Home Forms, Laws, and Publications Managed Care Policy Letters

Managed Care Policy Letters

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

| 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 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
PL Distribution of Senate Bill 335 Funds Received After September 2013 Capitation Payments (PDF)	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PL 14-004 (PDF)	Site Reviews: Facility Site Review and Medical Record Review Superseded by APL 20-006	05/22/2014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Disabilities PL 14-005 Attachment: Reporting Instructions (PDF) PL 14-005 Attachment: Reporting Template (MS Excel) Superseded by APL 17-013	06/12/2014
PL 14-006 (PDF)	Comprehensive Tobacco Cessation Services for Medi-Cal Members: Preventing Tobacco use in Children and Adolescents Superseded by APL 16-014	09/03/2014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PL 13-001 Revised (PDF)	Requirements for Staying Healthy Assessment/Individual Health Education Behavioral Assessment Superseded by APL 22-030	10/08/2013
PL 13-002 (PDF)	Dental Services-General Anesthesia Coverage Superseded by APL 15-012	11/14/2013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Member Incentive Program, Request for Approval Form PL 12-002 Attachment: Member Incentive Program, Plan Update Form Superseded by APL 16-005	05/04/2012
PL 12-003 (PDF)	Obstetrical Care-Perinatal Services (supersedes PL 12-001 and 96-01) Superseded by APL 26-005	06/26/2012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

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) Superseded by APL 17-002	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

Superseded by APL 16-005

03/16/2009

PL 09-006 (PDF)

Timeframes For Member Grievances

Superseded by APL 17-006

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 Superseded by APL 22-030	05/05/2008
PL 08-011 (PDF)	Cost Avoidance and Post-Payment Recovery for Other Health Coverage Superseded by APL 21-002	11/26/2008
PL 08-013 (PDF)	Pharmacy Prior Authorization Requests by California Licensed Pharmacists	12/16/2008

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 Superseded by APL 20-006	06/23/2003

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

Superseded by APL 20-006

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- RETIRED	06/21/2002

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 Retired 11/03/2023
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 Retired 11/03/2023
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 Superseded by APL 21-004	04/02/1999
PL 99-004 (PDF)	Translation of Written Informing Materials Superseded by APL 21-004	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

1998 – Policy Letters

Letter Number	Title (Subject) of Letter	Date of Issue
PL 98-001 (PDF)	Newborns’ and Mothers’ Health Act of 1997- RETIRED	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 Superseded by APL 26-005	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 Superseded by APL 26-005	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

Superseded by APL 18-004

11/27/1996