Current All Plan and Policy Letters
2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001 | 2000 | 1999 | 1998 | 1997 | 1996 | Archive
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 Superseded letters are moved to the “Archived All Plan, Duals Plan and Policy Letters” web page when the information is no longer current.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 |
|---|---|---|
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Medi-Cal Managed Care Health Plan Guidance on Network Provider Status |
01/17/2019 |
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Network Certification Requirements (Supersedes APL 18-005) APL 19-002 Attachments:
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01/30/2019 |
2018
|
Letter Number |
Title (Subject) of Letter |
Date of Issue |
|---|---|---|
|
Voluntary Inpatient Detoxification (Supersedes APL 14-005) |
01/11/2018 |
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2018-2019 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule |
01/11/2018 |
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Administrative and Financial Sanctions (Supersedes APL 15-014) |
01/25/2018 |
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Immunization Requirements (Supersedes PL 96-013 and APL 07-015) |
01/31/2018 |
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Network Certification Requirements |
02/16/2018 |
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Responsibilities for Behavioral Health Treatment Coverage for Members Under the Age of 21 (Supersedes APL 15-025) |
03/02/2018 |
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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 |
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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 |
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Memorandum of Understanding Requirements for Medi-Cal Managed Care Health Plans and Regional Centers (Supersedes APL 15-022) |
03/02/2018 |
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Proposition 56 Directed Payment Expenditures for Specified Services for State Fiscal Year 2017-18 |
05/01/2018 |
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California Children’s Services Whole Child Model Program |
06/07/2018 |
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Health Homes Program Requirements |
06/28/2018 |
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Hepatitis C Virus Treatment Policy Update (Supersedes APL 15-016) |
08/14/2018 |
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Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care (Supersedes APL 17-016) |
09/14/2018 |
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Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans APL 18-015 Attachments: |
09/19/2018 |
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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 |
|---|---|---|
|
2017-2018 Medi-Cal Managed Care Health Plan Meds/834 Cutoff And Processing Schedule |
01/03/2017 |
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Health Education and Cultural and Linguistic Group Needs Assessment (Supersedes PL 10-012) |
02/03/2017 |
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Treatment of Recoveries Made by the Managed Care Health Plan of Overpayments to Providers |
03/30/2017 |
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Subcontractual Relationships and Delegation |
04/18/2017 |
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Certification of Document and Data Submissions |
05/02/2017 |
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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 |
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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 |
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Requirement to Participate in the Medi-Cal Drug Utilization Review Program |
05/10/2017 |
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Reporting Requirements Related To Provider Preventable Conditions (Supersedes APL 16-011) |
05/23/2017 |
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Non-Emergency Medical and Non-Medical Transportation Services |
06/29/2017 Revised 07/17/2017 |
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Standards for Determining Threshold Languages and Requirements for Section 1557 of the Affordable Care Act (Supersedes APL 14-008) |
06/30/2017 |
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Care Coordination Requirements for Managed Long – Term Services and Supports (Supersedes APL 14-010) |
07/11/2017 |
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Requirements for Health Risk Assessment of Medi-Cal Seniors and Persons with Disabilities(Supersedes PL 14-005) |
07/11/2017 |
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Quality and Performance Improvement Requirements (Supersedes APL 16-018) |
09/11/2017 |
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Palliative Care and Medi-Cal Managed Care |
10/19/2017 |
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Long Term Care Coordination and Disenrollment (Supersedes APL 03-003) |
10/27/2017 |
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Medi-Cal Managed Care Health Plan Responsibilities for Outpatient Mental Health Services(Supersedes APL 13-021) |
10/27/2017 |
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Provider Credentialing / Recredentialing and Screening / Enrollment (Supersedes APL 16-012) |
11/14/2017 |
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American Indian Health Programs |
12/15/2017 |
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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 |
|---|---|---|
|
Medi-Cal Provider and Subcontract Suspensions, Terminations, and Decertifications (Supersedes APL 06-007) |
01/08/2016 |
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2016-2017 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule |
01/19/2016 |
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Family Planning Services Policy for Contraceptive Supplies |
02/05/2016 Revised 12/23/2016 |
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Medi-Cal Managed Care Health Plans Carved-Out Drugs (Supersedes APL 03-004) |
02/19/2016 |
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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 |
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End of Life Option Act |
06/08/2016 |
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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 |
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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 |
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Adult Immunizations as a Pharmacy Benefit |
08/31/2016 Revised 12/23/2016 |
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Medi-Cal Managed Care Health Plan Pharmaceutical Formulary Comparability Requirement |
09/06/2016 |
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Provider Credentialing and Recredentialing (Supersedes PL 02-003) |
09/27/2016 |
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Ensuring Access to Medi-Cal Services for Transgender Beneficiaries (Supersedes APL 13-011) |
10/06/2016 |
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Comprehensive Tobacco Prevention and Cessation Services for Medi-Cal Beneficiaries (Supersedes PL 14-006) |
11/30/2016 |
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Acupuncture Services |
12/01/2016 |
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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 |
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Provision of Certified Nurse Midwife and Alternative Birth Center Facility Services (Supersedes APL 15-017) |
12/09/2016 |
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Quality and Performance Improvement Requirements (Supersedes APL 15-024) |
12/22/2016 |
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Managed Care Provider Data Reporting Requirements (Supersedes APL 14-006) |
12/28/2016 |
2015
|
Letter Number |
Title (Subject) of Letter |
Date of Issue |
|---|---|---|
|
Multipurpose Senior Services Program Complaint, Grievance, Appeal, and State Hearing Responsibilities in Coordinated Care Initiative Counties |
01/22/2015 |
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Podiatric and Chiropractic Services at Federally Qualified Health Centers and Rural Health Clinics |
01/26/2015 |
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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 |
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Data Request Requirements for Child Health Disability Prevention Report Contained in Policy Letter 10-013 (Supersedes PL 10-013) |
02/12/2015 |
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Dispute Resolution Process for Mental Health Services |
04/01/2015 |
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Professional Fees for Office Visits Associated with Alcohol and Substances Use Disorder Treatment Services |
04/16/2015 |
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Proper Use and Billing for Makena (Supersedes APL 13-016) |
04/16/2015 |
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Affordable Care Act Section 1202 Increased Payments for Medi-Cal Primary Care Services – Revised Guidance and Contractual Requirements |
05/01/2015 |
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Dental Services – Intravenous Sedation and General Anesthesia Coverage (Supersedes PL 13-002) |
05/12/2015 Revised 08/21/2015 |
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Requirements for Medi-Cal Managed Care Health Plans and Qualified Agency Contract |
05/22/2015 |
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Physical Health Care Covered Services Provided for Members Who Are Admitted to Inpatient Psychiatric Facilities |
06/12/2015 |
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Hepatitis C Virus Treatment Policy Update |
06/29/2015 |
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Criteria for Coverage of Wheelchairs and Applicable Seating and Positioning Components |
07/09/2015 |
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Abortion Services (Supersedes PL 99-008) |
09/30/2015 |
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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 |
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Facility Site Review Tools for Ancillary Service and Community-Based Adult Services Providers |
10/28/2015 |
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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 |
| 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 |
| 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 |