Medi-Cal: provider enrollment.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law also establishes the Family Planning, Access, Care, and Treatment (Family PACT) Program to provide comprehensive clinical family planning services to individuals who meet specified income requirements. Existing law provides for a schedule of benefits under the Medi-Cal program, including services provided under the Family PACT Program. Existing law authorizes the department to adopt regulations for certification of each applicant and each provider in the Medi-Cal program. Existing law requires certain applicants or providers, as defined, to submit a complete application package for enrollment, continuing enrollment, or enrollment at a new location or a change in location. Existing law generally requires the department to give written notice as to the status of an application to an applicant or provider within 180 days after receiving an application package, or from the date of notifying an applicant or provider that they do not qualify as a preferred provider, notifying the applicant or provider if specified circumstances apply, such as if the application package is incomplete, or, on the 181st day, to grant provisional provider status to the applicant or provider. This bill would require the department, within 30 calendar days of receiving confirmation of certification for enrollment as a Medi-Cal provider for an applicant that is a specified clinic or student health center, to provide specified written notice to the applicant informing the applicant that its Medi-Cal enrollment is approved, and to enroll the applicant retroactive to the date of certification. The bill would also impose similar requirements upon the department with respect to an application for enrollment into the Family PACT Program from a specified clinic or student health center, and would make the effective date of enrollment into the Family PACT Program the later of the date the department receives confirmation of enrollment as a Medi-Cal provider, or the date the applicant meets all Family PACT provider enrollment requirements.