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MMCD All Plan & Policy Letters - Subject Listing 

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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

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

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Banking

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

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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
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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

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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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