DHCS All Plan Letter 13-021: Medi-Cal Managed Care Plan Responsibilities for Outpatient Mental Health Services

Prior to 2014, Medi-Cal beneficiaries enrolled in a Medi-Cal Managed Care Plan (MCP) received services within the scope of their primary care provider’s (PCP’s) practice through their PCP and received specialty mental health services for serious mental illness through the county Mental Health Plan (MHP). Effective January 1, 2014, Medi-Cal Managed Care Plans are responsible for providing certain mental health services through the plan’s provider network to beneficiaries with mild to moderate impairment of mental, emotional, or behavioral functioning resulting from a mental health disorder even when those services are outside the PCP’s scope of practice.  The letter, available here, delineates the MCP’s responsibilities for referring to, and coordinating with MHPs for the delivery of mental health services.