Medi-Cal managed care plans: financial incentives.

Existing law establishes 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. Under existing law, one of the methods by which Medi-Cal services are provided is pursuant to contracts with various types of managed care health plans. Existing law authorizes a Medi-Cal managed care contractor to offer nonmonetary incentives to promote good health practices by its Medi-Cal enrollees. This bill would require a Medi-Cal managed care plan contract entered into, or amended, on or after January 1, 2021, to require the contracting Medi-Cal managed care plan to offer financial incentives to its existing enrollees for the purpose of promoting participation in preventive health or wellness activities, as specified, for a value of at least $100 annually per participating enrollee. The bill would require the Medi-Cal managed care plan to annually evaluate its financial incentive programs and to submit an annual report to the department. The bill would require the department to submit a report to the Legislature detailing those financial incentive programs, as specified. The bill would require that its provisions be implemented only if all necessary federal approvals have been obtained, and only to the extent permitted by federal law. The bill would repeal these provisions on January 1, 2026.