CA AB3156

Requires the State Department of Health Care Services to ensure non-contracted providers billing Medi-Cal managed care plans do not face administrative requirements exceeding those for billing the Medi-Cal fee-for-service system when Medi-Cal is the payer of last resort.

Allows Medi-Cal fee-for-service providers to bill managed care plans for allowable costs without contracting as in-network providers, except for Medicare coverage situations.

Permits managed care plans to require letters of agreement from non-contracted providers only when services require prior authorization, are not covered by other health insurance but covered by the plan, or involve continuity of care requirements.

Requires the department to solicit stakeholder input on payment coordination between Medi-Cal and commercial coverage, with emphasis on regional center services, and discuss the topic at the 2025 Medi-Cal Managed Care Advisory Committee meeting.

Mandates annual updates to legislative health committees from 2025 through 2028 on implementation effectiveness and authorizes the department to implement provisions through plan letters without formal regulatory action.