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Managed Care All Plan Letters – 1998 to Current

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Return to Managed Care All Plan & Policy Letters – Subject Listing

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2026 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 26-001

Initial Health Appointment1/7/2026
APL 26-002

Medi-Cal Managed Care Plan Responsibilities for Non-Specialty Mental Health Services (Supersedes APL 22-006)2/2/2026
APL 26-003

Quality Measures For Encounter Data Update: Quality Measures For Encounter Data 2.0 (Supersedes APL 14-020)3/13/2026
APL 26-004

Medi-Cal Managed Care Plan Responsibilities For Behavioral Health Data-Sharing3/16/2026
APL 26-005

Maternity Services for Pregnant and Postpartum Medi-Cal Members (Supersedes APLs 00-012, 18-022, and Policy Letters 98-006, 98-010, and 12-003)3/25/2026
APL 26-006

Skilled Nursing Facility Workforce Quality Incentive Program (Supersedes APl 25-002)
3/20/2026
APL 26-007Medi-Cal Managed Care Plan Guidance on Network Provider Agreements (Supersedes APL 19-001)
4/24/2026

2025 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 25-0012024-2025 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule1/17/2025
APL 25-002Skilled Nursing Facility Workforce Quality Incentive Program (Superseded by APL 26-006)1/13/2025
APL 25-003Establishing Dual Eligible Special Needs Plans by 20261/15/2025
APL 25-004Community Reinvestment Requirements2/7/2025
APL 25-005Standards For Determining Threshold Languages, Nondiscrimination Requirements, Language Assistance Services, And Alternative Formats (Supersedes APL 21-004)2/12/2025
APL 25-006

Timely Access Requirements4/25/2025

Revised
11/18/2025
APL 25-007

Enforcement Actions: Corrective Action Plans, Administrative and Monetary Sanctions (Supersedes APL 23-012)
4/25/2025
APL 25-008

Hospice Services and Medi-Cal Managed Care5/5/2025
APL 25-009Community Advisory Committee

5/12/2025

APL 25-010

Adult and Youth Screening and Transition of Care Tools for Medi-Cal Mental Health Services (Supersedes APL 22-028)

6/3/2025
APL 25-011

H.R. 1 – Federal Payments to Prohibited Entities7/3/2025

Revised

09/17/2025

APL 25-012

Targeted Provider Rate Increases8/19/2025
APL 25-013

Medi-Cal Rx Pharmacy Benefits, And Cell and Gene Therapy Coverage (Supersedes APL 22-012)
9/18/2025
APL 25-014

Update to Provider Directory Requirements9/26/2025
APL 25-015Data Sharing and Quality Rate Production for Directed Payment Initiatives and Alternative Payment Methodology Programs10/2/2025
APL 25-016

Alternative Format Selection For Members With Visual Impairments (Supersedes APL 22-002)11/13/2025
APL 25-0172025-2027 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule 12/26/2025

2024 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 24-001Street Medicine Provider: Definitions and Participation in Managed Care (Supersedes APL 22-023)01/12/2024
APL 24-002Medi-Cal Managed Care Plan Responsibilities for Indian Health Care Providers and American Indian Members (Supersedes APL 09-009)2/8/2024
APL 24-003Abortion And Directly Related Medical Services And Supplies3/28/2024
APL 24-004Quality Improvement and Health Equity Transformation Requirements (Supersedes APL 19-017)4/8/2024
APL 24-005California Housing And Homelessness Incentive (Supersedes APL 22-007)4/29/2024
APL 24-006Community Health Worker Services Benefit (Supersedes APL 22-016)5/13/2024
APL 24-007Targeted Provider Rate Increases6/20/2024
APL 24-008

Immunization Requirements (Supersedes APLs 18-004 and 16-009)6/21/2024
APL 24-009

Skilled Nursing Facilities – Long Term Care Benefit Standardization and Transition of Members to Managed Care (Supersedes APL 23-004)9/16/2024
APL 24-010

Subacute Care Facilities – Long Term Care Benefit Standardization and Transition of Members to Managed Care (Supersedes APL 23-027)    9/16/2024
APL 24-011

Intermediate Care Facilities for Individuals with Developmental Disabilities – Long Term Care Benefit Standardization and Transition of Members to Managed Care (Supersedes APL 23-023)9/16/2024
APL 24-012Non-Specialty Mental Health Services: Member Outreach, Education, and Experience Requirements9/17/2024
APL 24-013Managed Care Plan Child Welfare Liaison9/18/2024
APL 24-014

Continuity Of Care For Medi-Cal Members Who Are Foster Youth And Former Youth In Single Plan Counties9/27/2024
APL 24-015

California Children’s Services Whole Child Model Program (Supersedes APL 23-034)12/2/2024
APL 24-016

Diversity, Equity, And Inclusion Training ProgramRequirements (Supersedes APL 23-025)12/5/2024
APL 24-017

Transgender, Gender Diverse or Intersex Cultural Competency Training Program and Provider Directory Requirements12/5/2024
APL 24-018

Medical Loss Ratio Requirements For Subcontractors And Downstream Subcontractors12/13/2024
APL 24-019Minor Consent to Outpatient Mental Health Treatment or Counseling12/31/2024

2023 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 23-001Network Certification Requirements (Supersedes APL 21-006)01/06/2023
APL 23-002

2023-2024 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule

01/17/2023
APL 23-003California Advancing and Innovating Medi-Cal Incentive Payment Program (Supersedes APL 21-016)03/08/2023
APL 23-004Skilled Nursing Facilities — Long Term Care Benefit Standardization and Transition of Members to Managed Care (Supersedes APL 22-018)03/14/2023
APL 23-005Requirements For Coverage of Early and Periodic Screening, Diagnostic, and Treatment Services for Medi-Cal Members Under the Age of 21 (Supersedes APL 19-010)03/16/2023
APL 23-006Delegation and Subcontractor Network Certification (Supersedes APL 17-004)03/28/2023
APL 23-007Telehealth Services Policy (Supersedes APL 19-009)04/10/2023
APL 23-008Proposition 56 Directed Payments for Family Planning Services (Supersedes APL 22-011)04/28/2023

Revised 06/27/2023
APL 23-009Authorizations for Post-Stabilization Care Services05/03/2023
APL 23-010Responsibilities for Behavioral Health Treatment Coverage for Members Under the Age of 21 (Supersedes APL 19-014)

05/04/2023

Revised 11/22/2023
APL 23-011Treatment of Recoveries Made by the Managed Care Health Plan of Overpayments to Providers (Supersedes APL 17-003)05/08/2023
APL 23-012Enforcement Actions: Administrative and Monetary Sanctions (Supersedes APL 22-015)(Superseded by 25-007)05/12/2023

Revised 12/04/2023
APL 23-013Mandatory Signatories to the California Health and Human Services Agency Data Exchange Framework05/18/2023

Revised
09/05/2023
APL 23-014Proposition 56 Value-Based Payment Program Directed Payments (Supersedes APL 22-019)06/09/2023
APL 23-015Proposition 56 Directed Payments For Private Services (Supersedes APL 19-013)06/09/2023
APL 23-016Directed Payments for Developmental Screening Services (Supersedes APL 19-016)06/09/2023
APL 23-017Directed Payments for Adverse Childhood Experiences Screening Services (Supersedes APL 19-018)06/13/2023
APL 23-018Managed Care Health Plan Transition Policy Guide06/23/2023
APL 23-019Proposition 56 Directed Payments for Physician Services (Supersedes APL 19-015)07/25/2023
APL 23-020Requirements for Timely Payment of Claims 

07/26/2023

Revised
10/12/2023
APL 23-021Population Needs Assessment and Population Health Management Strategy (Supersedes APL 19-011)08/15/2023
APL 23-022Continuity of Care for Medi-Cal Beneficiaries Who Newly Enroll in Medi-Cal Managed Care from Medi-Cal Fee-For-Service, on or After January 1, 2023 (Supersedes APL 22-032)08/15/2023
APL 23-023Intermediate Care Facilities for Individuals with Developmental Disabilities — Long Term Care Benefit Standardization and Transition of Members to Managed Care (Superseded by APL 24-011)08/18/2023

Revised 11/28/2023
APL 23-024Doula Services (Supersedes APL 22-031)

08/24/2023

Revised
11/3/2023
APL 23-025Diversity, Equity, and Inclusion Training Program Requirements (Supersedes APL 99-005) (Superseded by APL 24-016)09/14/2023
APL 23-026Federal Drug Utilization Review Requirements Designed to Reduce Opioid Related Fraud, Misuse and Abuse (Supersedes APL 19-012)09/25/2023

Revised
02/20/2024
APL 23-027Subacute Care Facilities — Long Term Care Benefit Standardization and Transition of Members to Managed Care09/26/2023
APL 23-028Dental Services – Intravenous Moderate Sedation and
Deep Sedation/General Anesthesia Coverage
(Supersedes APL 15-012)
10/03/2023
APL 23-029Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and Third-Party Entities10/11/2023










Revised
08/11/2025
APL 23-030Medi-Cal Justice-Involved Reentry Initiative-Related State Guidance10/24/2023
APL 23-031Medi-Cal Managed Care Plan Implementation of Primary Care Provider Assignment for the Age 26-49 Adult Expansion Transition12/20/2023
APL 23-032Enhanced Care Management Requirements (Supersedes APL 21-012)12/22/2023
APL 23-0332024-2025 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule12/26/2023
APL 23-034California Children’s Services Whole Child Model Program (Supersedes APL 21-005) (Superseded by APL 24-015)12/27/2023
APL 23-035Student Behavioral Health Incentive Program 12/28/2023

2022 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 22-0012022-2023 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule01/11/2022
APL 22-002Alternative Format Selection for Members with Visual Impairments 03/14/2022
APL 22-003Medi-Cal Managed Care Health Plan Responsibility to Provide Services to Members with Eating Disorders03/17/2022
APL 22-004 (Revised)Strategic Approaches for Use By Managed Care Plans to Maximize Continuity of Coverage as Normal Eligibility and Enrollment Operations Resume 03/17/2022

Revised 04/18/2023
APL 22-005No Wrong Door for Mental Health Services Policy

03/30/2022
APL 22-006Medi-Cal Managed Care Health Plan Responsibilities for Non-Specialty Mental Health Services (Supersedes APL 17-018)
Superseded by APL 26-002
04/08/2022
APL 22-007California Housing and Homelessness Incentive Program05/05/2022

Revised
9/19/2022
APL 22-008Non-Emergency Medical and Non-Medical Transportation Services and Related Travel Expenses (Supersedes APL 17-010)05/18/2022
APL 22-009COVID-19 Guidance for Medi-Cal Managed Care Health Plans- RETIRED06/13/2022
APL 22-010Cancer Biomarker Testing

06/22/2022
APL 22-011Proposition 56 Directed Payments for Family Planning Services (Supersedes APL 20-013)

Superseded by 23-008
06/23/2022
APL 22-012Governor’s Executive Order N-01-19, Regarding Transitioning Medi-Cal Pharmacy Benefits from Managed Care to Medi-Cal RX (Supersedes APL 20-020)07/11/2022

Revised 12/30/2022
APL 22-013Provider Credentialing/Re-Credentialing and Screening/Enrollment (Supersedes APL 19-004) 07/19/2022

Revised
1/02/2025
APL 22-014Electronic Visit Verification Implementation Requirements

07/21/2022
APL 22-015Enforcement Actions: Administrative and Monetary Sanctions (Supersedes APL 18-003)

Superseded by 23-012
08/24/2022
APL 22-016Community Health Worker Services Benefit 09/02/2022

Revised 09/18/2023
APL 22-017Primary Care Provider Site Reviews: Facility Site Review and Medical Record Review (Supersedes APL 20-006)09/22/2022
APL 22-018Skilled Nursing Facilities — Long Term Care Benefit Standardization and Transition of Members to Managed Care

Superseded by 23-004
09/28/2022

Revised 12/27/2022
APL 22-019Proposition 56 Value-Based Payment Program Directed Payments (Supersedes APL 20-014)

Superseded by 23-014
10/10/2022
APL 22-020Community-Based Adult Services Emergency Remote Services (Supersedes APL 20-007)
Reporting Template
10/21/2022

Revised 11/2/2022
APL 22-021Proposition 56 Behavioral Health Integration Incentive Program10/26/2022
APL 22-022Abortion Services (Supersedes APL 15-020)

Superseded by 24-003
10/28/2022
APL 22-023Street Medicine Provider: Definitions and Participation in Managed Care

Superseded by 24-001
11/08/2022
APL 22-024Population Health Management Program Guide (Supersedes APLs 17-012 and 17-013)11/28/2022
APL 22-025Responsibilities for Annual Cognitive Health Assessment for Eligible Members 65 Years of Age or Older11/28/2022
APL 22-026Interoperability and Patient Access Final Rule

11/29/2022
APL 22-027Cost Avoidance and Post-Payment Recovery for Other Health Coverage (Supersedes APL 21-002)

12/06/2022
APL 22-028Adult and Youth Screening and Transition of Care Tools for Medi-Cal Mental Health Services

Superseded by 25-010
12/27/2022
APL 22-029Dyadic Services and Family Therapy Benefit12/27/2022

Revised 03/20/2023
APL 22-030Initial Health Appointment (Supersedes APL 13-017 
and Policy Letters 13-001 and 08-003)
12/27/2022
APL 22-031Doula Services

Superseded by 23-024
12/27/2022
APL 22-032Continuity of care for Medi-Cal Beneficiaries who newly enroll in Medi-Cal Managed Care from Medi-Cal Fee-for-Service, and for Medi-Cal members who transition into a new Medi-Cal Managed Care Health Plan on or after January 1, 2023 (Supersedes APL 18-008)

Superseded by 23-022
12/27/2022

2021 – All Plan Letters

Letter Number

Title (Subject) of LetterDate of Issue
APL 21-001
2021-2022 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule
01/07/2021
APL 21-002Cost Avoidance and Post-Payment Recovery for Other Health Coverage
(Supersedes Policy Letter 08-011)
Superseded by 22-027
02/25/2021

Revised
07/14/2021


APL 21-003Medi-Cal Network Provider and Subcontractor Terminations (Supersedes APL 16-001)03/03/2021
APL 21-004Standards for Determining Threshold Languages, Nondiscrimination Requirements, and Language Assistance Services (Supersedes APL 17-011 and Policy Letters 99-003 and 99-004) 04/08/2021

Revised
05/24/2023


APL 21-005California Children’s Services Whole Child Model Program (Supersedes APL 18-023)

Superseded by 23-034
04/15/21

Revised 12/10/21
APL 21-006Network Certification Requirements (Supersedes APL 20-003)
Superseded by 23-001
04/27/2021
APL 21-007Third Party Tort Liability Reporting Requirements
(Supersedes APLs 01-002, 11-012 AND 17-021)
AP 21-007 Attachments:
05/10/2021
APL 21-008

Tribal Federally Qualified Health Center Providers
APL 21-008 Attachments:
05/12/2021

Revised:
04/09/2026
APL 21-009

Collecting Social Determinants of Health Data08/10/2021

Revised
02/03/2022
APL 21-010 (Revised)Medi-Cal COVID-19 Vaccination Incentive Program
APL 21-010 Attachments:
Attachment A: Vaccination Incentive Program – Health Plan Outcome Metrics
8/13/2021

Revised:
03/07/2022 
APL 21-011Grievance and Appeals Requirements, Notice and “Your Rights” Templates
(Supersedes APL 17-006)

 
APL 21-011 Member Notices:

 
Notice of Action (NOA)
Notice of Appeal Resolution (NAR)
08/31/2021

Revised 08/31/2022
APL 21-012Enhanced Care Management Requirements

Superseded by 23-032

09/15/2021
APL 21-013Dispute Resolution Process Between Mental Health Plans and Medi-Cal Managed Care Health Plans (Supersedes APL 15-007)10/04/2021
APL 21-014Alcohol and Drug Screening, Assessment, Brief Interventions and Referral to Treatment (Supersedes APL 18-014)

10/11/2021
APL 21-015Benefit Standardization and Mandatory Managed Care Enrollment Provisions of the California Advancing and Innovating Medi-Cal Initiative

10/18/2021

Revised 10/14/2022
APL 21-016California Advancing and Innovating Medi-Cal Incentive Payment Program

Superseded by 23-003
10/27/2021
APL 21-017Community Supports Requirements 11/05/2021

Revised
03/01/2022
APL 21-018Public and Private Hospital Directed Payment Programs for State Fiscal Years 2017-18 and 2018-19, the Bridge Period, and Calendar Year 202112/23/2021

2020 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue
APL 20-001
2020-2021 Medi-Cal Managed Care Health Plan Meds/834 Cutoff And Processing Schedule

01/03/2020
APL 20-002Non-Contract Ground Emergency Medical Transport Payment Obligations01/31/2020
APL 20-003Network Certification Requirements 
(Supersedes APL 19-002)
APL 20-003 Attachments:
02/27/2020
APL 20-004 (Revised)Emergency Guidance for Medi-Cal Managed Care Health Plans in Response to COVID-19 – RETIRED06/08/2020

Revised:
04/04/2023
APL 20-005 Extension of the Adult Expansion Risk Corridor for State Fiscal Year 2017-1803/26/2020
APL 20-006Site Reviews: Facility Site Review and Medical Record Review (Supersedes PLs 14-004 and 03-002, and APL 03-007)
Superseded by 22-017
03/04/2020
APL 20-007 (Revised)

Policy Guidance for Community-Based Adult Services in Response to COVID-19 Public Health Emergency


 

Superseded by 22-020

03/30/2020

Revised: 04/13/2020

APL 20-008Mitigating Health Impacts of Secondary Stress Due to the COVID-19 Emergency
04/07/2020
APL 20-009Preventing Isolation of and Supporting Older and Other At-Risk Individuals to Stay Home and Stay Healthy During COVID-19 Efforts04/15/2020
APL 20-010RETRACTED
APL 20-011 (Revised)Governor’s Executive Order N-55-20 in Response to COVID-19

06/12/2020

Revised 07/08/2021
APL 20-012Private Duty Nursing Case Management Responsibilities tor Medi-Cal Eligible Members Under the Age of 2105/15/2020
APL 20-013Proposition 56 Directed Payments for Family Planning Services

Superseded by 22-011
05/13/2020
APL 20-014Proposition 56 Value-Based Payment Program Directed Payments

Superseded by 22-019
05/15/2020
APL 20-015State Non-Discrimination and Language Assistance Requirements

06/24/2020
APL 20-016 (Revised)Blood Lead Screening of Young Children (Supersedes APL18-017)

09/29/2020

Revised:
11/02/2020
APL 20-017Requirements for Reporting Managed Care Program Data (Supersedes APLs 14-013 (Revised) and 14-012)10/14/2020
APL 20-018Ensuring Access to Transgender Services (Supersedes APL16-013)10/26/2020
APL 20-019RETRACTED
APL 20-020Governor’s Executive Order N-01-19, Regarding Transitioning Medi-Cal Pharmacy Benefits from Managed Care to Medi-Cal Rx

Superseded by 22-012
11/04/2020
APL 20-021 (Revised)Acute Hospital Care at Home – RETIRED

12/28/2020

Revised 01/19/2021
APL 20-022 (Revised)COVID-19 Vaccine Administration – RETIRED12/28/2020

Revised
10/06/2022

2019 – All Plan Letters

Letter Number Title (Subject) of LetterDate of Issue
Medi-Cal Managed Care Health Plan Guidance on Network Provider Status (Superseded by APL 27-007)
01/17/2019
APL 19-002Network Certification Requirements (Supersedes APL 18-005)
APL 19-002 Attachments:
Superseded by 20-003
01/30/2019
APL 19-003Providing Informing Materials to Medi-Cal Beneficiaries in an Electronic Format05/02/2019
APL 19-004Provider Credentialing / Recredentialing and Screening / Enrollment (Supersedes APL 17-019)

Medi-Cal Provider Enrollment Frequently Asked Questions

Superseded by 22-013
06/12/2019
APL 19-005

Federally Qualified Health Centers and Rural Health Clinics Financial Incentive and Pay For Performance Payment Policy

06/12/2019
APL 19-006Proposition 56 Physicians Directed Payments for Specified Services for State Fiscal Years 2017-18 & 2018-19 (Supersedes APL 18-010)

Superseded by 19-015
06/13/2019
APL 19-007Non-Contract Ground Emergency Medical Transport Payment Obligations for State Fiscal Year 2018-1906/14/2019
APL 19-008Rate Changed for Emergency and Post-Stabilization Services Provided by Out-of-Network Border Hospitals Under the Diagnosis Related Group Payment Methodology: Outcome of Federal Court Litigation Rejecting A Challenge to State Plan Amendment 15-020 (Supersedes APL 16-016) 06/18/2019

APL 19-009 (Revised)

Telehealth Services Policy

Superseded by 23-007

08/05/2019

Revised: 03/18/2020

APL 19-010Requirements for Coverage of Early and Periodic Screening, Diagnostic, and Treatment Services for 
Medi-Cal Members Under the Age of 21 (Supersedes APL 18-007 and 07-008)

 
Superseded by 23-005
08/14/2019
APL 19-011Health Education and Cultural and Linguistic Population Needs Assessment (Supersedes APL 17-002)

Superseded by 23-021
09/30/2019
APL 19-012Federal Drug Utilization Review Requirements Designed to Reduce Opioid Related Fraud, Misuse and Abuse

Superseded by 23-026
09/30/2019

Revised: 11/15/2019
APL 19-013Proposition 56 Hyde Reimbursement Requirements for Specified Services 

Superseded by 23-015
10/17/2019
APL 19-014Responsibilities for Behavioral Health Treatment Coverage for Members Under the Age of 21 (Supersedes APL 18-006)

Superseded by 23-010
11/12/2019
APL 19-015Proposition 56 Directed Payments for Physician Services (Supersedes APL 19-006)

Superseded by 23-019
12/24/2019
APL 19-016Proposition 56 Directed Payments for Developmental Screening Services

Superseded by 23-016
12/26/2019
APL 19-017Quality and Performance Improvement Requirements (Supersedes APL 17-014)

12/26/2019
APL 19-018 Proposition 56 Directed Payments for Adverse Childhood Experiences Screening Services

Superseded by 23-017
12/26/2019

2018 – All Plan Letters

Letter Number Title (Subject) of LetterDate of Issue
Voluntary Inpatient Detoxification (Supersedes APL 14-005)
01/11/2018
APL 18-002
2018-2019 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule
01/11/2018
APL 18-003Administrative and Financial Sanctions (Supersedes APL 15-014)01/25/2018
APL 18-004Immunization Requirements (Supersedes PL 96-013 and APL 07-015)

Superseded by 24-008
01/31/2018
APL 18-006Responsibilities for Behavioral Health Treatment Coverage for Members Under the Age of 21 (Supersedes APL 15-025)

Superseded by 19-014
03/02/2018
APL 18-007Requirements for Coverage of Early and Periodic Screening, Diagnostic, and Treatment Services for Medi-Cal Members Under the Age of 21 (Supersedes APL 14-017)

Superseded by 19-010
03/02/2018
APL 18-008 (Revised)Continuity of Care for Medi-Cal Members Who Transition into Medi-Cal Managed Care (Supersedes APL 15-019)

Superseded by 22-032

03/02/2018

Revised: 12/07/2018

APL 18-009Memorandum of Understanding Requirements for Medi-Cal Managed Care Health Plans and Regional Centers (Supersedes APL 15-022)03/02/2018

Retired 10/23/2023
APL 18-010Proposition 56 Directed Payment Expenditures for Specified Services for State Fiscal Year 2017-18

Superseded by 19-006
05/01/2018
APL 18-011California Children’s Services Whole Child Model Program

Superseded by 18-023
06/07/2018
APL 18-012Health Homes Program Requirements

06/28/2018
APL 18-013 Hepatitis C Virus Treatment Policy Update (Supersedes APL 15-016) – RETIRED08/14/2018
APL 18-014Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care (Supersedes APL 17-016)

Superseded by 21-014
09/14/2018
APL 18-015

Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans

APL 18-015 Attachments:

09/19/2018

Retired 10/23/2023
APL 18-016

Readability and Suitability of Written Health Education Materials (Supersedes APL 11-018)

APL 18-016 Attachments:                  

10/05/2018
APL 18-017Blood Lead Screening of Young Children (Supersedes PL 02-01)

Superseded by 20-016 
10/22/2018
APL 18-018Diabetes Prevention Program11/16/2018
APL 18-019

Family Planning Services Policy for Self-Administered Hormonal Contraceptives

(Supersedes APL 16-003)

11/21/2018
APL 18-020Palliative Care (Supersedes APL 17-015) 12/07/2018
APL 18-0212019-2020 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule12/19/2018
APL 18-022Access Requirements for Freestanding Birth Centers and the Provision of Midwife Services (Supersedes APL 16-017)
Superseded by APL 26-005
12/19/2018
APL 18-023California Children’s Services Whole Child Model Program (Supersedes APL 18-011)

Superseded by 21-005
12/23/2018

2017 – All Plan Letters

Letter Number Title (Subject) of LetterDate of Issue
2017-2018 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff And Processing Schedule
01/03/2017
APL 17-002

Health Education and Cultural and Linguistic Group Needs Assessment (Supersedes PL10-012)

Superseded by 19-011

02/03/2017
APL 17-003Treatment of Recoveries Made by the Managed Care Health Plan of Overpayments to Providers

Superseded by 23-011
03/30/2017
APL 17-004Subcontractual Relationships and Delegation

Superseded by 23-006
04/18/2017
APL 17-005Certification of Document and Data Submissions05/02/2017
APL 17-006

Grievance and Appeal Requirements and Revised Notice Templates and “Your Rights” Attachments (Supersedes All Plan Letters 04-006 and 05-005 and Policy Letter 09-006)

Superseded by APL 21-011

Supplement to APL 17-006: Emergency State Fair Hearing Timeframe Changes

Superseded by Supplement to APL 21-011

APL 17-006 Member Notices: 
Superseded by APL 21-011 Member Notices
 
1557 Notices
  • Language Assistance Taglines
  • Nondiscrimination Notice 
Notice of Action (NOA)
  • Deny
  • Delay
  • Modify
  • Carve-Out
  • Terminate
  • NOA Your Rights (Knox-Keene)
  • NOA Your Rights (non Knox-Keene)
Notice of Appeal Resolution (NAR)
  • Overturn
  • Uphold
  • NAR Your Rights (Knox-Keene)
    NAR Your Rights (non Knox-Keene)
State Hearing Form

 
05/09/2017
APL 17-007Continuity of Care for New Enrollees Transitioned to Managed Care After Requesting a Medical Exemption and Implementation of Monthly Medical Exemption Review Denial Reporting (Supersedes All Plan Letter 15-001) 05/11/2017
APL 17-008Requirement to Participate in the Medi-Cal Drug Utilization Review Program05/10/2017
APL 17-009Reporting Requirements Related To Provider Preventable Conditions (Supersedes All Plan Letter 16-011)05/23/2017
APL 17-010 (Revised)

Non-Emergency Medical and Non-Medical Transportation Services

Superseded by 22-008

06/29/2017

Revised:

09/08/2020

APL 17-011Standards for Determining Threshold Languages and Requirements for Section 1557 of the Affordable Care Act (Supersedes APL 14-008)

Superseded by 21-004
06/30/2017
APL 17-012

Care Coordination Requirements for Managed Long – Term Services and Supports

Superseded by 22-024

07/11/2017
APL 17-013Requirements for Health Risk Assessment of Medi-Cal Seniors and Persons with Disabilities Superseded by 22-02407/11/2017
APL 17-014Quality and Performance Improvement Requirements (Supersedes APL 16-018)

Superseded by 19-017
09/11/2017
APL 17-015Palliative Care and Medi-Cal Managed Care

Superseded by 18-020
10/19/2017
APL 17-016Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care (Supersedes APL 14-004)

Superseded by 18-014
10/27/2017
APL 17-017Long Term Care Coordination and Disenrollment (Supersedes APL 03-003)10/27/2017
APL 17-018Medi-Cal Managed Care Health Plan Responsibilities for Outpatient Mental Health Services (Supersedes APL 13-021)

Superseded by 22-006
10/27/2017
APL 17-019

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

Superseded by 19-004
11/14/2017
APL 17-020

American Indian Health Programs

12/15/2017

Revised: 

04/09/2026

APL 17-021Workers’ Compensation – Notice of Change to Workers’ Compensation Recovery Program; Reporting and Other Requirements (Supersedes APL 04-004)

Superseded by 21-007
12/26/2017

2016 – All Plan Letters

Letter Number Title (Subject) of LetterDate of Issue
Medi-Cal Provider and Subcontract Suspensions, Terminations, and Decertifications (Supersedes APL 06-007) 

 
Superseded by 21-003
01/08/2016
APL 16-002   2016-2017 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule01/19/2016
APL 16-003Family Planning Services Policy for Contraceptive Supplies

02/05/2016

Revised:
12/23/2016
APL 16-004     Medi-Cal Managed Care Health Plans Carved-Out Drugs (Supersedes APL 03-004)02/19/2016
APL 16-005

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

02/25/2016

Revised:
11/23/2016
APL 16-006  End of Life Option Act06/08/2016
APL 16-007    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    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 Adult Immunizations as a Pharmacy Benefit 


Superseded by 24-008

08/31/2016

Revised: 12/23/2016

APL 16-010Medi-Cal Managed Care Health Plan Pharmaceutical Formulary Comparability Requirement – RETIRED09/06/2016
APL 16-011Reporting Requirements Related to Provider Preventable Conditions (Supersedes APL 15-006)

Superseded by 17-009
09/20/2016
APL 16-012Provider Credentialing and Recredentialing (Supersedes PL 02-003)

Superseded by 17-019
09/27/2016
APL 16-013)Ensuring Access to Medi-Cal Services for Transgender Beneficiaries (Supersedes APL 13-011)

Superseded by 20-018
 
10/06/2016
APL 16-014Comprehensive Tobacco Prevention and Cessation Services for Medi-Cal Beneficiaries (Supersedes PL 14-006)11/30/2016
APL 16-015Acupuncture Services12/01/2016
APL 16-016Rate Changes for Emergency and Post-Stabilization Services Provided by Out-of-Network “Border” Hospitals Under the Diagnosis Related Group Payment Methodology

Superseded by 19-008
12/07/2016
APL 16-017Provision of Certified Nurse Midwife and Alternative Birth Center Facility Services (Supersedes APL 15-017)

Superseded by 18-022
12/09/2016
APL 16-018Quality and Performance Improvement Requirements (Supersedes APL 15-024)

Superseded by 17-014
12/22/2016
APL 16-019   Managed Care Provider Data Reporting Requirements (Supersedes APL 14-006)  12/28/2016

2015 – All Plan Letters

Letter Number Title (Subject) of LetterDate of Issue
Continuity of Care for New Enrollees Transitioned to Managed Care After Requesting a Medical Exemption
Superseded by APL 17-007
01/14/2015
APL 15-002     Multipurpose Senior Services Program Complaint, Grievance, Appeal, and State Hearing Responsibilities in Coordinated Care Initiative Counties01/22/2015
APL 15-003   Podiatric and Chiropractic Services at Federally Qualified Health Centers and Rural Health Clinics01/26/2015
APL 15-004   Medi-Cal Managed Care Health Plan Requirements for Nursing Facility Services in Coordinated Care Initiative Counties For Beneficiaries not Enrolled in Cal Mediconnect02/12/2015
APL 15-005  Data Request Requirements for Child Health Disability Prevention Report Contained in Policy Letter 10-013 (Supersedes PL 10-013)02/12/2015
APL 15-006  Reporting Requirements Related to Provider Preventable Conditions
(Supersedes APL 13-007)

Superseded by 16-011
03/11/2015
APL 15-007    Dispute Resolution Process for Mental Health Services

Superseded by 21-013
04/01/2015
APL 15-008    Professional Fees for Office Visits Associated with Alcohol and Substances Use Disorder Treatment Services04/16/2015
APL 15-009    Proper Use and Billing for Makena (Supersedes APL 13-016) – RETIRED04/16/2015
APL 15-010Affordable Care Act Section 1202 Increased Payments for Medi-Cal Primary Care Services – Revised Guidance and Contractual Requirements05/01/2015
APL 15-011   Designated Public Hospitals: Billing for Beneficiaries with California Children’s Services Eligible Conditions and/or Medi-Cal Managed Care

Superseded by 16-007
05/11/2015
APL 15-012   Dental Services – Intravenous Sedation and General Anesthesia Coverage
(Supersedes Policy Letter 13-002)

Superseded by 23-028
05/12/2015
                 
Revised:
8/21/2015
APL 15-013Requirements for Medi-Cal Managed Care Health Plans and Qualified Agency Contract05/22/2015
APL 15-014   Administrative and Financial Sanctions

Superseded by 18-003
06/12/2015
APL 15-015  Physical Health Care Covered Services Provided for Members Who Are Admitted to Inpatient Psychiatric Facilities06/12/2015
APL 15-016  Hepatitis C Virus Treatment Policy Update

Superseded by 18-013
06/29/2015
APL 15-017Provision of Certified Nurse Midwife and Alternative Birth Center Facility Services

Superseded by 16-017
06/30/2015
APL 15-018  Criteria for Coverage of Wheelchairs and Applicable Seating and Positioning Components07/09/2015
APL 15-019

Continuity of Care for Medi-Cal Beneficiaries who Transition into Medi-Cal Managed Care

(Supersedes APL 14-021)

Superseded by 18-008 

08/26/2015
APL 15-020    Abortion Services (Supersedes PL 99-08)

Superseded by 22-022
09/30/2015
APL 15-021 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 15-022  Memorandum of Understanding Requirements for Medi-Cal Managed Care Health Plans and Regional Centers

Superseded by 18-009
10/02/2015
APL 15-023   Facility Site Review Tools for Ancillary Service and Community-Based Adult Services Providers10/28/2015
APL 15-024    Quality and Performance Improvement Requirements (Supersedes APL 14-003)

Superseded by 16-018

11/16/2015

Revised:
12/10/2015
APL 15-025    Responsibilities for Behavioral Health Treatment Coverage for Children Diagnosed with Autism Spectrum Disorder (Supersedes APL 14-011)

Superseded by 18-006
12/03/2015
APL 15-026   Actions Required Following Notice of a Credible Allegation of Fraud12/30/2015

2014 – All Plan Letters

Letter Number Title (Subject) of LetterDate of Issue

APL 14-001   

2014-2015 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule

01/03/2014

APL 14-002  Summary of 2013 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Health Plans

01/13/2014

APL 14-003   Quality and Performance Improvement Program Requirements for 2014

Superseded by 15-024

01/14/2014

APL 14-004  Screening, Brief Intervention, and Referral to Treatment for Misuse of Alcohol

Superseded by 17-016

02/10/2014

APL 14-005   New Benefit – Voluntary Inpatient Detox

Superseded by 18-001

03/11/2014

APL 14-006   Ongoing Provider File Submission Requirements (Supersedes APL 11-020)

Superseded by 16-019

03/12/2014

APL 14-007   Dual-Eligible Special Needs Plans

 06/26/2014 

APL 14-008Standards for Determining Threshold Languages

Superseded by 17-011

07/10/2014
Revised:
8/27/2014

APL 14-009

Transition of Encounter Data Submission to National Standard Transactions

(ASC X12 837 5010, NCPDP 2.2 or 4.2)

07/30/2014

APL 14-010   Care Coordination Requirements for Managed Long-Term Services and Supports 

Superseded by 17-012
09/10/2014
APL 14-011   Interim Policy for the Provision of Behavioral Health Treatment Coverage for Children Diagnosed with Autism Spectrum Disorder

Superseded by 15-025
09/15/2014
APL 14-012 

Call Center Report Template

Superseded by 20-017
09/25/2014
APL 14-013 

Grievance Report Template

Superseded by 20-017

09/25/2014
Revised:
11/3/2014

APL 14-014     Enrollment Requirements for Dual-Eligible Special Needs Plans in Alameda and Orange Counties10/10/2014
APL 14-015   Primary Care Provider Assignment in Medi-Cal Managed Care for Dual-Eligible Beneficiaries – RETIRED11/24/2014
APL 14-016   Summary of 2014 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Health Plans11/24/2014
APL 14-017   Requirements for Coverage of Early and Periodic Screening, Diagnostic, and Treatment Services for Medi-Cal Beneficiaries under the Age of Twenty One

Superseded by 18-007
12/12/2014
APL 14-018    2015-2016 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule12/19/2014
APL 14-019   Encounter Data Submission Requirements12/19/2014
APL 14-020    Quality Measures for Encounter Data  
APL 14-020 Attachment: DHCS Quality Measures for Encounter Data 
Superseded by APL 26-003

12/23/2014

Revised:
8/8/2018

APL 14-021

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

(Supersedes APL 13-023)

Superseded by 15-019

12/29/2014

2013 – All Plan Letters

Letter Number Title (Subject) of LetterDate of Issue

APL 13-001    

Coordination of Benefits: Medicare and Medi-Cal

Superseded by APL 13-003

01/03/2013

APL 13-002   Processing Errors Related to Denied Medical Exemption Requests Regarding Mandatory Enrollment into a Medi-Cal Managed Care Plan

01/23/2013

APL 13-003     Coordination of Benefits: Medicare and Medi-Cal (Supersedes APL 13-001)

02/08/2013

APL 13-004      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 (Supersedes APL 07-014)

02/12/2013

APL 13-005

Quality & Performance Improvement Program Requirements for 2013 (Supersedes APL 11-021)   

Superseded by APL 14-003

04/12/2013

APL 13-006   Encounter Data Element for Medi-Cal Managed Care Health Plans, Version 2.0.

Superseded by APL 14-019

05/30/2013

APL 13-007    

Reporting Encounter Data Related to Provider Preventable Conditions 

Superseded by APL 15-006

06/25/2013

APL 13-008   Contracts with Dual-Eligible Special Needs Plans    

07/12/2013

APL 13-009   Affordable Care Act (ACA) Section 1202 Final Rule on Increased Payments for Medi-Cal Primary Care Services

10/04/2013

APL 13-010 Managed Care Compliance Plan for Section 1202 of the Affordable Care Act

10/04/2013

APL 13-011    Ensuring Access to Transgender Services

Superseded by APL 16-013

08/25/2013

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

Superseded by APL 16-008

10/04/2013

APL 13-013   

Continuity of Care for New Enrollees Transitioned to Managed Care after Requesting a Medical Exemption

Superseded by APL 15-001

10/04/2013

Revised: 4/3/2014

APL 13-014     Hospice Services and Medi-Cal Managed Care

10/28/2013

APL 13-015    Marketing Requirements for Medi-Cal and Covered California

10/29/2013

APL 13-016 Proper use of and Billing for Makena

Superseded by 15-009

11/14/2013

APL 13-017 Staying Healthy Assessment/Individual Health Education Behavioral Assessment for Enrollees from Low-Income Health Program

Superseded by 22-030

11/18/2013

APL 13-018 Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans

Superseded by 18-015

11/27/2013

APL 13-019 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    Open Authorization and Scheduled Service Information for New Beneficiaries Transitioning from The Low-Income Health Program

12/04/2013

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

Superseded by 17-018

12/13/2013

APL 13-022

Medi-Cal Managed Care Health Plan Implementation of Primary Care Provider Assignment and Reimbursement for New Adult Expansion Members

12/24/2013 Revised: 7/25/2014

APL 13-023 Continuity of Care for Medi-Cal Beneficiaries who Transition from Fee-For-Service Medi-Cal into Medi-Cal Managed Care  

Superseded by 14-021

12/24/2013

APL 13-024   Designating Non-Qualified Health Plan Medi-Cal Managed Care Plans as Medicaid Certified Application Counselors  

12/30/2013

2012 – All Plan Letters 

Letter Number Title (Subject) of LetterDate of Issue

APL 12-001    

Contracts with Dual-Eligible Special Needs Plans

04/18/2012

APL 12-002  

2012-13 Rates For Post-Stabilization Inpatient Services Provided By Out-Of-Network Acute Care Hospitals

Superseded by APL 12-004

07/05/2012

APL 12-003 Revised 

2012-13 Rates For Emergency-Based Inpatient Services Provided By Out-Of-Network Acute Care Hospitals

07/13/2012

APL 12-004 Revised   

2012-13 Rates For Post-Stabilization Inpatient Services Provided By Out-Of-Network Acute Care Hospitals (Supersedes APL12-002)

07/13/2012

APL 12-0052013-2014 Managed Care Plan MEDS/834 Cutoff and Processing Schedule

12/27/2012

2011 – All Plan Letters 

Letter NumberTitle (Subject) of LetterDate of Issue

APL 11-002   

Quality and Performance Improvement Program Requirements for 2011 (supersedes APL 10-001)

01/31/2011

APL 11-005     

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       

Disclosure of Select Provider Contracting Program Rates 

02/10/2011

APL 11-008

Aid Code 4T: Aid Code to Identify Children in the New Federal KIN-GAP Program

03/08/2011

APL 11-010

Competency and Sensitivity Training Required in Serving the Needs of Seniors and Persons with Disabilities – RETIRED

APL 11-012  

Reporting Responsibilities Regarding Third-Party Tort Liability

05/23/2011

APL 11-014     

Transition to Update HIPAA Transactions for Enrollment and Premium Payments      

06/10/2011

APL 11-015    

Rate Setting: Increased Percentage of Countywide Rates  

06/20/2011

APL 11-016      

2011-2012 Rates for Emergency-Based Inpatient Services Provided by Out-of-Network Acute Care Hospitals  

07/18/2011

APL 11-017    

2011-2012 Rates for Post-Stabilization Inpatient Services Provided by Out-of-Network Acute Care Hospitals

07/18/2011

APL 11-018    

Readability and Suitability of Written Health Education Materials

Superseded by APL 18-016

08/19/2011

APL 11-019

Extended Continuity of Care for Seniors and Persons with Disabilities  

09/21/2011

APL 11-020    

Medi-Cal Managed Care Plan Ongoing Provider File Submission Requirements (Supersedes APL 10-006)

Superseded by APL 14-006

09/21/2011

APL 11-021   

Quality and Performance Improvement Program Requirements for 2012 (Supersedes APL 11-002)

Superseded by APL 13-005

09/21/2011

APL 11-022     Six New Derivative Foster Care Aid Codes

12/06/2011

APL 11-023     Aid Code 0W

12/06/2011

APL 11-024 

2012-2013 Managed Care Plan MEDS/FAME/5010 834 Cutoff and Processing Schedule

12/27/2011

2010 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue

APL 10-001   

Quality and Performance Improvement Program Requirements for 2010 (supersedes APL 08-009)

Superseded by APL 11-002

03/04/2010

APL 10-002    

Rogers Amendment Data Request

03/22/2010

APL 10-003  

Augmented Reimbursement for Family Planning Services 

06/22/2010

APL 10-005    

Financial Reporting Requirements

06/22/2010

APL 10-006    

Medi-Cal Managed Care Plan Ongoing Provider File Updates

Superseded by APL 11-020

07/13/2010

APL 10-007   

2010-11 Rates for Emergency Inpatient Services Provided by Out-Of-Network Acute Care Hospitals

07/06/2010

APL 10-008   

2010-11 Rates for Post-Stabilization Inpatient Services Provided by Out-of-Network
Acute Care Hospitals

07/06/2010

APL 10-009  

Utilization and Payment Data for Safety-Net Providers

07/13/2010

APL 10-010  

Reinstatement of Optometry Services

07/15/2010

APL 10-011   

The Rogers Amendment and Tertiary Hospitals 

09/02/2010

APL 10-014  

Correction to All Plan Letter 10-003 Regarding Augmented Reimbursement for Family Planning Services 

12/28/2010

APL 10-015  

2011-2012 Managed Care Plans MEDS/FAME/834+Supplemental Cutoff and Processing Schedule 

12/28/2010

2009 – All Plan Letters 

Letter NumberTitle (Subject) of LetterDate of Issue

APL 09-001 

2008 Chaptered Legislation Affecting, or of Interest to Medi-Cal Managed Care Plans

01/14/2009

APL 09-002  

Aid Codes 06 and 46

01/28/2009

APL 09-003

Medi-Cal Managed Care Capitation Report

01/28/2009

APL 09-004

Aid Code 6G

03/16/2009

APL 09-007

List of Contracted Hospitals and Bed Days

06/04/2009

APL 09-008

Procedures for Submitting QIP Documents and New Resources for Plans

06/09/2009

APL 09-009

Indian Health Services

Superseded by 24-002

06/11/2009

APL 09-010 

Aid Code 2H

06/22/2009

APL 09-011     

List of Contracted Hospitals and Bed Days

06/22/2009

APL 09-012   

2009-10 Rates For Non-Contracted Hospital Emergency Inpatient Services

06/29/2009

APL 09-013   

2009-10 Rates For Hospital Payment for Medi-Cal Post-Stabilization Services 

06/29/2009

APL 09-014

Exhibit G, Health Insurance Portability and Accountability Act (HIPAA) 

09/29/2009

APL 09-015

2010-2011 Managed Care Plan MEDS/FAME/834+Supplemental Cutoff and Processing Schedule 

12/29/2009

2008 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue

APL 08-001

Summary of 2007 Chaptered Legislation Affecting, or of Interest to Medi-Cal Managed Care Plans

02/05/2008

APL 08-004

Managed Care Rate Reductions for FY 2008-09

05/12/2008

APL 08-005

Managed Care Rate Reductions for FY 2008-09; Technical Clarification to All Plan Letter NO. 08-004

06/18/2008

APL 08-006

Interim Procedures Until Execution of New EQRO Contract

06/30/2008

APL 08-007

Requirements for Employee Education Regarding False Claims Recovery

07/01/2008

APL 08-008

Reimbursement for Non-contracted Hospital Emergency Inpatient Services

10/02/2008

APL 08-009

Quality and Performance Improvement Requirements for 2009

10/27/2008

APL 08-010

Hospital Payment for Post Medi-Cal Post-Stabilization Services

11/10/2008

APL 08-012

2009-2010 Managed Care Plan MEDS/FAME/834+Supplemental Cutoff and Processing Schedule

12/08/2008

2007 – All Plan Letters

 Letter NumberTitle (Subject) of LetterDate of Issue

APL 07-001

Conversion to Electronic Filing of Financial Reports

05/18/2007

APL 07-002

Conlan v. Bonta: Conlan v. Shewry: Court Ordered Medi-Cal Beneficiary Reimbursement Process

01/31/2007

APL 07-003

Federal Deficit Reduction Act of 2005 (Reimbursement for Non-Contracted Emergency Services Providers)

03/16/2007

APL 07-004

Summary of 2006 Chaptered Legislation Affecting, or of Interest to, Medi-Cal Managed Care Plans

02/13/2007

APL 07-005

Implementation of NPI Update

05/18/2007

APL 07-007

Federal Deficit Reduction Act of 2005 (Employee Education About False Claims)

03/09/2007

APL 07-008

Topical Fluoride Varnish

Superseded by APL 19-010

04/18/2007

APL 07-009

New Financial Reporting Requirements

05/14/2007

APL 07-011

Update on California Department of Health Services Reorganization

06/06/2007

APL 07-012

Identification of Regional Center Consumers

08/24/2007

APL 07-013 

Quality and Performance Improvement Program Requirements for 2008

09/25/2007

APL 07-014

Hospice Services and Medi-Cal Managed Care

10/12/2007

APL 07-015

Human Papillomavirus Vaccine

Superseded by APL 18-004

10/18/2007

APL 07-017

Federal Deficit Reduction Act of 2005, Section 6036 (Citizenship Verification Requirement)

11/06/2007

APL 07-019

2008-2009 Managed Care Plan MEDS/FAME/834+Supplemental Cutoff and Processing Schedule

12/20/2007

APL 07-020

Medi-Cal Billing Restriction on the Use of Social Security Numbers

12/26/2007

2006 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue

APL 06-001

HIPAA Requirements: Notice of Privacy Practices and Notification of Breaches

04/13/2006

APL 06-002

MEDICARE PART D UPDATE

06/21/2006

APL 06-003

MEDICARE PART D UPDATE

06/21/2006

APL 06-004

National Provider Identifier (NPI)

06/14/2006

APL 06-005

Protected Health Information (PHI) and Notification of Breaches

08/03/2006

APL 06-006

Update to All Plan Letter 06-04 re: Implementation of the National Provider Identifier (NPI)

09/08/2006

APL 06-007

Termination of Subcontracting Relationships

Superseded by APL 16-001

09/18/2006

APL 06-008

Contraceptive Devices – RETIRED

10/26/2006

APL 06-009

Supplemental Data Request                

10/23/2006

APL 06-010

Quality and Performance Improvement Requirements for 2007

11/30/2006

APL 06-011

Same Day Banking

11/01/2006

APL 06-012

2007-2008 Managed Care Plan MEDS/FAME Cutoff and Processing Schedule

12/06/2006

2005 – All plan letters

Letter NumberTitle (Subject) of LetterDate of Issue

APL 05-001

Summary of 2003 and 2004 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans

01/06/2005

APL 05-002

New Process for Transmitting Enrollment/Disenrollment Data

03/28/2005

APL 05-003

Hospice Services and Medi-Cal Managed Care

03/25/2005

APL 05-004

Personal Injury Inquiry Letter

04/11/2005

APL 05-006

HIPAA Requirements:  Plans’ Reporting Responsibilities- RETIRED

05/02/2005

APL 05-007

Erectile Dysfunction Treatment for Known Sex Offenders

06/13/2005

APL 05-008

Review and Analysis of Financial Status of Health Plans Proposed Request for Funding Augmentations

10/18/2005

APL 05-009

Carve out Erectile Dysfunction Drugs

11/18/2005

APL 05-010

Advance Directive Form

11/23/2005

APL 05-011

2005-2006 Managed Care Plan (MCP) MEDS/FAME Cutoff and Processing Schedule

no date

APL 05-012

Medicare Modernization Act; Medicare Part D Prescription Drug Plan – RETIRED

12/14/2005

APL 05-013

Medicare Modernization Act; Medicare Part D Implementation System Changes

12/29/2005

APL 05-014

Summary of 2005 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans

12/30/2005

2004 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue

APL 04-001

2004 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule

02/02/2004

APL 04-002

Recovery of Capitation Paid to Health Care Plans for Deceased Beneficiaries

04/27/2004

APL 04-003

Medi-Cal Providers on Probation

04/30/2004

APL 04-004

Workers’ Compensation (WC)- Notice Award of New Workers’ Compensation Recovery Program (WCRP) Contractor; Reporting and Other Requirements

Superseded by APL 17-021

07/13/2004

APL 04-005

Implementation of New Enrollment Forms

07/15/2004

APL 04-006

SB 59 (Stats. 1999, Chapter 539) Required Notices of Action

Superseded by APL 17-006

11/01/2004

APL 04-007

Implementation of New Enrollment Forms

10/29/2004

APL 04-008

2004-2005 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule

12/16/2004

2003 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue

APL 03-001

Default Assignment of Beneficiaries

01/17/2003

APL 03-002

SB 87 Medi-Cal Contact Information Release Form

01/31/2003

APL 03-003

LTC Guidelines/Policy Letters GMC/Two Plan Letter

Superseded by APL 17-017

02/03/2003

APL 03-004

Medi-Cal Managed Care Health Plan Capitated and Non-Capitated Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and Antipsychotic Drugs – RETIRED

Superseded by APL 16-004

04/07/2003

APL 03-005

Medi-Cal Intercounty Transfers

05/20/2003

APL 03-006

Facility Site Review Clarification #2

06/23/2003

APL 03-007

Certified Quality Provider Site Certificate

Superseded by APL 20-006

06/23/2003

APL 03-008

Quarterly Submission of Grievance Logs

07/07/2003

APL 03-009

Implementation of Expedited State Hearings – RETIRED

08/27/2003

APL 03-010

Medi-Cal Managed Care Plan Requirements for Provision of Contraceptive Drug Services and Supplies – RETIRED

09/12/2003

APL 03-011

Fraud Referral Procedure to Audits and Investigations (A&I)

10/22/2003

APL 03-012

Medi-Cal Providers on Probation

10/24/2003

APL 03-013

Non Contracted Emergency Room Rate Schedule

12/12/2003

APL 03-014

Delmarva Foundation for Medical Care, Inc.

12/12/2003

APL 03-015

Use of Services Measures

12/17/2003

2002 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue

APL 02-001

Medi-Cal HIV/AIDS Home and Community Based Services Waiver Program

07/19/2002

APL 02-002

Possible Movement of Fame Files from the CA Health and Human Services (CalHHS) Data Center to the Medi-Cal Web Site

03/15/2002

APL 02-003

Cultural and Linguistic Contractual Requirements: Threshold and Concentration Standard Languages Update

Superseded by APL 16-012

07/07/2002

APL 02-004

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

Emergency Services Medical Claim Coding and Documentation Guidelines

08/07/2002

APL 02-006

Implementation of Medi-Cal Managed Care Policy Letter 02-02

09/25/2002

APL 02-007

Summary of 2002 Chaptered Legislation for Medi-Cal Managed Care Plans

11/12/2002

APL 02-008

External Accountability Set (EAS) Performance Measure Audits

11/26/2002

APL 02-009

2003 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule

12/27/2002

2001 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue

APL 01-001

Summary of 2000 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans

01/16/2001

APL 01-002

Reporting and Other Requirements Regarding Workers’ Compensation Recovery

Superseded by APL 21-007

02/21/2001

APL 01-003

Mifepristone (RU-486) As a Medi-Cal Benefit- RETIRED

07/25/2001

APL 01-004

Health Plan Choice Reminders (Annual Renotifications)

08/21/2001

APL 01-005

Implementation of a New Process Which Will Reject Encounter Data At Record Level

11/26/2001

APL 01-006

2002 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule

12/24/2001

APL 01-007

Summary of 2001 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans

12/17/2001

APL 01-008

Breast and Cervical Cancer Treatment Program

12/17/2001

2000 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue

APL 00-001

2000 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule 

02/03/2000

APL 00-002

Medi-Cal Managed Care Medical Exemptions

02/29/2000

APL 00-003

Policy and Procedure Revisions

03/07/2000

APL 00-004

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

Invitation to All Plan Meeting on Year 2000 Proposed Contract Amendments

05/09/2000

APL 00-006

Maximus Warehouse Relocation

Superseded by APL 14-017

06/05/2000

APL 00-007

Potential Increase in New Enrollees Due to Changes in the Section 1931(b) Program

07/05/2000

APL 00-008

Importance of Increased Outreach to New Eligibles Under the Section 1931(b) Program

08/15/2000

APL 00-009

Percent of Poverty Population

09/15/2000

APL 00-010

Draft 2000 Medi-Cal Managed Care Contract Amendments Package 00-01

09/13/2000

APL 00-011

Ensuring Beneficiaries Receive Laboratory Services From CLIA Certified Laboratories

10/17/2000

APL 00-012

Utilization Review of Initial Risk Assessments for Pregnant Women

Superseded by APL 26-005

12/22/2000

APL 00-013

Amended Regulations for Enrollment and Disenrollment for Two-Plan Model Plans

12/28/2000

APL 00-014

2001 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule

12/29/2000

1999 – All Plan Letters

Letter NumberTitle (Subject) of LetterDate of Issue

APL 99-001

Managed Care Plan Utilization of Therapeutic Pharmaceutical Agents-Certified Optometrists

01/21/1999

APL 99-002

1999 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule

01/21/1999

APL 99-003

Year 2000 Readiness Certification and Business Continuation Plan

01/27/1999

APL 99-004

New Laws from the 1997-98 Session of the California Legislature Affecting the Medi-Cal Program

02/17/1999

APL 99-005

Cultural Competency in Health Care – Meeting the Needs of a Culturally and Linguistically Diverse Population

Superseded by APL 23-025

04/02/1999

APL 99-006

Encounter Data Work Group

 4/28/1999

APL 99-007

Medi-Cal Managed Care Health Education Work Group and the “Staying Healthy” Assessment Subcommittee

06/01/1999

APL 99-008

Updates to Managed Care Data Dictionary

07/14/1999

APL 99-009

Draft 1999 Medi-Cal Managed Care Contract Amendments

07/26/1999

APL 99-010

Status of the Conversion to the Fiscal Intermediary Access to Medi-Cal Eligibility

08/03/1999

APL 99-011

New Medi-Cal Managed Care Exemption Forms

08/03/1999

APL 99-012

Revision to All Plan Letter 99003 Re: Year 2000 Readiness

10/08/1999

APL 99-013

Concurrent Participation in the Medi-Cal Managed Care Program and the Multipurpose Senior Services Program

10/20/1999

APL 99-014

Summary of 1999 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans

12/01/1999

APL 99-015

Emergency Services Claims

12/06/1999

APL 99-016

Year 2000 Contingency Plan Update

12/16/1999

1998 – All Plan Letters

Letter Number Title (Subject) of LetterDate of Issue

APL 98-003

1998 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule

02/20/1998

APL 98-006

California Children Services Numbered Letters 01-0298 and 09-0598

07/28/1998

APL 98-007

Recombinant Growth Hormone Injections 

03/27/1998

APL 98-009

AID Code 38

11/25/1998