CA SB1385

Require Medi-Cal managed care plans to adopt policies and procedures by July 1, 2025 establishing a billing pathway for supervising providers to claim for community health worker services during emergency department visits and outpatient followups to emergency department visits.

Require the State Department of Health Care Services to develop guidance by July 1, 2025 on billing procedures for supervising providers in the fee-for-service delivery system for community health worker services in emergency department and outpatient followup settings.

Define "supervising provider" as an enrolled Medi-Cal provider authorized to supervise community health workers under the federally approved Medicaid state plan amendment and ensuring workers meet department qualifications.

Require Medi-Cal managed care plans to conduct outreach and education to enrollees about community health worker services, including eligibility criteria, provider lists, and contact information for additional information.

Authorize the department to implement these provisions through policy letters and provider bulletins without formal rulemaking, contingent on federal financial participation and necessary approvals.