CA AB2428

Requires that when a Medi-Cal managed care plan and network provider mutually agree on Community-Based Adult Services (CBAS) reimbursement rates, the amount must be equal to or greater than what would be paid in the Medi-Cal fee-for-service system.

CBAS continues as a capitated benefit available to qualified Medi-Cal beneficiaries enrolled in comprehensive risk contracts with managed care plans, effective January 1, 2022.

CBAS must be delivered in compliance with federal home and community-based settings regulations under Title 42 of the Code of Federal Regulations.

Capitation rates paid to Medi-Cal managed care plans must be actuarially sound and account for CBAS payment levels described in the bill.

Managed care plans and CBAS network providers may be required to submit information to the State Department of Health Care Services as necessary for implementation.