Policy and Contracts Management Branch
Policy and Contracts Section
Policy Unit
The Policy Unit develops, reviews, and processes legislative bill analysis on legislation that could potentially affect the Medi-Cal Managed Care Program. The unit is also responsible for developing legislatively mandated reports, researching and developing program Policy, coordinating the All Plan and Policy letters process, and developing regulatory language required for the managed care program. Adjunct responsibilities also include the interpretation or clarification of federal or state statutes, regulations, or other policy-making instruments.
Contract Processing Unit
The Contract Processing Unit (CPU) processes all Medi-Cal Managed Care (MMCD) contracts. CPU coordinates and processes contract information and documents for the Plan Management Branch (PMB). CPU coordinates, and reviews rate and financial information for MMCD contracts with the Capitation Rate Development Division (CRDD). CPU serves as a liaison for all contract development and changes with Contract Management Unit (CMU), a general services contract regulatory agency, and Centers for Medicare and Medicaid Services (CMS).
Payments Section
Capitation Payment Unit
The Capitation Payment Unit (CPU) is responsible for the oversight and development of all health plan capitation payments for MMCD, Long-Term Care Division (LTCD) to include Senior Care Action Network (SCAN), Program of All-inclusive Care for the Elderly (PACE), and Medi-Cal Dental Services Branch (MDSB). All capitation payments are based on Department contracts with Medi-Cal Managed Care health plan partners.