provisions contained in section 1004 of the SUPPORT Act.  Describe the opioid related prospective safety edits, as well as the automated process for retrospective claims review that CenCal Health has in place to address duplicate fill, early fill, and quantity limits. CenCal Health will describe the prospective safety edits for the maximum morphine milligram equivalents (MEE)/daily that can be prescribed to CenCal Health members enrolled for treatment of chronic pain, not to exceed 500 MME/daily dose limitation.  Will monitor and manage appropriate use of all psychiatric drugs to include antipsychotics, mood stabilizers and anti-depressant medications for all children under 18 years of age and all foster children.

For additional resources visit CenCal Health’s Drug Utilization Review section of the website

APL 23-025
Date: Sept. 14, 2023

Diversity, Equity, and Inclusion Training Program Requirements

DHCS has provided guidance regarding the Diversity, Equity, and Inclusion (DEI) training program requirements for our contracted Provider Network and all CenCal Health Staff.
This APL supersedes APL 99-005: Cultural Competency in Health Care Meeting Needs of a Culturally and Linguistically Diverse Population.

In December 2023, CenCal Health will develop a DEI training program that encompasses sensitivity, diversity, culturally competency and cultural humility, and health equity trainings, for all CenCal Health staff and Network Providers regardless of their cultural or professional training and background.  CenCal Health will develop a way to monitor DEI training completion, deficiencies, and record maintenance.  In addition to annually inform the Quality Improvement and Health Equity Committee of the DEI training program with reports.

The DEI training applies to newly onboarded CenCal Health staff, Subcontractors, Downstream Subcontractors, and Network Providers service CenCal Health Members within 90 days of start date in addition to implementing ongoing DEI training to such groups during times of re-credentialing or contract renewals.

To learn more please reference Section B of the CenCal Health’s Provider Manual.

APL 23-024
Date: Aug. 24, 2023
Revision Date:
Nov. 3, 2023

Doula Services (Supersedes APL 22-031)

The focus for this service is to provide guidance regarding the qualifications for providing Doula services, effective for dates of service on or after January 1, 2023.

CenCal Health must provide Doula services for prenatal, perinatal, and postpartum Members, and provide Doulas with all necessary, initial, and ongoing training and resources regarding relevant MCP services and processes, including any available service through the MCP for prenatal, perinatal, and postpartum Members.

Also, provide technical support in the administration of doula services, ensuring accountability for all service requirements while ensuring doulas document the dates, time, and duration of services provided to CenCal Health Members.

To learn more about the Doula Service Benefit, please reference Section E of the CenCal Health’s Provider Manual.

APL 23-023
Date: Aug. 18, 2023
Revision Date:
Nov. 28, 2023

 

 

Intermediate Care Facilities for Individuals With Developmental Disabilities– Long Term Care Benefit Standardization and Transition of Members to Managed Care

DHCS has provided requirements to all MCPs including CenCal Health for the Long-Term Care (LTC) ICF/DD services provisions of the CalAIM benefit standardization initiative. This APL contains requirements related to ICF/DD Homes, ICF/DD-H Homes, and ICF/DD-N Homes.  This benefit requirement provides all Medically Necessary Covered Services for Members residing in or obtaining care in an ICF/DD home.  The benefit also provides the appropriate level of care coordination in adherence to the PHM Policy Guide, to authorize and cover Medically Necessary ICF/DD Home services consistent with the Medi-Cal Provider Manual definitions.

To learn more, please reference CenCal Health’s Provider Manual.

APL 23-022
Date: Aug. 15, 2023

Continuity of Care for Medi-Cal Beneficiaries who newly enroll in Medi-Cal Managed Care from Medi-Cal Fee-For-Service, and for Medical Members who transition into a new Medi-Cal Managed Care Health Plan on or after January 1, 2023 (Supersedes APL 22-032)

This All-Plan Letter (APL) provides guidance on Continuity of Care for beneficiaries who are mandatorily transitioning from Medi-Cal Fee-For-Service (FFS) to enroll as Members in Medi-Cal managed care. This APL applies to both Medi-Cal only beneficiaries and those dually eligible for Medicare and Medi-Cal, for their Medi-Cal Providers. This APL also describes other types of transitions into Medi-Cal managed care for specific Medi-Cal Member populations.

CenCal Health will demonstrate that we are meaningfully responding to community needs as well as provide other updates on the PHM Program to inform DHCS’ monitoring efforts.  In addition, CenCal Health will continue to report on existing metrics related to any Continuity of Care provisions outlined in state law and regulations, or other state guidance documents.

APL 23-021
Date: Aug. 15, 2023

Population Health  Needs Assessment and Population Health Management Strategy (Supersedes APL 19-011)

This APL provides guidance on the modified Population Needs Assessment (PNA) and new Population Health Management (PHM) Strategy requirements for CenCal Health.

DHCS now requires CenCal Health to demonstrate that we are meaningfully responding to community needs as well as provide other updates on the PHM Program to inform DHCS’ monitoring efforts.  In addition, CenCal Health is no longer required to submit an
annual PNA Action Plan. In addition, the PHM Policy Guide will be updated with details on the modified PNA and future submissions of the PHM Strategy deliverable due in 2024.

APL 23-020
Date: July 26, 2023
Revision Date:
Oct. 12, 2023

Requirements for Timely Payment of Claims

DHCS would like Managed Care Plans to remind our provider network of the responsibilities to pay all claims within contractually mandated statutory timeframes and in accordance with the timely payment standards.  CenCal Health will maintain sufficient claims processing/tracking/payment system capabilities to comply with HSC section 1371 through 1371.36, which govern Provider compensation and to pay clean claims within 30 calendar days of receipt (pay interest of untimely payments).

To learn more, please reference the Claims and Billing Guidelines Section of our Provider Manual.

APL 23 – 019
Date: July 26, 2023

Prop 56 Directed Payment for Physician Services (Supersedes APL 19-015)

This requires Managed Care Plans (MCP) to make uniform and fixed dollar add-on payments to eligible individual Providers rendering specified service with the date of service.  CenCal Health must ensure these directed payments are received by the individual rendering Providers that are eligible Network Providers and to not pay any amount for any services or items, other than Emergency Services, to Provider that are suspended, excluded, or terminated from the Medi-Cal Program.

CenCal Health will include an itemization of payments made with each payment to the Network Provider and will follow the Prop 56 Directed Payments Expenditures File Technical Guidance for reporting requirements, and ensure the payments required are made in accordance with the timely payment standards.

To learn more, please visit cencalhealth.org/providers/proposition-56/ for more resources.

APL 23 – 018
Date: June 23, 2023

Managed Care Health Plan Transition Policy

APL 23-018 announces the release of DHCS’s 2024 Managed Care Plan Transition Policy Guide. This Guide contains DHCS operational requirements and guidelines specific to Member transitions prompted by county-driven MCP model changes, changes to commercial MCP contracting, and a new direct contract with Kaiser Permanente.

APL 23 – 017
Date: June 13, 2023

Directed Payments for Adverse Childhood Experiences Screening Services

Date: June 13, 2023 The Budget Act of 2021 changed the source of the nonfederal share of the supplemental payments for trauma screenings to the state General Fund.  In accordance with the State Plan Amendment (SPA) 21-0045,5 effective July 1, 2022, the ACEs program will become a benefit, and it will no longer be funded by Proposition 56. The ACEs Aware program must continue to be utilized to provide informational resources for ACE screening services.

ACEs Aware Trainings: The “Becoming ACEs Aware in California” Core Training is a free, two-hour training for which clinicians and clinical team members will receive 2.0 Continuing Medical Education and/or 2.0 Maintenance of Certification credits upon completion. Please find the training here: https://www.acesaware.org/learn-about-screening/training/

Providers must complete this training and the DHCS ACEs Provider Training Attestation form to qualify for payment for completing ACE Screenings.

More information about training is available at https://www.acesaware.org/learn-about-screening/training/.

Allowed ACE Screening Tools: For Children and Adolescents: The Pediatric ACEs and Related Life-Events Screener (PEARLS) is used to screen children and adolescents ages 0-19 for ACEs.

Three versions of the tool are available, based on age and reporter:

  • PEARLS child tool, for ages 0-11, to be completed by a parent/caregiver;
  • PEARLS adolescent, for ages 12-19, to be completed by a parent/caregiver; and
  • PEARLS for adolescent self-report tool, for ages 12-19, to be completed by the adolescent

For Adults: The ACE questionnaire may be used for adults (ages 18 years and older).

Members who are dually eligible for Medi-Cal and Medicare Part B will not qualify for reimbursement (regardless of enrollment in Medicare part A or Part D).

Details pertaining to ACEs Aware Certification, Eligibility, Provider Requirements, ACE Screening Implementation, HCPCS Codes, Descriptions, Directed Payment, and notes can be found in the APL.

APL 23-016
Date: June 9, 2023

Directed Payments for Developmental Screening Services

The Budget Act of 2021 changed the source of the nonfederal share of these payments to the state General Fund.

The CPT Code, description and Directed Payment amount can be found on page 4 of the APL.
More information can be found on the DHCS Directed payments – Proposition 56 website .

APL 23-015
Date: June 9, 2023

Proposition 56 Directed Payments for Private Services

DHCS intends to continue this directed payment arrangement on an annual basis for the duration of the program.Please refer to the APL for Procedure Codes, Descriptions, Minimum Fee Schedule amounts, and Dates of services from July 1, 2017 to “Ongoing” which means the directed payment is in effect, subject to future budgetary authorization and appropriation by the California Legislature, until discontinued by DHCS via an amendment to this APL.

APL 23 – 014
Date: June 9, 2023

Proposition 56 Value-Based Payment (VBP) Program Directed Payments

The funding that was approved through June 2022 will be distributed following timely payment standards in the Contract for Clean Claims or accepted encounters that were received no later than one year after the date of service up to June 30, 2022.Please see Appendix A of this APL to understand the Domain, Measure and Add-on Amounts from Dates of service between July 1, 2019 and June 30, 2022.Services performed after June 30, 2022, are not eligible for VBP directed payments.

APL 23-013
Date: May 18, 2023
Revision Date: Sept. 5, 2023

Mandatory Signatories to the California Health and Human Services Agency Data Exchange Framework

Mandatory Signatories to the California Health and Human Services Agency Data Exchange Framework


APL 23-012

Date: May 12, 2023
Revision Date: Dec. 4, 2023
Enforcement Actions: Administrative and Monetary Sanctions
Enforcement Actions: Administrative and Monetary Sanctions (Supersedes APL 22-015)
APL 23-011
Date: May 8, 2023
Treatment of Recoveries made by the Managed Care Health Plan of Overpayments to Providers

Provides guidance and clarification regarding federal and state legal requirements for recovery of all Overpayments to Providers. All network Providers are to report to CenCal Health when they have received an overpayment and to return the overpayment to CenCal Health within 60 calendar days, in addition to a notification in writing of the reason of the overpayment.
APL 23-010
May 4, 2023
Revision Date: Nov. 22, 2023
Responsibilities for Behavioral Health Treatment Coverage for Members Date: Under the Age of 21

Provides guidance about the provision of Medically Necessary Behavioral Health Treatment (BHT) services for Members under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit in accordance with mental health parity requirements.Clarifies responsibility of coordination with other entities, and ensures all of a Member’s needs for Medically Necessary BHT services are met across environments, including on-site at school or during virtual school sessions.
APL 23-009
Date: May 3, 2023
Authorization for Post-Stabilization Care Services

Clarifies contractual obligations for authorizing post-stabilization care services.
APL 23-008
Date: April 28, 2023
Revision Date: June 27, 2023

Proposition 56 Directed Payments for Family Planning Services

The funding that was approved through June 2022 will be distributed following timely payment standards in the Contract for Clean Claims or accepted encounters that were received no later than one year after the date of service.
DHCS requested approval from CMS for this directed payment arrangement for CY 2022 and CY 2023.Subject to future appropriation of funds by the California Legislature and the necessary federal approvals of the directed payment arrangement, DHCS intends to continue this directed payment arrangement on an annual basis for the duration of the program. The requirements of this APL may change if necessary to obtain CMS approvals applicable to this directed payment arrangement or to comport with future state legislation.This directed payment program is intended to enhance the quality of patient care by ensuring that Providers in California who offer family planning services receive enhanced payment for their delivery of family planning services. Timely access to vital family planning services is a critical component of Member and population health.In particular, this program is focused on the following categories of family planning services:

  • Long-acting contraceptives

  • Other contraceptives (other than oral contraceptives) when provided as a medical benefit

  • Emergency contraceptives when provided as a medical benefit

  • Pregnancy testing

  • Sterilization procedures (for females and males)

APL 23-007
Date: April 10, 2023

Telehealth Services Policy

As technology continues to advance, the healthcare industry has embraced telehealth as a valuable modality for delivering services. In the state of California, providers and practitioners offering telehealth services to members must adhere to specific guidelines and requirements.

Providers offering Covered Services via Telehealth in California must be licensed in the state and enrolled as a Medi-Cal Provider or affiliated with a Medi-Cal Provider group. If the provider is located outside of California, they need to be associated with a Medi-Cal enrolled Provider group in California or a border community. 

While telehealth can be a convenient and effective means of providing Covered Services, certain services are not suitable for remote delivery. Procedures requiring the in-person presence of a member, direct visualization or instrumentation of bodily structures, or sampling of tissues or medical device insertion/removal cannot be appropriately delivered via Telehealth. 

With the exception of Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal Health Providers (THPs), all providers can be reimbursed for consultations offered via Telehealth. It’s important to note that e-consults can only be initiated by the provider and not the member. Additionally, providers, including FQHCs, RHCs, and THPs, are eligible for reimbursement for brief virtual communication with members who are not physically present.
 
Starting January 1, 2024, providers offering applicable Covered Services through audio-only synchronous interactions must also offer the same service via video synchronous interactions. This change aims to preserve the member choice and ensure access to comprehensive telehealth services.
 
To safeguard a member’s right to in-person care, providers delivering services through video or audio-only synchronous interactions must take the following steps:

  1. Offer the same services through in-person, face to face contact; OR
  2. Facilitate a referral for in-person care, ensuring members do not need to independently contact another provider. 

Prior to initiating Covered Services via Telehealth, providers must inform members about the use of this modality and obtain their verbal or written consent. It is crucial to document this consent in the member’s medical record, as it may be requested for review by the Department of Health Care Services.

During the consent process, providers must explain the following to members: 

  1. The member’s right to access Covered Services in person if desired.
  2. The voluntary nature of Telehealth and the ability to withdraw consent at any time.
  3. The availability of Non-Medical Transportation for in-person visits.
  4. The potential limitations or risks associated with receiving Covered Services through Telehealth compared to an in-person visit.

Telehealth offers providers and practitioners the opportunity to provide Covered Services remotely, expanding access to care for patients.

Please reference the July Provider Pulse E-Newsletter for more information. 

APL 23-006
Date: March 28, 2023

Delegation and Subcontractor Network CertificationDelegation and Subcontractor Network Certification (Supersedes APL 17-004)

APL 23-005
Date: March 16, 2023
Requirements for Coverage of Early and Periodic Screening, Diagnostic, and
Treatment Services for Medical Members Under the Age of 21

Requirements For Coverage of Early and Periodic Screening, Diagnostic, and Treatment Services for Medi-Cal Members Under the Age of 21 (Supersedes APL 19-010)​
APL 23-004
March 14, 2023
Skilled Nursing Facilities – Long Term Care Benefit Standardization and Date:
Transition of members to Managed Care

Provides requirements on the Skilled Nursing Facility (SNF) Long Term Care (LTC) benefit standardization provisions of the California Advancing and Innovating Medi-Cal (CalAIM) initiative, including the mandatory transition of beneficiaries to managed care plans such as CenCal Health.
APL 23-003
Date: March 8, 2023
California Advancing and Innovating Medi-Cal Incentive Payment Program

California Advancing and Innovating Medi-Cal Incentive Payment Program (Supersedes APL 21-016)
APL 23-002
Date: Jan. 17, 2023

2023-2024 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule

2023-2024 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule
Network Certification Requirements (Supersedes APL 21-006)