CA AB2426

Creates a directed payment program in Medi-Cal managed care requiring total reimbursement for outpatient hospital services at Martin Luther King, Jr. Community Hospital to approximately equal the hospital's costs for those services.

Establishes that hospital's projected Medi-Cal costs shall be based on cost-finding principles from the hospital's Medi-Cal cost report, determined annually before each fiscal year in consultation with the hospital.

Requires General Fund appropriations to cover the nonfederal share of additional payments when reimbursement rates fall below 72 percent of the hospital's projected Medi-Cal costs, with the County of Los Angeles able to fund remaining nonfederal share at its election.

Directs the department to develop an alternative mechanism for ensuring inpatient services payment levels from Medi-Cal managed care plans and may develop value-based quality directed payments in consultation with the hospital.

Implementation is contingent on federal approvals or waivers and an appropriation by the Legislature in the annual Budget Act.