MMCD APL & PL Subject Listing

MMCD All Plan & Policy Letters - Subject Listing

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Note: Please check back periodically as new letters are added. Policy Letters are preceded by 'PL'. Policy Letters were not issued from 2003 - 2006.

Abortion Services

Abortion Services PL 99-008
Mifepristone (RU-486) as a Medi-Cal Benefit 01-003

Acquired Immune Deficiency Syndrome/Acquired Immunodeficiency Virus AIDS/HIV

Medi-Cal HIV/AIDS Home and Community Based Services Waiver Program 02-001
Medi-Cal Managed Care Health Plan Capitated and Non-Capitated Human Immunodeficiency Virus/Acquired Immunie Deficiency Syndrom (HIV/AIDS) and Antipsychotic Drugs 03-004

Aged-Senior Services

Concurrent Participation in the Medi-Cal Managed Care Program and the Multipurpose Senior Services Program 99-013

Aid Codes

Aid Code 38 98-009

Amendments

Draft 2000 Medi-Cal Managed Care Contract Amendments Package 00-01 00-010
Draft 1999 Medi-Cal Managed Care Contract Amendments 99-009
Invitation to All Plan Meeting on Year 2000 Proposed Contract Amendments 00-005

Audits

Corrective Action Plan (CAP) Standardized Format (Supersededs PL 92-20) PL 01-001
External Accountability Set (EAS) Performance Measure Audits 02-008

Banking

Same Day Banking 06-011

Beneficiary Notices

Conlan v. Bonta; Conlan v. Shewry: Court Ordered Medi-Cal Beneficiary Reimbursement Process 07-002

Billing

Medi-Cal Billing Restriction on the Use of Social Security Numbers 07-020
Payment of Invoices Beyond the Six-Month Billing Limit PL 08-002

CAHPS Survey

Quality and Performance Improvement Requirements for 2007 06-010

California Children's Services

California Children’s Services (CCS) Policy Regarding the Requirement That All CCS Applicants Shall Make Application to the Medi-Cal Program (Health and Safety Code Section 123995) 00-004
California Children Services Numbered Letters 01-0298 and 09-0598 98-006

Capitation

Recovery of Capitation Paid to Health Care Plans for Deceased Beneficiaries 04-002
Same Day Banking 06-011

Clinical Laboratories Improvements Amendments of 1988 (CLIA)

Ensuring Beneficiaries Receive Laboratory Services From CLIA Certified Laboratories 00-011

Conlan Court Decisions

Conlan v. Bonta; Conlan v. Shewry: Court Ordered Medi-Cal Beneficiary Reimbursement Process 07-002

Contraceptive Devices

Contraceptive Devices 06-008

Corrective Action Plan (CAP)

Corrective Action Plan (CAP) Standardized Format PL 01-001

Cultural and Linguistics

Community Advisory Committee (CAC) PL 99-001
Cultural Competency in Health Care—Meeting the Needs of a Culturally and Linguistically Diverse Population 99-005
Cultural and Linguistic Contractual Requirements: Threshold and Concentration Standard Languages Update 02-003
Health Education and Cultural and Linguistic Group Needs Assessment PL 99-002
Linguistic Services PL 99-003
Translation of Written Informing Materials PL 99-004

Data

Conversion of MESH to the Medi-Cal Web Site PL 01-002
Data for Conversion to Fiscal Intermediary Access to Medi-Cal Eligibility Data PL 99-006
Encounter Data Work Group 99-006
Health Plan Employer Data and Information Set (HEDIS) and Consumer Assessment of Health Plans (CAHPS) Reports Are Now Available on the DHS internet Site 02-004
Implementation of a New Process Which Will Reject Encounter Data At Record Level 01-005
New Process for Transmitting Enrollment/Disenrollment Data 05-002
Possible Movement of FAME Files from the CA Health and Services Data Center to the Medi-Cal Website 02-002
Status of the Conversion to the Fiscal Intermediary Access to Medi-Cal Eligibility 99-010
Supplemental Data Request 06-009
Updates to Managed Care Data Dictionary 99-008

Dental

Dental Services - Anesthesia Coverage PL 00-005
Topical Fluoride Varnish 07-008

DFMC - Delmarva Foundation for Medical Care Inc.

Delmarva Foundation for Medical Care Inc. 03-014

Early and Periodic Screening Diagnosis and Treatment Services

Blood Lead Screening of Young Children PL 02-001

Eligibility

Addendum to MMCD Policy Letter 98-03 - Conversion to New Eligibility Report System PL 99-005
Conlan v. Bonta; Conlan v. Shewry: Court Ordered Medi-Cal Beneficiary Reimbursement Process 07-002
Conversion to New Eligibility Reporting System PL 98-003
Medi-Cal Intercounty Transfers 03-005
Refugee Health Care PL 98-007
Status of the Conversion to the Fiscal Intermediary Access to Medi-Cal Eligibility Data 99-010

Emergency Services (ER Care)

Emergency Services Medical Claim Coding and Documentation Guidelines 02-005
Emergency Services Claims 99-015
Non-Contracted Emergency Room Rate Schedule 03-013

Enrollments and Disenrollments

2008-2009 Managed Care Plan MEDS/FAME/834+Supplemental Cutoff and Processing Schedule 07-019
2007-2008 Managed Care Plan MEDS/FAME Cutoff and Processing Schedule 06-012
Amended Regulations for Enrollment and Disenrollment for Two-Plan Model Plans 00-013
Change of Children in Percent of Poverty Aid Categories to Mandatory Enrollment for Medi-Cal Managed Care PL 00-003
Default Assignment for Beneficiaries 03-001
Enrollment Forms in Primary Care Provider Offices and Enrollment Packet Material Distribution PL 98-004
Enrollment of Medi-Cal/Medicare Dual Eligibles and Medi-Cal Beneficiaries with Commercial Health Maintenance Coverage PL 98-005
Implementation of New Enrollment Forms 04-007
Implementation of New Enrollment Forms 04-005
LTC Guidelines/Policy Letters GMC/Two-Plan Letter 03-003
Medi-Cal Managed Care Medical Exemptions 00-002
New Medi-Cal Managed Care Exemption Forms 99-011
New Process for Transmitting Enrollment/Disenrollment Data 05-002
Potential Increase in New Enrollees Due to Changes in the Section 1931(b) Program 00-007

ESH - Expedited State Hearing

Implementation of Expedited State Hearings 03-009

External Accountability Set

Interim Procedures Until Execution of New EQRO Contract 08-006
External Accountability Set (EAS) Performance Measure Audits 02-008
Quality and Performance Improvement Requirements for 2007 06-010

FAME

2008-2009 Managed Care Plan MEDS/FAME/834+Supplemental Cutoff and Processing Schedule 07-019
2007-2008 Managed Care Plan MEDS/FAME Cutoff and Processing Schedule 06-012

Family Planning

Contraceptive Devices 06-008
Family Planning Services in Medi-Cal Managed Care PL 98-011
Medi-Cal Managed Care Plan Requirements for Provision of Contraceptive Drug Services and Supplies 03-010
Senate Bill (SB) 94 - Family Planning Services PL 07-018

Federal Deficit Reduction Act of 2005

Federal Deficit Reduction Act of 2005 (Reimbursement for Non-Contracted Emergency Services Providers) 07-003
Federal Deficit Reduction Act of 2005 (Employee Education About False Claims) 07-007
Federal Deficit Reduction Act of 2005, Section 6036 (Citizenship Verification Requirement) 07-017
Requirements for Employee Education Regarding False Claims Recovery 08-007

Finance

Conversion to Electronic Filing of Financial Reports 07-001
New Financial Reporting Requirements 07-009
Review and Analysis of Financial Status of Health Plans Proposed Request for Funding Augmentations 05-008
Same Day Banking 06-011

Fraud

Fraud Referral Procedure to Audits and Investigations (A&I) 03-011

Grievance

Quarterly Submission of Grievance Logs 03-008

Health Assessments

Initial Comprehensive Health Assessment PL 08-003

Health Education

Health Education PL 02-004
Health Education and Cultural and Linguistic Group Needs Assessment PL 99-002
Individual Health Education Behavioral Assessment PL 99-007
Medi-Cal Managed Care Health Education Work Group and the “Staying Healthy” Assessment Subcommittee 99-007

HIPAA - Health Insurance Portability and Accountability Act of 1996

Certificates of Creditable Coverage Under the Health Insurance Portability and Accountability Act of 1996 PL 98-002
HIPAA Requirements: Notice of Privacy Practices and Notification of Breaches 06-001
HIPAA Requirements: Plans' Reporting Responsibilities 05-006
Protected Health Information (PHI) and Notification of Breaches 06-005

Legislation

All Plan Letter 04006 Regarding Senate Bill 59 Notice of Action Letter 05-005
Erectile Dysfunction Treatment for Known Sex Offenders 05-007
Newborns' and Mothers' Health Act of 1997 PL 98-001
New Laws from the 1997-98 Session of the California Legislature Affecting the Medi-Cal Program 99-004
SB 59 (Stats. 1999, Chapter 539) Required Notices of Action 04-006
SB 87 Medi-Cal Contact Information Release Form 03-002
Summary of 2007 Chaptered Legislation Affecting, or of Interest to Medi-Cal Managed Care Plans 08-001
Summary of 2006 Chaptered Legislation Affecting, or of Interest to Medi-Cal Managed Care Plans 07-004
Summary of 2005 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans 05-014
Summary of 2003 and 2004 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans 05-001
Summary of 2002 Chaptered Legislation for Medi-Cal Managed Care Plans 02-007
Summary of 2001 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans 01-007
Summary of 2000 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans 01-001
Summary of 1999 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans 99-014

Local Education Agencies (LEAs)

Managed Care Relationship with Local Education Agency Providers PL 00-006

MEDS - Medi-Cal Eligibility Data System

2008-2009 Managed Care Plan MEDS/FAME/834+Supplemental Cutoff and Processing Schedule 07-019
2007-2008 Managed Care Plan MEDS/FAME Cutoff and Processing Schedule 06-012
2005-2006 Managed Care Plan (MCP) MEDS/FAME Cut-Off and Processing Schedule 05-011
2004-2005 Managed Care Plan (MCP) MEDS/FAME Cut-Off and Processing Schedule 04-008
2004 Managed Care Plan (MCP) MEDS/FAME Cut-Off and Processing Schedule 04-001
2003 Managed Care Plan (MCP) MEDS/FAME Cut-Off and Processing Schedule 02-009
2002 Managed Care Plan (MCP) MEDS/FAME Cut-Off and Processing Schedule 01-006
2001 Managed Care Plan (MCP) MEDS/FAME Cut-Off and Processing Schedule 00-014
2000 Managed Care Plan (MCP) MEDS/FAME Cut-Off and Processing Schedule 00-001
1999 Managed Care Plan (MCP) MEDS/FAME Cut-Off and Processing Schedule 99-002
1998 Managed Care Plan (MCP) MEDS/FAME Cut-Off and Processing Schedule 98-003
Medicare Modernization Act; Medicare Part D Implementation System Changes 05-013
Medicare Part D Update 06-002, 06-003
Possible Movement of FAME Files from the CA Health and Human Services (CHHS) Data Center to the Medi-Cal Web Site 02-002

Mental Health

Med-Cal Managed Care Plan Responsibilities Under the Medi-Cal Specialty Mental Health Services Consolidation Program PL 00-001 Rev
Medi-Cal Managed Care Plan Responsibilities Under the Medi-Cal Specialty Mental Health Services Consolidation Program PL 00-001

Miscellaneous

Community Advisory Committee (CAC) PL 99-001
Conlan v. Bonta; Conlan v. Shewry: Court Ordered Medi-Cal Beneficiary Reimbursement Process 07-002
Errata of MMCD Policy Letter 01-01 dated October 30, 2001 PL 01-002 Rev
Health Plan Choice Reminders (Annual Renotifications) 01-004
Maximus Warehouse Relocation 00-006
Percent of Poverty Population 00-009
Plan-Paid Advertising Extended Until January 31, 2001 PL 00-004
Same Day Banking 06-011
Update on California Department of Health Services Reorganization 07-011
Workers’ Compensation (WC)- Notice Award of New Workers’ Compensation Recovery Program (WCRP) Contractor; Reporting and Other Requirements 04-004

National Provider Identifier (NPI)

Implementation of NPI Update 07-005
Update to All Plan Letter 06-04 re: Implementation of National Provider Identifier (NPI) 06-006
National Provider Identifier (NPI) 06-004

Outreach

Importance of Increased Outreach to New Eligibles Under the Section 1931(b) Program 00-008

Personal Injury

Personal Injury Inquiry Letter 05-004

Primary Care Physician (PCP)

Primary Care Physician Selection and Assignment Policy PL 98-012

Policy and Procedure

Policy and Procedure Revisions 00-003

Prescriptions (Rx)

Carve out Erectile Dysfunction Drugs 05-009
Contraceptive Devices 06-008
Managed Care Plan Utilization of Therapeutic Pharmaceutical Agents-Certified Optometrist 99-001
Medi-Cal Managed Care Plan Requirements for Provision of Contraceptive Drug Services and Supplies 03-010
Medi-Cal Managed Care Health Plan Capitated and Non-Capitated Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and Antipsychotic Drugs 03-004
Medicare Modernization Act; Medicare Part D Prescription Drug Plan 05-012
Recombinant Growth Hormone Injections 98-007
Therapeutic Enteral Formulas for Medical Conditions in Infants and Children (Note: revised 11/07/07, see APL 07-016) PL 07-006
Therapeutic Enteral Formulas for Medical Conditions in Infants and Children (revised) MMCD Policy Letter 07-006 dated April 2, 2007 PL 07-016

Provider Directory

Health Plan Provider Directory Policy, Guidelines and Delivery Standards PL 00-002

Provider Participation

Termination of Subcontracting Relationships 06-007
Facilities Excluded from the Medi-Cal Program PL 98-009
Medi-Cal Providers on Probation 03-012
Medi-Cal Providers on Probation 04-003

QIP- Quality and Performance Improvement Program

Quality and Performance Improvement Requirements for 2008 07-013
Quality and Performance Improvement Requirements for 2007 06-010
Certification of Managed Care Plan Staff Responsible for the Conduct of Primary Care Provider site Reviews PL 03-002
Certified Quality Provider Site Certificate 03-007
Credentialing & Re-Credentialing: Time Line Change, New Primary Source Verification Requirements and Verification of Credentials of Non-Physician Practitioners PL 02-003
Facility Site Review Clarification #2 03-006
Implementation of Medi-Cal Managed Care Division (MMCD) Policy Letter 02-002 02-006
Quality and Performance Improvement Program PL 03-001
Site Review PL 02-002
Use of Services Measures 03-015

Quality Improvement Projects (QIPs)

Quality and Performance Improvement Requirements for 2007 06-010

Rates

Fee-For-Service Reimbursement Rate Assistance PL 98-008
Managed Care Rate Reductions for FY 2008-09; Technical Clarification to MMCD All Plan Letter NO. 08-004 08-005
Managed Care Rate Reductions for FY 2008-09 08-004
Non-Contracted Emergency Room Rate Schedule 03-013
Reimbursement for Non-contracted Hospital Emergency Inpatient Services 08-008
Senate Bill (SB) 94 - Family Planning Services PL 07-018
Supplemental Data Request 06-009

Regional Center Consumers

Identification of Regional Center Consumers 07-012

Reimbursement

Conlan v. Bonta; Conlan v. Shewry: Court Ordered Medi-Cal Beneficiary Reimbursement Process 07-002
Reimbursement for Non-contracted Hospital Emergency Inpatient Services 08-008

Services

Blood Lead Screening of Young Children PL 02-001
Breast and Cervical Cancer Treatment Program 01-008
Breastfeeding Promotion PL 98-010
Hospice Services and Medi-Cal Managed Care 07-014
Hospice Services and Medi-Cal Managed Care 05-003
Managed Care Plan Utilization of Therapeutic Pharmaceutical Agents-Certified Optometrists 99-001
Newborn and Prenatal Genetic Screening Services PL 98-006
Non Contracted Emergency Room Rate Schedule 03-013
Reimbursement for Non-contracted Hospital Emergency Inpatient Services 08-008

State Hearings

Conlan v. Bonta; Conlan v. Shewry: Court Ordered Medi-Cal Beneficiary Reimbursement Process 07-002

Third Party Liability

Reporting and Other Requirements Regarding Workers’ Compensation Recovery 01-002

Utilization Review (UR)

Utilization Review of Initial Risk Assessments for Pregnant Women 00-012

Vaccines

Human Papillomavirus Vaccine 07-015

Year 2000 (Y2K)

Year 2000 Contingency Plan Update 99-016
Revision to MMCD All Plan Letter 99-003 Re: Year 2000 Readiness 99-012
Year 2000 Readiness Certification and Business Continuation Plan 99-003