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CA SB324
Bill
Status
5/27/2025
Primary Sponsor
Caroline Menjivar
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AI Summary
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Requires Medi-Cal managed care plans to contract with community providers for enhanced care management (ECM) benefits and community supports, with providers demonstrating capability to meet quality requirements and Medi-Cal guidelines
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Mandates managed care plans set goals every other year, in consultation with the Department of Health Care Services, for contracting and utilization levels with community providers and local entities
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Requires managed care plans to assign members to contracted community providers who submit referrals or authorization requests for ECM or community support services, if the provider can appropriately meet the member's needs
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Changes the department's public reporting on ECM and community supports utilization data from annual to quarterly, with demographic data stratified by county, age, sex, race, ethnicity, languages spoken, and provider type
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Directs the department to develop standardized templates for including community providers with limited contracting experience and guidance allowing community providers to act as primary subcontractors with third-tier subcontracting arrangements
Legislative Description
Medi-Cal: enhanced care management and community supports.
Last Action
August 29 hearing: Held in committee and under submission.
8/29/2025