Medi-Cal: treatment authorization requests.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, and pursuant to which, health care services are provided to qualified low-income persons. Under existing law, one of the utilization controls to which services are subject under the Medi-Cal program is the treatment authorization request (TAR) process, which is approval by a department consultant of a specified service in advance of the rendering of that service based upon a determination of medical necessity. Existing law requires the department to pursue means to improve and streamline the TAR process. This bill would require the department, in pursuing means to improve and streamline the TAR process, to do so in specified ways, including performing a cost-benefit analysis for each procedure requiring a TAR and reducing the number of TARs required. Existing law specifies the number of days within which certain TARs are required to be authorized. This bill would reduce the number of days within which these TARs shall be authorized.