Cal. Welf. & Inst. Code § 14197.07
Medi-Cal Managed Care Plans
Redline — January 1, 2019 → current.View current text →
Current — January 1, 2025
As of January 1, 2019
(a) (1) As part of the federally required external quality review organization (EQRO) review of Medi-Cal managed care plans in the annual detailed technical report, as required by Section 438.364 of Title 42 of the Code of Federal Regulations, effective for contract periods commencing on or after July 1, 2020, the EQRO entity shall review and report annually on Medi-Cal managed care plan metrics for developmental screenings included in the federal Centers for Medicare and Medicaid Services’ Core Set of Children’s Health Care Quality Measures for Medicaid and Children’s Health Insurance Program (CHIP).
(2) The department shall use the EQRO’s technical report to monitor Medi-Cal managed care plans’ compliance with providing enrollees access to developmental screenings pursuant to subdivision (v) of Section 14132.
(b) This section shall remain in effect only until July 1, 2023, and as of that date is repealed.
(a) A Medi-Cal managed care plan shall ensure access to care for latent tuberculosis infection and active tuberculosis disease and coordination with local health department tuberculosis control programs for plan enrollees with active tuberculosis disease, including, but not limited to, both of the following:
(1) Arranging for and coordinating outpatient diagnostic and treatment services to all plan enrollees with suspected or active tuberculosis disease to minimize delays in initiating isolation and treatment of infectious patients. These outpatient services shall include physical examination, drug therapy, laboratory testing, and radiology.
(2) Consulting with local health departments to assess the risk of noncompliance with drug therapy for each plan enrollee who requires placement on antituberculosis drug therapy, in accordance with the plan’s existing contract with the department.
(b) For purposes of this section, “Medi-Cal managed care plan” has the same meaning as set forth in Section 14197.08.
Official source: California Legislative Information. Reproduced from public-domain California statutes; confirm against the official source for the current text. Not legal advice.