CA SB256

Establishes the CalAIM (California Advancing and Innovating Medi-Cal) initiative to identify and manage health risks of Medi-Cal beneficiaries, transition the program to a more seamless system, and improve quality outcomes through value-based initiatives and payment reform.

Requires Medi-Cal managed care plans to implement a Population Health Management Program starting January 1, 2023, that prioritizes preventive services, identifies social determinants of health, and reduces health disparities through standardized requirements.

Authorizes Medi-Cal managed care plans to cover Enhanced Care Management (ECM) services for target populations including homeless individuals, high utilizers, and those with serious mental illness, with implementation beginning January 1, 2022.

Permits Medi-Cal managed care plans to cover "in lieu of services" such as housing assistance, recuperative care, and asthma remediation as cost-effective alternatives to standard covered benefits, starting January 1, 2022.

Allows the department to establish incentive payments for managed care plans meeting CalAIM milestones and metrics, and permits regional capitation rates as an alternative to health plan and county-specific rates, subject to federal approval and legislative reporting requirements.