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Managed Care Policy Letters

Note: Policy Letters were not issued in 2004, 2005 or 2006

| 2014 | 2013 | 2012 | 201120102009 | 2008 | 2007 | 2003 | 2002 | 2001 | 2000 | 1999 | 1998 | 1997 | 1996

2014 - Policy Letters

Letter Number Title (Subject of Letter) Date of Issue
PL 14-001 (PDF) Changes to the Historical Utilization Data Provided to Medi-Cal Managed Care   Health Plans for Seniors and Persons with Disabilities Effective February 1, 2014 01/03/2014
Provides guidance to the Geographic Managed Care (GMC) plans on the distribution of funds received after September 2013 capitation payments related to Chapter 286, Statutes of 2011 (SB 335, Hernandez).
01/07/2014
PL 14-002 (PDF) Requirement to Use Food and Drug Administration Approved Drugs, Rather Than Compounded Alternatives 02/19/2014
PL 14-003 (PDF)    Enteral Nutrition Products   04/11/2014
PL 14-004 (PDF)   ​Site Reviews: Facility Site Review and Medical Record Review ​05/22/2014
PL 14-005 (PDF)    Requirements for Health Risk Assessment for Seniors and Persons with Disabilities  
PL 14-005 Attachment: Reporting Instructions (PDF)  
PL 14-005 Attachment: Reporting Template (MS Excel)   
06/12/2014
PL 14-006 (PDF)   
Comprehensive Tobacco Cessation Services for Medi-Cal Members: Preventing Tobacco use in Children and Adolescents
09/03/2014

 

2013 - Policy Letters

 Letter Number  Title (Subject of Letter) Date of Issue
PL 13-001 Revised (PDF)     Requirements for Staying Healthy Assessment/Individual Health Education Behavioral Assessment 10/08/2013
PL 13-002 (PDF) Dental Services-General Anethesia Coverage 11/14/2013
PL AB 97 (PDF)  Assembly Bill 97 Implementation
PL AB 97 Attachment: Specialty Physician Services (PDF)   
08/28/2013

 

 

2012 - Policy Letters 

Letter Number Title (Subject of Letter) Date of Issue

PL 12-001 (PDF)  

Obstetrical Care-Perinatal Services

02/28/2012

PL 12-002 (PDF)     

Non-Monetary Member Incentive Guidelines Addendum to Policy Letter 09-005
PL 12-002 Attachment: Member Incentive Program, Request for Approval Form   
PL 12-002 Attachment: Member Incentive Program, Plan Update Form         

05/04/2012

PL 12-003 (PDF)        

Obstetrical Care-Perinatal Services (supersedes PL 12-001 and 96-01)

06/26/2012

PL 12-004 (PDF) Requirements for Health Risk Assessment of Medi-Cal Seniors and Persons with Disabilities (supersedes PL 11-007) 07/17/2012

PL 12-005 (PDF)     

Enteral Nutrition Products (supersedes PL 07-006 and 07-016)

07/13/2012

PL 12-006 (PDF) Revised Facility Site Review Tool (supersedes PL 11-013) 08/09/2012

 

 

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2011 - Policy Letters  

Letter Number Title (Subject of Letter) Date of Issue

PL 11-001 (PDF)  

Requirements for Health Risk Assessment of Medi-Cal Seniors and Persons with Disabilities (replaced by 11-007 (PDF))

01/05/2011

PL 11-003 (PDF)    

Member-Specific Data Files To Be Provided To Plans For New Medi-Cal Only SPD Members

02/10/2011

PL 11-004 (PDF)     

The Implementation of Section 2302 of the Affordable Care Act, Entitled "Concurrent Care For Children."

02/10/2011

PL 11-007 (PDF) Revision To Policy Letter 11-001 Regarding Requirements for Health Risk Assessment of Medi-Cal Seniors and Persons with Disabilities 02/25/2011

PL 11-009 (PDF)    

Update to Health Plan Provider Directory Policy and Guidelines

4/14/2011

PL 11-011 (PDF)   

Reporting On The Distribution Of Funds Pursuant To Assembly Bill 1653
11-011 Attachment: AB 1653 Plan Monitoring Schedules (MS Excel)  

5/23/2011

PL 11-013 (PDF)  

Revised Facility Site Review (FSR) Tool

5/23/2011

 

  

2010 - Policy Letters  

Letter Number Title (Subject of Letter) Date of Issue

PL 10-012 (PDF)  

Health Education and Cultural and Linguistic Group Needs Assessment (GNA)

11/10/2010

PL 10-013 (PDF)     

Data Request CHDP (Child Health Disability Prevention) Report for FY 2007-2008 and FY 2008-2009

12/20/2010

PL 10-016 (PDF)   

Revised Facility Site Review Tool

12/31/2010

 

 

2009 - Policy Letters 

Letter Number Title (Subject of Letter) Date of Issue

PL 09-005 (PDF)

Non-Monetary Member Incentive Guidelines

03/16/2009

PL 09-006 (PDF)

 

Timeframes For Member Grievances

04/21/2009

 

 

2008 - Policy Letters

Letter Number Title (Subject of Letter) Date of Issue

PL 08-002 (PDF)

Payment of Invoices Beyond the Six-Month Billing Limit

04/16/2008

PL 08-003 (PDF)

Initial Comprehensive Health Assessment

05/05/2008

PL 08-011 (PDF)

Cost Avoidance and Post-Payment Recovery for Other Health Coverage

11/26/2008

PL 08-013 (PDF)

Pharmacy Prior Authorization Requests by California Licensed Pharmacists

12/16/2008

 

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2007 - Policy Letters

 Letter Number

Title (Subject) of Letter Date of Issue

PL 07-006 (PDF)

Therapeutic Enteral Formulas for Medical Conditions in Infants and Children (Note: revised 11/06/07 - see PL 07-016)

 04/02/2007

PL 07-016 (PDF)

Therapeutic Enteral Formulas for Medical Conditions in Infants and Children (revised) Policy Letter 07-006 dated April 2, 2007

 11/06/2007

PL 07-018 (PDF)

Senate Bill (SB) 94 - Family Planning Services

12/21/2007

 

 

2003 - Policy Letters

Letter Number Title (Subject) of Letter Date of Issue

PL 03-001 (PDF)

Quality and Performance Improvement Program

06/05/2003

PL 03-002 (PDF)

Certification of Managed Care Plan Staff Responsible for the Conduct of Primary Care Provider Site Reviews

06/23/2003

 

 

2002 - Policy Letters

Letter Number Title (Subject) of Letter Date of Issue

PL 02-001 (PDF)

Blood Lead Screening of Young Children

02/22/2002

PL 02-002 (PDF - 28.2MB)

Site Review

03/16/2002

PL 02-003 (PDF)

Credentialing & Re-Credentialing:  Time Line Change, New Primary Source Verification Requirements and Verification of Credentials of Non-Physician Practitioners

05/16/2002

PL 02-004 (PDF)

Health Education

06/21/2002

 

 

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2001 - Policy Letters

Letter Number Title (Subject) of Letter Date of Issue

PL 01-001 (PDF)

Corrective Action Plan (CAP) Standardized Format

02/13/2001

PL 01-002 (PDF)

Conversion of MESH to the Medi-Cal Web Site

11/09/2001

PL 01-002Rev (PDF)

Errata of Policy Letter 01-01 Dated October 30, 2001

11/09/2001

 

 

2000 - Policy Letters

Letter Number Title (Subject) of Letter Date of Issue

PL 00-001 (PDF)

Medi-Cal Managed Care Plan Responsibilities Under the Medi-Cal Specialty Mental Health Services Consolidation Program

03/16/2000

PL 00-001 Rev (PDF - 4.3MB)

Medi-Cal Managed Care Plan Responsibilities Under the Medi-Cal Specialty Mental Health Services Consolidation Program

03/16/2000

PL 00-002 (PDF)

Health Plan Provider Directory Policy, Guidelines and Delivery Standards

04/13/2000

PL 00-003 (PDF)

Change of Children in Percent of Poverty Aid Categories to Mandatory Enrollment for Medi-Cal Managed Care

07/05/2000

PL 00-004 (PDF)

Plan-Paid Advertising Extended Until January 31, 2001

09/25/2000

PL 00-005 (PDF - 2.1MB)

Dental Services—Anesthesia Coverage

09/30/2000

PL 00-006 (PDF)

Managed Care Relationships with Local Education Agency Providers

12/11/2000

 

 

1999 - Policy Letters

Letter Number Title (Subject) of Letter Date of Issue

PL 99-001 (PDF)

Community Advisory Committee (CAC)

04/02/1999

PL 99-002 (PDF)

Health Education and Cultural and Linguistic Group Needs Assessment (replaced by 10-012 (PDF))

04/02/1999

PL 99-003 (PDF - 8.4MB)

Cultural and Linguistics

04/02/1999

PL 99-004 (PDF)

Translation of Written Informing Materials

04/02/1999

PL 99-005 (PDF - 3.0MB)

Addendum to Policy Letter 98-03-Conversion to New Eligibility Reporting System

05/07/1999

PL 99-006 (PDF)

Date for Conversion to Fiscal Intermediary Access to Medi-Cal Eligibility Data

08/20/1999

PL 99-007 (PDF - 2.1MB)

Individual Health Education Behavioral Assessment

09/21/1999

PL 99-008 (PDF)

Abortion Services

10/20/1999

 

 

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1998 - Policy Letters

Letter Number Title (Subject) of Letter Date of Issue

PL 98-001 (PDF)

Newborns’ and Mothers’ Health Act of 1997

01/16/1998

PL 98-002 (PDF - 3.6MB)

 

 

Certificates of Creditable Coverage Under the Health Insurance Portability and Accountability Act of 1996

01/27/1998

PL 98-003 (PDF)

Conversion to New Eligibility Reporting System.

02/20/1998

PL 98-004 (PDF)

Enrollment Forms is Primary Care Provider Offices and Enrollment Packet Material Distribution

02/20/1998

PL 98-005 (PDF - 9.4MB)

Enrollment of Medi-Cal/ Medicare Dual Eligibles and Medi-Cal Beneficiaries with Commercial Health Maintenance Coverage

02/20/1998

PL 98-006 (PDF - 38.2MB)

Newborn and Prenatal Genetic Screening Services

03/20/1998

PL 98-007 (PDF)

Refugee Health Care

04/17/1998

PL 98-008 (PDF)

Fee-For-Service Reimbursement Rate Assistance

04/27/1998

PL 98-009 (PDF)

Facilities Excluded from the Medi-Cal Program

12/10/1998

PL 98-010 (PDF)

Breastfeeding Promotion

12/10/1998

PL 98-011 (PDF - 31.9MB)

Family Planning Services in Medi-Cal Managed Care

12/28/1998

PL 98-012 (PDF)

Primary Care Physician Selection and Assignment Policy

12/30/1998

 

 

1997 - Policy Letters

Letter Number Title (Subject of Letter) Date of Issue

PL 97-008 (PDF)  

HIV Counseling and Testing Policy

08/13/1997

 

 

1996 - Policy Letters 

Letter Number Title (Subject of Letter) Date of Issue

PL 96-009 (PDF - 2.2MB)      

Sexually Transmitted Disease Services in Medi-Cal Managed Care

09/26/1996

PL 96-013 (PDF) 

Immunization Services in Medi-Cal Managed Care

11/27/1996

 

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Last modified on: 1/12/2017 8:25 AM