COVID-19 Medi-Cal managed care guidance

The California Department of Health Care Services (DHCS) has issued information to Medi-Cal managed care plans (MCP) about changes because of COVID-19.  Several fee-for-service policies already issued apply to Medi-Cal including providing care in alternative settings, pharmacy, transporation and telehealth.  MCPs must waive prior authorization requirements, including screening and testing, for services related to COVID-19.  MCPs are strongly encouraged to implement expedited authorization procedures during the COVID-19 public health crisis.

For Health Homes, DHCS encourages MCPs and their contracted Community-Based Care Management Entities to use telephone and video conference assessments.  In-person requirements are suspended until the COVID-19 emergency declaration is rescinded.

The requirement for an Initial Health Assessment for newly enrolled members within 120 days is temporarily suspended.  MCPs can deter Initial Health Assessments until the COVID-19 emergency declaration is rescinded.  However, Initial Health Assessments must be done for these members when the public health emergency is over.  (APL 20-004, April 27, 2020.)