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Current All Plan and Policy Letters

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Listed below are current All Plan Letters (APLs) and Policy Letters (PLs) applicable to contractors. Superseded letters are moved to the “Archived All Plan, Duals Plan and Policy Letters” web page when the information is no longer current.  Note: PLs were not issued between 2003 and 2006, and have not been issued since 2014. 

 2019 

Letter Number Title (Subject) of Letter Date of Issue

APL 19-001 (PDF)

Medi-Cal Managed Care Health Plan Guidance on Network Provider Status

01/17/2019

APL 19-002 (PDF)

Network Certification Requirements (Supersedes APL 18-005)

APL 19-002 Attachments:

01/30/2019

2018

Letter Number

Title (Subject) of Letter

Date of Issue

APL 18-001 (PDF)

Voluntary Inpatient Detoxification (Supersedes APL 14-005)

01/11/2018

APL 18-002 (PDF)

2018-2019 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule

01/11/2018

APL 18-003 (PDF)

Administrative and Financial Sanctions (Supersedes APL 15-014)

01/25/2018

APL 18-004 (PDF)

Immunization Requirements (Supersedes PL 96-013 and APL 07-015)

01/31/2018

APL 18-005 (PDF)

Network Certification Requirements                   

02/16/2018

APL 18-006 (PDF)

Responsibilities for Behavioral Health Treatment Coverage for Members Under the Age of 21

(Supersedes APL 15-025)

03/02/2018

APL 18-007 (PDF)

Requirements for Coverage of Early and Periodic Screening, Diagnostic, and Treatment Services for Medi-Cal Members Under the Age of 21

(Supersedes APL 14-017)

03/02/2018

APL 18-008 (Revised) (PDF)

Continuity of Care for Medi-Cal Members Who Transition into Medi-Cal Managed Care

(Supersedes APL 15-019)

03/02/2018

Revised 07/10/2018

APL 18-009 (PDF)

Memorandum of Understanding Requirements for Medi-Cal Managed Care Health Plans and Regional Centers (Supersedes APL 15-022)

03/02/2018

APL 18-010 (PDF)

Proposition 56 Directed Payment Expenditures for Specified Services for State Fiscal Year 2017-18

05/01/2018

APL 18-011 (PDF)

California Children’s Services Whole Child Model Program

06/07/2018

APL 18-012 (PDF)

Health Homes Program Requirements

06/28/2018

APL 18-013 (PDF)

Hepatitis C Virus Treatment Policy Update (Supersedes APL 15-016)

08/14/2018

APL 18-014 (PDF)

Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care

(Supersedes APL 17-016)

09/14/2018

APL 18-015 (PDF)

Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans

APL 18-015 Attachments:

09/19/2018

APL 18-016 (PDF)

Readability and Suitability of Written Health Education Materials

                  (Supersedes APL 11-018)

APL 18-016 Attachments:

10/05/2018

2017

Letter Number

Title (Subject) of Letter

Date of Issue

APL 17-001 (PDF)

2017-2018 Medi-Cal Managed Care Health Plan Meds/834 Cutoff And Processing Schedule

01/03/2017

APL 17-002 (PDF)

Health Education and Cultural and Linguistic Group Needs Assessment (Supersedes PL 10-012)

02/03/2017

APL 17-003 (PDF)

Treatment of Recoveries Made by the Managed Care Health Plan of Overpayments to Providers

03/30/2017

APL 17-004 (PDF)

Subcontractual Relationships and Delegation

04/18/2017

APL 17-005 (PDF)

Certification of Document and Data Submissions

05/02/2017

APL 17-006 (PDF)

Grievance and Appeal Requirements and Revised Notice Templates and “Your Rights” Attachments

APL 17-006 Member Notices: 

1557 Notices

Notice of Action (NOA)

Notice of Appeal Resolution (NAR)

(Supersedes APL 04-006, APL 05-005, and PL 09-006)

05/09/2017

APL 17-007 (PDF)

Continuity of Care for New Enrollees Transitioned to Managed Care After Requesting a Medical Exemption and Implementation of Monthly Medical Exemption Review Denial Reporting

(Supersedes APL 15-001)

05/11/2017

APL 17-008 (PDF)

Requirement to Participate in the Medi-Cal Drug Utilization Review Program

05/10/2017

APL 17-009 (PDF)

Reporting Requirements Related To Provider Preventable Conditions (Supersedes APL 16-011)

05/23/2017

APL 17-010 (Revised) (PDF)

Non-Emergency Medical and Non-Medical Transportation Services

06/29/2017

Revised 07/17/2017

APL 17-011 (PDF)

Standards for Determining Threshold Languages and Requirements for Section 1557 of the Affordable Care Act (Supersedes APL 14-008)

06/30/2017

APL 17-012 (PDF)

Care Coordination Requirements for Managed Long – Term Services and Supports

(Supersedes APL 14-010)

07/11/2017

APL 17-013 (PDF)

Requirements for Health Risk Assessment of Medi-Cal Seniors and Persons with Disabilities(Supersedes PL 14-005)

07/11/2017

APL 17-014 (PDF)

Quality and Performance Improvement Requirements (Supersedes APL 16-018)

09/11/2017

APL 17-015 (PDF)

Palliative Care and Medi-Cal Managed Care

10/19/2017

APL 17-017 (PDF)

Long Term Care Coordination and Disenrollment (Supersedes APL 03-003)

10/27/2017

APL 17-018 (PDF)

Medi-Cal Managed Care Health Plan Responsibilities for Outpatient Mental Health Services(Supersedes APL 13-021)

10/27/2017

APL 17-019 (PDF)

Provider Credentialing / Recredentialing and Screening / Enrollment (Supersedes APL 16-012)

11/14/2017

APL 17-020 (PDF)

American Indian Health Programs

12/15/2017

APL 17-021 (PDF)

Workers’ Compensation – Notice of Change to Workers’ Compensation Recovery Program; Reporting and Other Requirements (Supersedes APL 04-004)

12/26/2017

2016

Letter Number

Title (Subject) of Letter

Date of Issue

APL 16-001  (PDF)

Medi-Cal Provider and Subcontract Suspensions, Terminations, and Decertifications

(Supersedes APL 06-007)

01/08/2016

APL 16-002  (PDF)

2016-2017 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule

01/19/2016

APL 16-003  (PDF)

Family Planning Services Policy for Contraceptive Supplies

02/05/2016

Revised 12/23/2016

APL 16-004  (PDF)

Medi-Cal Managed Care Health Plans Carved-Out Drugs (Supersedes APL 03-004)

02/19/2016

APL 16-005  (PDF)

Requirements for Use of Non-Monetary Member Incentives for Incentive Programs, Focus Groups, and Member Surveys (Supersedes PL 09-005 and PL 12-002)

02/25/2016

Revised 11/23/2016

APL 16-006  (PDF)

End of Life Option Act

06/08/2016

APL 16-007  (PDF)

Designated Public Hospitals: Billing for Beneficiaries with California Children’s Services Eligible Conditions and/or Medi-Cal Managed Care (Supersedes APL 15-011)

07/18/2016

APL 16-008  (PDF)

Diagnosis Related Groups: Billing for Beneficiaries with California Children’s Services Eligible Conditions and/or Medi-Cal Managed Care (Supersedes APL 13-012)

07/18/2016

APL 16-009  (PDF)

Adult Immunizations as a Pharmacy Benefit 

08/31/2016

Revised 12/23/2016

APL 16-010  (PDF)

Medi-Cal Managed Care Health Plan Pharmaceutical Formulary Comparability Requirement

09/06/2016

APL 16-012 (PDF)

Provider Credentialing and Recredentialing (Supersedes PL 02-003)

09/27/2016

APL 16-013  (PDF)

Ensuring Access to Medi-Cal Services for Transgender Beneficiaries  (Supersedes APL 13-011)

10/06/2016

APL 16-014  (PDF)

Comprehensive Tobacco Prevention and Cessation Services for Medi-Cal Beneficiaries

(Supersedes PL 14-006)

11/30/2016

APL 16-015  (PDF)

Acupuncture Services

12/01/2016

APL 16-016  (PDF)

Rate Changes for Emergency and Post-Stabilization Services Provided by Out-of-Network “Border” Hospitals Under the Diagnosis Related Group Payment Methodology

12/07/2016

APL 16-017  (PDF)

Provision of Certified Nurse Midwife and Alternative Birth Center Facility Services

(Supersedes APL 15-017)

12/09/2016

APL 16-018 (PDF)

Quality and Performance Improvement Requirements (Supersedes APL 15-024)

12/22/2016

APL 16-019 (PDF)

Managed Care Provider Data Reporting Requirements (Supersedes APL 14-006)

12/28/2016

2015

Letter Number

Title (Subject) of Letter

Date of Issue

APL 15-002 (PDF)

Multipurpose Senior Services Program Complaint, Grievance, Appeal, and State Hearing Responsibilities in Coordinated Care Initiative Counties

01/22/2015

APL 15-003 (PDF)

Podiatric and Chiropractic Services at Federally Qualified Health Centers and Rural Health Clinics

01/26/2015

APL 15-004 (PDF)

Medi-Cal Managed Care Health Plan Requirements for Nursing Facility Services in Coordinated Care Initiative Counties For Beneficiaries not Enrolled in Cal MediConnect

02/12/2015

APL 15-005 (PDF)

Data Request Requirements for Child Health Disability Prevention Report Contained in Policy Letter 10-013 (Supersedes PL 10-013)

02/12/2015

APL 15-007 (PDF)

Dispute Resolution Process for Mental Health Services

04/01/2015

APL 15-008 (PDF)

Professional Fees for Office Visits Associated with Alcohol and Substances Use Disorder Treatment Services

04/16/2015

APL 15-009 (PDF)

Proper Use and Billing for Makena (Supersedes APL 13-016)

04/16/2015

APL 15-010 (PDF – 3.6MB)

Affordable Care Act Section 1202 Increased Payments for Medi-Cal Primary Care Services – Revised Guidance and Contractual Requirements

05/01/2015

APL 15-012 (PDF)

Dental Services – Intravenous Sedation and General Anesthesia Coverage (Supersedes PL 13-002)

05/12/2015 

Revised 08/21/2015

APL 15-013 (PDF)

Requirements for Medi-Cal Managed Care Health Plans and Qualified Agency Contract

05/22/2015

APL 15-015 (PDF)

Physical Health Care Covered Services Provided for Members Who Are Admitted to Inpatient Psychiatric Facilities

06/12/2015

APL 15-016 (PDF)

Hepatitis C Virus Treatment Policy Update

06/29/2015

APL 15-018 (PDF)

Criteria for Coverage of Wheelchairs and Applicable Seating and Positioning Components

07/09/2015

APL 15-020 (PDF)

Abortion Services (Supersedes PL 99-008)

09/30/2015

APL 15-021 (PDF)

General Acute Care Inpatient Services:  Claiming for Beneficiaries Covered by Medi-Cal Managed Care and Medi-Cal Diagnosis Related Group Fee-For-Service

10/01/2015

APL 15-023 (PDF)

Facility Site Review Tools for Ancillary Service and Community-Based Adult Services Providers

10/28/2015

APL 15-026 (PDF)

Actions Required Following Notice of a Credible Allegation of Fraud

12/30/2015

2014

Letter Number Title (Subject) of Letter Date of Issue
APL 14-001 (PDF) 2014-2015 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule 01/03/2014
APL 14-002 (PDF) Summary of 2013 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Health Plans 01/13/2014
APL 14-007 (PDF) Dual-Eligible Special Needs Plans 06/26/2014Revised 07/11/14
APL 14-009 (PDF) Transition of Encounter Data Submission to National Standard Transactions (ASC X12 837 5010, NCPDP 2.2 or 4.2) 07/30/2014
APL 14-012 (PDF) Call Center Report Template APL 14-012 Attachment: DHCS Call Center Report Template (MS Excel) 09/25/2014
APL 14-013 (PDF) Grievance Report Template APL 14-013 Attachment: DHCS Grievance Report Template (MS Excel) 09/25/2014 Revised 11/03/2014
APL 14-014 (PDF) Enrollment Requirements for Dual-Eligible Special Needs Plans in Alameda and Orange Counties (Supersedes APL 14-007 for Alameda and Orange Counties) 10/10/2014
APL 14-015 (PDF) Primary Care Provider Assignment in Medi-Cal Managed Care for Dual-Eligible Beneficiaries 11/24/2014
APL 14-016 (PDF) Summary of 2014 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Health Plans 11/24/2014
APL 14-018 (PDF) 2015-2016 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule 12/19/2014
APL 14-019 (PDF) Encounter Data Submission Requirements (Supersedes APL 13-006) 12/19/2014
APL 14-020 (PDF) Quality Measures for Encounter Data APL 14-020 Attachment: DHCS Quality Measures for Encounter Data (PDF) 12/23/2014
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  (Supersedes PL 11-003) 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  (Supersedes PL 02-002) 05/22/2014

2013

Letter Number Title (Subject) of Letter Date of Issue
APL 13-002 (PDF) Processing Errors Related to Denied Medical Exemption Requests Regarding Mandatory Enrollment into a Medi-Cal Managed Care Plan 01/23/2013
APL 13-003 (PDF) Coordination of Benefits: Medicare and Medi-Cal (Supersedes APL 13-001) 02/08/2013
APL 13-004 (PDF) Rates For Emergency And Post-Stabilization Acute Inpatient Services Provided By Out-Of-Network General Acute Care Hospitals Based On Diagnosis Related Groups Effective July 1, 2013 02/12/2013
APL 13-008 (PDF) Contracts with Dual-Eligible Special Needs Plans 07/12/2013
APL 13-009 (PDF) Affordable Care Act (ACA) Section 1202 Final Rule on Increased Payments for Medi-Cal Primary Care Services 10/04/2013 Revised 12/24/13
APL 13-010 (PDF) Managed Care Compliance Plan for Section 1202 of the Affordable Care Act 10/04/2013 Revised 12/24/13
APL 13-014 (PDF) Hospice Services and Medi-Cal Managed Care (Supersedes APL 07-014) 10/28/2013
APL 13-015 (PDF) Marketing Requirements for Medi-Cal and Covered California 10/29/2013Revised 10/30/13
APL 13-017 (PDF) Staying Healthy Assessment/Individual Health Education Behavioral Assessment for Enrollees from Low-Income Health Program 11/18/2013
APL 13-018 (PDF) Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans 11/27/2013
APL 13-019 (PDF) Utilization Data File to be Provided to Medi-Cal Managed Care Health Plans for Transitioning Low-Income Health Program Beneficiaries 11/27/2013
APL 13-020 (PDF) Open Authorization and Scheduled Service Information for New Beneficiaries Transitioning from The Low-Income Health Program 12/04/2013
APL 13-022 (PDF) Medi-Cal Managed Care Health Plan Implementation of Primary Care Provider Assignment and Reimbursement for New Adult Expansion Members 12/24/2013Revised 07/25/2014
APL 13-024 (PDF) Designating Non-Qualified Health Plan Medi-Cal Managed Care Plans as Medicaid Certified Application Counselors 12/30/2013Revised 04/03/14
PL 13-001 (PDF) Requirements for Staying Healthy Assessment/Individual Health Education Behavioral Assessment (Supersedes PL 99-007) 06/28/2018 Revised10/08/2013
PL AB 97 (PDF) Assembly Bill 97 Implementation PL AB 97 Attachment: Specialty Physician Services (PDF) 08/28/2013

2012

Letter Number Title (Subject) of Letter Date of Issue
APL 12-001 (PDF) Contracts with Dual-Eligible Special Needs Plans 04/18/2012
APL 12-003 (PDF) 2012-13 Rates For Emergency-Based Inpatient Services Provided By Out-Of-Network Acute Care Hospitals 07/13/2012Revised
APL 12-004 (PDF) 2012-13 Rates For Post-Stabilization Inpatient Services Provided By Out-Of-Network Acute Care Hospitals (Supersedes APL 12-002) 07/13/2012
APL 12-005 (PDF) 2013-2014 Managed Care Plan MEDS/834 Cutoff and Processing Schedule 12/27/2012
PL 12-003 (PDF) Obstetrical Care-Perinatal Services (Supersedes PL 12-001 and 96-001) 06/26/2012
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

Letter Number Title (Subject) of Letter Date of Issue
APL 11-005 (PDF) Aid Codes 4H and 4L: Identifying Foster Care Children in the California Work Opportunity and Responsibility to Kids (CalWORKS) or 1931(b) Programs 02/10/2011
APL 11-006 (PDF) Disclosure of Select Provider Contracting Program Rates 02/10/2011
APL 11-008 (PDF) Aid Code 4T: Aid Code to Identify Children in the New Federal KIN-GAP Program 03/08/2011
APL 11-010 (PDF) Competency and Sensitivity Training Required In Serving The Needs of Seniors and Persons with Disabilities 05/12/2011
APL 11-012 (PDF) Reporting Responsibilities Regarding Third-Party Tort Liability  (Supersedes PL 96-17) 05/23/2011
APL 11-014 (PDF) Transition to Update HIPAA Transactions for Enrollment and Premium Payments 06/10/2011
APL 11-015 (PDF) Rate Setting: Increased Percentage of Countywide Rates 06/20/2011
APL 11-016 (PDF) 2011-2012 Rates for Emergency-Based Inpatient Services Provided by Out-of-Network Acute Care Hospitals 07/18/2011
APL 11-017 (PDF) 2011-2012 Rates for Post-Stabilization Inpatient Services Provided by Out-of-Network Acute Care Hospitals 07/18/2011
APL 11-018 (PDF) Readability and Suitability of Written Health Education Materials 08/19/2011
APL 11-019 (PDF) Extended Continuity of Care for Seniors and Persons with Disabilities 09/21/2011
APL 11-022 (PDF) Six New Derivative Foster Care Aid Codes 12/06/2011
APL 11-023 (PDF) Aid Code 0W 12/06/2011
APL 11-024 (PDF) 2012-2013 Managed Care Plan MEDS/FAME/5010 834 Cutoff and Processing Schedule 12/27/2011
PL 11-004 (PDF) The Implementation of Section 2302 of the Affordable Care Act, Entitled “Concurrent Care For Children.” 02/10/2011
PL 11-009 (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

2010

Letter Number Title (Subject) of Letter Date of Issue
APL 10-002 (PDF) Rogers Amendment Data Request 03/22/2010
APL 10-003 (PDF) Augmented Reimbursement for Family Planning Services 06/22/2010
APL 10-005 (PDF) Financial Reporting Requirements 06/22/2010
APL 10-007 (PDF) 2010-11 Rates for Emergency Inpatient Services Provided by Out-Of-Network Acute Care Hospitals 07/06/2010
APL 10-008 (PDF) 2010-11 Rates for Post-Stabilization Inpatient Services Provided by Out-of-Network Acute Care Hospitals 07/06/2010
APL 10-009 (PDF) Utilization and Payment Data for Safety-Net Providers 07/13/2010
APL 10-010 (PDF) Reinstatement of Optometry Services 07/15/2010
APL 10-011 (PDF) The Rogers Amendment and Tertiary Hospitals  09/02/2010
APL 10-014 (PDF) Correction to All Plan Letter 10-003 Regarding Augmented Reimbursement for Family Planning Services 12/28/2010
APL 10-015 (PDF) 2011-2012 Managed Care Plans MEDS/FAME/834+Supplemental Cutoff and Processing Schedule 12/28/2010
PL 10-016 (PDF) Revised Facility Site Review Tool  (Supersedes PL 02-002) 12/31/2010

2009

Letter Number Title (Subject) of Letter Date of Issue
APL 09-001 (PDF) 2008 Chaptered Legislation Affecting, or of Interest to Medi-Cal Managed Care Plans 01/14/2009
APL 09-002 (PDF) Aid Codes 06 and 46 01/28/2009
APL 09-003 (PDF) Medi-Cal Managed Care Capitation Report 01/28/2009
APL 09-004 (PDF) Aid Code 6G 03/16/2009
APL 09-008 (PDF) Procedures for Submitting QIP Documents and New Resources for Plans (Includes changes to APL 08-009) 06/09/2009
APL 09-009 (PDF) Indian Health Services 06/11/2009
APL 09-010 (PDF) Aid Code 2H 06/22/2009
APL 09-011 (PDF) List of Contracted Hospitals and Bed Days (Supersedes APL 09-007) 06/22/2009
APL 09-012 (PDF) 2009-10 Rates For Non-Contracted Hospital Emergency Inpatient Services 06/29/2009
APL 09-013 (PDF) 2009-10 Rates For Hospital Payment for Medi-Cal Post-Stabilization Services 06/29/2009
APL 09-014 (PDF) Exhibit G, Health Insurance Portability and Accountability Act (HIPAA)  09/29/2009
APL 09-015 (PDF 2MB) 2010-2011 Managed Care Plan MEDS/FAME/834+Supplemental Cutoff and Processing Schedule  12/29/2009

2008

Letter Number Title (Subject) of Letter Date of Issue
APL 08-001 (PDF) Summary of 2007 Chaptered Legislation Affecting, or of Interest to Medi-Cal Managed Care Plans 02/05/2008
APL 08-004 (PDF) Managed Care Rate Reductions for FY 2008-09 05/12/2008
APL 08-005 (PDF) Managed Care Rate Reductions for FY 2008-09; Technical Clarification to All Plan Letter NO. 08-004 06/18/2008
APL 08-006 (PDF) Interim Procedures Until Execution of New EQRO Contract 06/30/2008
APL 08-007  (PDF) Requirements for Employee Education Regarding False Claims Recovery 07/01/2008
APL 08-008  (PDF) Reimbursement for Non-contracted Hospital Emergency Inpatient Services 10/02/2008
APL 08-010  (PDF) Hospital Payment for Post Medi-Cal Post-Stabilization Services 11/10/2008
APL 08-012  (PDF) 2009-2010 Managed Care Plan MEDS/FAME/834+Supplemental Cutoff and Processing Schedule 12/08/2008
PL 08-002  (PDF) Payment of Invoices Beyond the Six-Month Billing Limit (Supersedes PL 98-11) 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

2007

Letter Number Title (Subject) of Letter Date of Issue

APL 07-001 (PDF)

 Conversion to Electronic Filing of Financial Reports 05/18/2007
APL 07-002  (PDF – 5.5MB) Conlan v. Bonta: Conlan v. Shewry: Court Ordered Medi-Cal Beneficiary Reimbursement Process 01/31/2007
APL 07-003  (PDF) Federal Deficit Reduction Act of 2005 (Reimbursement for Non-Contracted Emergency Services Providers) 03/16/2007
APL 07-004  (PDF) Summary of 2006 Chaptered Legislation Affecting, or of Interest to, Medi-Cal Managed Care Plans 02/13/2007
APL 07-005  (PDF) Implementation of NPI Update 05/18/2007
APL 07-007  (PDF) Federal Deficit Reduction Act of 2005 (Employee Education About False Claims) 03/09/2007
APL 07-008  (PDF) Topical Fluoride Varnish 04/18/2007
APL 07-009  (PDF) New Financial Reporting Requirements 05/14/2007
APL 07-011  (PDF) Update on California Department of Health Services Reorganization 06/06/2007
APL 07-012  (PDF) Identification of Regional Center Consumers 08/24/2007
APL 07-013  (PDF) Quality and Performance Improvement Program Requirements for 2008 09/25/2007
APL 07-017  (PDF) Federal Deficit Reduction Act of 2005, Section 6036 (Citizenship Verification Requirement) 11/06/2007
APL 07-019  (PDF) 2008-2009 Managed Care Plan MEDS/FAME/834+Supplemental Cutoff and Processing Schedule 12/20/2007
APL 07-020  (PDF) Medi-Cal Billing Restriction on the Use of Social Security Numbers 12/26/2007
PL 07-018  (PDF) Senate Bill (SB) 94 – Family Planning Services 12/21/2007

2006

Letter Number Title (Subject) of Letter Date of Issue
APL 06-001 (PDF) HIPAA Requirements: Notice of Privacy Practices and Notification of Breaches 04/13/2006
APL 06-002 (PDF – 4.0MB) MEDICARE PART D UPDATE 06/21/2006
APL 06-003 (PDF – 2.4MB) MEDICARE PART D UPDATE 06/21/2006
APL 06-004 (PDF) National Provider Identifier (NPI) 06/14/2006
APL 06-005 (PDF) Protected Health Information (PHI) and Notification of Breaches 08/03/2006
APL 06-006 (PDF) Update to All Plan Letter 06-04 re: Implementation of the National Provider Identifier (NPI) 09/08/2006
APL 06-008 (PDF) Contraceptive Devices 10/26/2006
APL 06-009 (PDF) Supplemental Data Request Attachment: CA Information Request (Excel)Attachment: Lookup Table (Excel) 10/23/2006
APL 06-010 (PDF) Quality and Performance Improvement Requirements for 2007 11/30/2006
APL 06-011 (PDF) Same Day Banking 11/01/2006
APL 06-012 (PDF) 2007-2008 Managed Care Plan MEDS/FAME Cutoff and Processing Schedule 12/06/2006

2005

Letter Number Title (Subject) of Letter Date of Issue
APL 05-001 (PDF) Summary of 2003 and 2004 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans 01/06/2005
APL 05-002 (PDF – 2.1MB) New Process for Transmitting Enrollment/Disenrollment Data 03/28/2005
APL 05-004 (PDF) Personal Injury Inquiry Letter 04/11/2005
APL 05-006 (PDF) HIPAA Requirements:  Plans’ Reporting Responsibilities 05/02/2005
APL 05-007 (PDF) Erectile Dysfunction Treatment for Known Sex Offenders 06/13/2005
APL 05-008 (PDF) Review and Analysis of Financial Status of Health Plans Proposed Request for Funding Augmentations 10/18/2005
APL 05-009 (PDF) Carve out Erectile Dysfunction Drugs 11/18/2005
APL 05-010 (PDF – 31MB) Advance Directive Form 11/23/2005
APL 05-011 (PDF 2.3MB) 2005-2006 Managed Care Plan (MCP) MEDS/FAME Cutoff and Processing Schedule no date
APL 05-012 (PDF) Medicare Modernization Act; Medicare Part D Prescription Drug Plan 12/14/2005
APL 05-013 (PDF) Medicare Modernization Act; Medicare Part D Implementation System Changes 12/29/2005
APL 05-014 (PDF – 17.3MB) Summary of 2005 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans 12/30/2005

2004

Letter Number Title (Subject) of Letter Date of Issue
APL 04-001 (PDF) 2004 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule 02/02/2004
APL 04-002 (PDF – 4.1MB) Recovery of Capitation Paid to Health Care Plans for Deceased Beneficiaries 04/27/2004
APL 04-003 (PDF – 7.6MB) Medi-Cal Providers on Probation 04/30/2004
APL 04-007 (PDF) Implementation of New Enrollment Forms (Supersedes APL 04-005) 10/29/2004
APL 04-008 (PDF) 2004-2005 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule 12/16/2004

2003

Letter Number Title (Subject) of Letter Date of Issue
APL 03-001 (PDF) Default Assignment of Beneficiaries 01/17/2003
APL 03-002 (PDF 2.5MB) SB 87 Medi-Cal Contact Information Release Form 01/31/2003
APL 03-005 (PDF 5.3MB) Medi-Cal Intercounty Transfers 05/20/2003
APL 03-006 (PDF) Facility Site Review Clarification #2 06/23/2003
APL 03-007 (PDF) Certified Quality Provider Site Certificate 06/23/2003
APL 03-008 (PDF) Quarterly Submission of Grievance Logs 07/07/2003
APL 03-009 (PDF) Implementation of Expedited State Hearings 08/27/2003
APL 03-010 (PDF) Medi-Cal Managed Care Plan Requirements for Provision of Contraceptive Drug Services and Supplies 09/12/2003
APL 03-011 (PDF) Fraud Referral Procedure to Audits and Investigations (A&I) 10/22/2003
APL 03-012 (PDF) Medi-Cal Providers on Probation 10/24/2003
APL 03-013 (PDF) Non Contracted Emergency Room Rate Schedule 12/12/2003
APL 03-014 (PDF) Delmarva Foundation for Medical Care, Inc. 12/12/2003
APL 03-015 (PDF) Use of Services Measures 12/17/2003
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

Letter Number Title (Subject) of Letter Date of Issue
APL 02-001 (PDF) Medi-Cal HIV/AIDS Home and Community Based Services Waiver Program 07/19/2002
APL 02-002 (PDF) Possible Movement of Fame Files from the CA Health and Human Services (CHHS) Data Center to the Medi-Cal Web Site 03/15/2002
APL 02-004 (PDF) Health Plan Employer Data and Information Set (HEDIS) and Consumer Assessment of Health Plans (CAHPS) Reports Are Now Available on the DHCS Internet Site 06/11/2002
APL 02-005 (PDF) Emergency Services Medical Claim Coding and Documentation Guidelines 08/07/2002
APL 02-006 (PDF) Implementation of Medi-Cal Managed Care Policy Letter 02-02 09/25/2002
APL 02-007 (PDF) Summary of 2002 Chaptered Legislation for Medi-Cal Managed Care Plans 11/12/2002
APL 02-008 (PDF) External Accountability Set (EAS) Performance Measure Audits 11/26/2002
APL 02-009 (PDF) 2003 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule 12/27/2002
PL 02-001 (PDF) Blood Lead Screening of Young Children 02/22/2002
PL 02-004 (PDF) Health Education 06/21/2002

2001

Letter Number Title (Subject) of Letter Date of Issue
APL 01-001 (PDF) Summary of 2000 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans 01/16/2001
APL 01-002 (PDF – 7.9MB) Reporting and Other Requirements Regarding Workers’ Compensation Recovery 02/21/2001
APL 01-003 (PDF) Mifepristone (RU-486) As a Medi-Cal Benefit 07/25/2001
APL 01-004 (PDF) Health Plan Choice Reminders (Annual Renotifications) 08/21/2001
APL 01-005 (PDF – 6.2MB) Implementation of a New Process Which Will Reject Encounter Data At Record Level 11/26/2001
APL 01-006 (PDF) 2002 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule 12/24/2001
APL 01-007 (PDF – 21.7MB) Summary of 2001 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans 12/17/2001
APL 01-008 (PDF) Breast and Cervical Cancer Treatment Program 12/17/2001
PL 01-001 (PDF) Corrective Action Plan (CAP) Standardized Format  (Supersedes PL 92-020) 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

Letter Number Title (Subject) of Letter Date of Issue
APL 00-001 (PDF – 10.1MB) 2000 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule  02/03/2000
APL 00-002 (PDF) Medi-Cal Managed Care Medical Exemptions 02/29/2000
APL 00-003 (PDF) Policy and Procedure Revisions 03/07/2000
APL 00-004 (PDF) 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) 04/14/2000
APL 00-005 (PDF) Invitation to All Plan Meeting on Year 2000 Proposed Contract Amendments 05/09/2000
APL 00-006 (PDF) Maximus Warehouse Relocation 06/05/2000
APL 00-007 (PDF) Potential Increase in New Enrollees Due to Changes in the Section 1931(b) Program 07/05/2000
APL 00-008 (PDF) Importance of Increased Outreach to New Eligibles Under the Section 1931(b) Program 08/15/2000
APL 00-009 (PDF) Percent of Poverty Population 09/15/2000
APL 00-010 (PDF) Draft 2000 Medi-Cal Managed Care Contract Amendments Package 00-01 09/13/2000
APL 00-011 (PDF) Ensuring Beneficiaries Receive Laboratory Services From CLIA Certified Laboratories 10/17/2000
APL 00-012 (PDF) Utilization Review of Initial Risk Assessments for Pregnant Women 12/22/2000
APL 00-013 (PDF) Amended Regulations for Enrollment and Disenrollment for Two-Plan Model Plans 12/28/2000
APL 00-014 (PDF) 2001 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule 12/29/2000
PL 00-001 (PDF) Medi-Cal Managed Care Plan Responsibilities Under the Medi-Cal Specialty Mental Health Services Consolidation Program 03/16/2000
PL 00-002 (PDF) Health Plan Provider Directory Policy, Guidelines and Delivery Standards (Supersedes PL 97-009) 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

1999

Letter Number Title (Subject) of Letter Date of Issue
APL 99-001 (PDF) Managed Care Plan Utilization of Therapeutic Pharmaceutical Agents-Certified Optometrists 01/21/1999
APL 99-002 (PDF) 1999 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule 01/21/1999
APL 99-003 (PDF) Year 2000 Readiness Certification and Business Continuation Plan 01/27/1999
APL 99-004 (PDF) New Laws from the 1997-98 Session of the California Legislature Affecting the Medi-Cal Program 02/17/1999
APL 99-005 (PDF) Cultural Competency in Health Care – Meeting the Needs of a Culturally and Linguistically Diverse Population 04/02/1999
APL 99-006 (PDF) Encounter Data Work Group 4/28/1999
APL 99-007 (PDF) Medi-Cal Managed Care Health Education Work Group and the “Staying Healthy” Assessment Subcommittee 06/01/1999
APL 99-008 (PDF) Updates to Managed Care Data Dictionary 07/14/1999
APL 99-009 (PDF) Draft 1999 Medi-Cal Managed Care Contract Amendments 07/26/1999
APL 99-010 (PDF) Status of the Conversion to the Fiscal Intermediary Access to Medi-Cal Eligibility 08/03/1999
APL 99-011 (PDF – 12.9MB) New Medi-Cal Managed Care Exemption Forms 08/03/1999
APL 99-012 (PDF) Revision to All Plan Letter 99003 Re: Year 2000 Readiness (Revises APL 99-003) 10/08/1999
APL 99-013 (PDF) Concurrent Participation in the Medi-Cal Managed Care Program and the Multipurpose Senior Services Program 10/20/1999
APL 99-014 (PDF) Summary of 1999 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans 12/01/1999
APL 99-015 (PDF) Emergency Services Claims 12/06/1999
APL 99-016 (PDF) Year 2000 Contingency Plan Update 12/16/1999
PL 99-001 (PDF) Community Advisory Committee (CAC) 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 – 3MB) 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

1998

Letter Number Title (Subject) of Letter Date of Issue
APL 98-003 (PDF) 1998 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule 02/20/1998
APL 98-006 (PDF) California Children Services Numbered Letters 01-0298 and 09-0598 07/28/1998
APL 98-007 (PDF) Recombinant Growth Hormone Injections  03/27/1998
APL 98-009 (PDF) AID Code 38 11/25/1998
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 98-006 (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  (Supersedes PL 94-13 and PL 95-03) 12/28/1998
PL 98-012 (PDF) Primary Care Physician Selection and Assignment Policy 12/30/1998

1997

Letter Number Title (Subject) of Letter Date of Issue
PL 97-008 (PDF) HIV Counseling and Testing Policy (Supersedes PL 94-13 and PL 96-09) 08/13/1997

1996

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