Managed Care All Plan Letters - 1998 to Current

If you would like to be added to the stakeholder comment distribution list and receive future updates, please email: prcuaplsubmission@dhcs.ca.gov.

Return to Medi-Cal Managed Care Letters

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

2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001 | 2000 | 1999 | 1998

2025 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 25-001	2024-2025 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule	1/17/2025
APL 25-002	Skilled Nursing Facility Workforce Quality Incentive Program	1/13/2025
APL 25-003	Establishing Dual Eligible Special Needs Plans by 2026	1/15/2025
APL 25-004	Community Reinvestment Requirements Appendix A Appendix B: Community Reinvestment Plan Instructions EXHIBIT 1: Attestation of Support from Public Health Director Template EXHIBIT 2: Attestation of Support from Behavioral Health Director Template EXHIBIT 3: Attestation of Acknowledgment Template EXHIBIT 4: Community Reinvestment Plan Template EXHIBIT 5: Proposed Allocation of Funds Template Appendix C Appendix D: Community Reinvestment Report Instructions Community Reinvestment Report Template	2/7/2025
APL 25-005	Standards For Determining Threshold Languages, Nondiscrimination Requirements, Language Assistance Services, And Alternative Formats (Supersedes APL 21-004) Threshold and Concentration Language for All Counties Notice of Nondiscrimination Template Notice of Availability Template Statement of Nondiscrimination for Small Sized Notices Template	2/12/2025
APL 25-006	Timely Access Requirements	4/25/2025
APL 25-007	Enforcement Actions: Corrective Action Plans, Administrative and Monetary Sanctions Attachment A- Network Adequacy Enforcement Attachment B- Timely Access Standards Enforcement Attachment C- Managed Care Accountability Set Monetary Sanction Methodology	4/25/2025
APL 25-008	Hospice Services and Medi-Cal Managed Care	5/5/2025
APL 25-009	Community 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 Entities	7/3/2025 Revised 09/17/2025
APL 25-012	Targeted Provider Rate Increases	8/19/2025
APL 25-013	Medi-Cal Rx Pharmacy Benefits, And Cell and Gene Therapy Coverage (Supersedes APL 22-012) Appendix A - Medi-Cal Rx Transition and NCQA Requirements	9/18/2025
APL 25-014	Update to Provider Directory Requirements	9/26/2025
APL 25-015	Data Sharing and Quality Rate Production for Directed Payment Initiatives and Alternative Payment Methodology Programs	10/2/2025

2024 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 24-001	Street Medicine Provider: Definitions and Participation in Managed Care (Supersedes APL 22-023)	01/12/2024
APL 24-002	Medi-Cal Managed Care Plan Responsibilities for Indian Health Care Providers and American Indian Members (Supersedes APL 09-009)	2/8/2024
APL 24-003	Abortion Services (Supersedes APL 22-022)	3/28/2024
APL 24-004	Quality Improvement and Health Equity Transformation Requirements (Supersedes APL 19-017)	4/8/2024
APL 24-005	California Housing And Homelessness Incentive (Supersedes APL 22-007)	4/29/2024
APL 24-006	Community Health Worker Services Benefit (Supersedes APL 22-016)	5/13/2024
APL 24-007	Targeted Provider Rate Increases	6/20/2024
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) MCP ICF/DD Authorization Request Form ICF/DD Credentialing Attestation Form	9/16/2024
APL 24-012	Non-Specialty Mental Health Services: Member Outreach, Education, and Experience Requirements	9/17/2024
APL 24-013	Managed Care Plan Child Welfare Liaison	9/18/2024
APL 24-014	Continuity Of Care For Medi-Cal Members Who Are Foster Youth And Former Youth In Single Plan Counties	9/27/2024
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 Requirements	12/5/2024
APL 24-018	Medical Loss Ratio Requirements For Subcontractors And Downstream Subcontractors	12/13/2024
APL 24-019	Minor Consent to Outpatient Mental Health Treatment or Counseling	12/31/2024

2023 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 23-001	Network Certification Requirements (Supersedes APL 21-006) Attachment A: Network Adequacy Standards (PDF) Attachment B: Annual Network Certification Instruction Manual (PDF) Attachment C: Alternative Access Standard (AAS) Request Template (.xls)	01/06/2023
APL 23-002	2023-2024 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule	01/17/2023
APL 23-003	California Advancing and Innovating Medi-Cal Incentive Payment Program (Supersedes APL 21-016)	03/08/2023
APL 23-004	Skilled Nursing Facilities -- Long Term Care Benefit Standardization and Transition of Members to Managed Care (Supersedes APL 22-018)	03/14/2023
APL 23-005	Requirements 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 23-006	Delegation and Subcontractor Network Certification (Supersedes APL 17-004) Attachment A: Subcontractor Network Certification Instruction Manual Attachment B: Subcontractor Network Exemptions Request Attachment C: Network Adequacy and Access Assurances Report	03/28/2023
APL 23-007	Telehealth Services Policy (Supersedes APL 19-009)	04/10/2023
APL 23-008	Proposition 56 Directed Payments for Family Planning Services (Supersedes APL 22-011)	04/28/2023 Revised 06/27/2023
APL 23-009	Authorizations for Post-Stabilization Care Services	05/03/2023
APL 23-010	Responsibilities for Behavioral Health Treatment Coverage for Members Under the Age of 21 (Supersedes APL 19-014)	05/04/2023 Revised 11/22/2023
APL 23-011	Treatment of Recoveries Made by the Managed Care Health Plan of Overpayments to Providers (Supersedes APL 17-003)	05/08/2023
APL 23-012	Enforcement Actions: Administrative and Monetary Sanctions (Supersedes APL 22-015)	05/12/2023 Revised 12/04/2023
APL 23-013	Mandatory Signatories to the California Health and Human Services Agency Data Exchange Framework	05/18/2023 Revised 09/05/2023
APL 23-014	Proposition 56 Value-Based Payment Program Directed Payments (Supersedes APL 22-019)	06/09/2023
APL 23-015	Proposition 56 Directed Payments For Private Services (Supersedes APL 19-013)	06/09/2023
APL 23-016	Directed Payments for Developmental Screening Services (Supersedes APL 19-016)	06/09/2023
APL 23-017	Directed Payments for Adverse Childhood Experiences Screening Services (Supersedes APL 19-018)	06/13/2023
APL 23-018	Managed Care Health Plan Transition Policy Guide	06/23/2023
APL 23-019	Proposition 56 Directed Payments for Physician Services (Supersedes APL 19-015)	07/25/2023
APL 23-020	Requirements for Timely Payment of Claims	07/26/2023 Revised 10/12/2023
APL 23-021	Population Needs Assessment and Population Health Management Strategy (Supersedes APL 19-011)	08/15/2023
APL 23-022	Continuity 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 23-023	Intermediate Care Facilities for Individuals with Developmental Disabilities -- Long Term Care Benefit Standardization and Transition of Members to Managed Care (Superseded by APL 24-011) MCP ICF/DD Authorization Request Form ICF/DD Credentialing Attestation Form	08/18/2023 Revised 11/28/2023
APL 23-024	Doula Services (Supersedes APL 22-031)	08/24/2023 Revised 11/3/2023
APL 23-025	Diversity, Equity, and Inclusion Training Program Requirements (Supersedes APL 99-005) (Superseded by APL 24-016)	09/14/2023
APL 23-026	Federal 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 23-027	Subacute Care Facilities -- Long Term Care Benefit Standardization and Transition of Members to Managed Care	09/26/2023
APL 23-028	Dental Services – Intravenous Moderate Sedation and Deep Sedation/General Anesthesia Coverage Attachment A: Policy for Intravenous Moderate Sedation and Deep Sedation/General Anesthesia Attachment B: Prior Authorization/Treatment Authorization Request and Reimbursement Scenarios (Supersedes APL 15-012)	10/03/2023
APL 23-029	Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and Third-Party Entities Base Memorandum of Understanding Template In Home Supportive Services Memorandum of Understanding Template Regional Center Memorandum of Understanding Template Specialty Mental Health Services Memorandum of Understanding Template Substance Use Disorder Treatment Services Memorandum of Understanding Template Local Health Department Memorandum of Understanding Template County Social Services Programs and Child Welfare Memorandum of Understanding Template Women, Infant, & Children Memorandum of Understanding Template County-Based Targeted Case Management Memorandum of Understanding Template Drug Medi-Cal State Plan Memorandum of Understanding Template First 5 Memorandum of Understanding Template Frequently Asked Questions	10/11/2023 Revised 08/11/2025
APL 23-030	Medi-Cal Justice-Involved Reentry Initiative-Related State Guidance	10/24/2023
APL 23-031	Medi-Cal Managed Care Plan Implementation of Primary Care Provider Assignment for the Age 26-49 Adult Expansion Transition	12/20/2023
APL 23-032	Enhanced Care Management Requirements (Supersedes APL 21-012)	12/22/2023
APL 23-033	2024-2025 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule	12/26/2023
APL 23-034	California Children’s Services Whole Child Model Program (Supersedes APL 21-005) (Superseded by APL 24-015)	12/27/2023
APL 23-035	Student Behavioral Health Incentive Program	12/28/2023

2022 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 22-001	2022-2023 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule	01/11/2022
APL 22-002	Alternative Format Selection for Members with Visual Impairments Alternative Format Selection Technical Guidance for Medi-Cal Managed Care Health Plans Alternative Format Data Process Guide Alternative Format Selection Application User Guide	03/14/2022
APL 22-003	Medi-Cal Managed Care Health Plan Responsibility to Provide Services to Members with Eating Disorders	03/17/2022
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 22-005	No Wrong Door for Mental Health Services Policy	03/30/2022
APL 22-006	Medi-Cal Managed Care Health Plan Responsibilities for Non-Specialty Mental Health Services (Supersedes APL 17-018)	04/08/2022
APL 22-007	California Housing and Homelessness Incentive Program	05/05/2022 Revised 9/19/2022
APL 22-008	Non-Emergency Medical and Non-Medical Transportation Services and Related Travel Expenses (Supersedes APL 17-010) Non-Emergency Medical and Non-Medical Transportation Services and Related Travel Expenses Frequently Asked Questions	05/18/2022
APL 22-009	COVID-19 Guidance for Medi-Cal Managed Care Health Plans- RETIRED	06/13/2022
APL 22-010	Cancer Biomarker Testing	06/22/2022
APL 22-011	Proposition 56 Directed Payments for Family Planning Services (Supersedes APL 20-013) Superseded by 23-008	06/23/2022
APL 22-012	Governor’s Executive Order N-01-19, Regarding Transitioning Medi-Cal Pharmacy Benefits from Managed Care to Medi-Cal RX (Supersedes APL 20-020) Appendix A – Medi-Cal Rx Transition and NCQA Requirements	07/11/2022 Revised 12/30/2022
APL 22-013	Provider Credentialing/Re-Credentialing and Screening/Enrollment (Supersedes APL 19-004) APL 22-013 Frequently Asked Questions	07/19/2022 Revised 1/02/2025
APL 22-014	Electronic Visit Verification Implementation Requirements	07/21/2022
APL 22-015	Enforcement Actions: Administrative and Monetary Sanctions (Supersedes APL 18-003) Superseded by 23-012	08/24/2022
APL 22-016	Community Health Worker Services Benefit	09/02/2022 Revised 09/18/2023
APL 22-017	Primary Care Provider Site Reviews: Facility Site Review and Medical Record Review (Supersedes APL 20-006) Facility Site Review Standards Medical Record Review Standards	09/22/2022
APL 22-018	Skilled 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 22-019	Proposition 56 Value-Based Payment Program Directed Payments (Supersedes APL 20-014) Superseded by 23-014	10/10/2022
APL 22-020	Community-Based Adult Services Emergency Remote Services (Supersedes APL 20-007) Reporting Template	10/21/2022 Revised 11/2/2022
APL 22-021	Proposition 56 Behavioral Health Integration Incentive Program	10/26/2022
APL 22-022	Abortion Services (Supersedes APL 15-020) Superseded by 24-003	10/28/2022
APL 22-023	Street Medicine Provider: Definitions and Participation in Managed Care Superseded by 24-001	11/08/2022
APL 22-024	Population Health Management Program Guide (Supersedes APLs 17-012 and 17-013)	11/28/2022
APL 22-025	Responsibilities for Annual Cognitive Health Assessment for Eligible Members 65 Years of Age or Older	11/28/2022
APL 22-026	Interoperability and Patient Access Final Rule	11/29/2022
APL 22-027	Cost Avoidance and Post-Payment Recovery for Other Health Coverage (Supersedes APL 21-002) Appendix A Appendix B FAQs	12/06/2022
APL 22-028	Adult and Youth Screening and Transition of Care Tools for Medi-Cal Mental Health Services Superseded by 25-010	12/27/2022
APL 22-029	Dyadic Services and Family Therapy Benefit	12/27/2022 Revised 03/20/2023
APL 22-030	Initial Health Appointment (Supersedes APL 13-017 and Policy Letters 13-001 and 08-003)	12/27/2022
APL 22-031	Doula Services Superseded by 23-024	12/27/2022
APL 22-032	Continuity 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 Letter	Date of Issue
APL 21-001	2021-2022 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule	01/07/2021
APL 21-002	Cost Avoidance and Post-Payment Recovery for Other Health Coverage (Supersedes Policy Letter 08-011) Appendix A Appendix B FAQs Superseded by 22-027	02/25/2021 Revised 07/14/2021
APL 21-003	Medi-Cal Network Provider and Subcontractor Terminations (Supersedes APL 16-001) Attachment A: Exclusionary Databases and Lists Attachment B: Facility Decertification Member Notice Template APL 21-003 Frequently Asked Questions	03/03/2021
APL 21-004	Standards for Determining Threshold Languages, Nondiscrimination Requirements, and Language Assistance Services (Supersedes APL 17-011 and Policy Letters 99-003 and 99-004) Threshold and Concentration Languages for All Counties Notice of Nondiscrimination Template Taglines Template Statement of Nondiscrimination for Small Sized Notices Template	04/08/2021 Revised 05/24/2023
APL 21-005	California Children's Services Whole Child Model Program (Supersedes APL 18-023) Superseded by 23-034	04/15/21 Revised 12/10/21
APL 21-006	Network Certification Requirements (Supersedes APL 20-003) Attachment A: Network Adequacy Standards (PDF) Attachment B: Annual Network Certification Instruction Manual (PDF) Attachment C: Alternative Access Standard (AAS) Request Template (.xls) Superseded by 23-001	04/27/2021
APL 21-007	Third Party Tort Liability Reporting Requirements (Supersedes APLs 01-002, 11-012 AND 17-021) AP 21-007 Attachments: Attachment A: DHCS Excel Template Attachment B: Secure File Transfer Protocol (SFTP) User Manual	05/10/2021
APL 21-008	Tribal Federally Qualified Health Center Providers APL 21-008 Attachments: Attachment 1: Rates for Tribal Federally Qualified Health Centers Attachment 2: List of Tribal Federally Qualified Health Center Providers	05/12/2021 Revised: 9/2/2025
APL 21-009	Collecting Social Determinants of Health Data	08/10/2021 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 Attachment B: Direct Member Incentives Reimbursement Template	8/13/2021 Revised: 03/07/2022
APL 21-011	Grievance and Appeals Requirements, Notice and “Your Rights” Templates (Supersedes APL 17-006) Supplement to APL 21-011: Emergency State Fair Hearing Timeframe Changes (Supersedes Supplement to APL 17-006) APL 21-011 Member Notices: 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 State Hearing Form – Large Print	08/31/2021 Revised 08/31/2022
APL 21-012	Enhanced Care Management Requirements Attachment 1: Enhanced Care Management Population of Focus Eligibility Criteria Superseded by 23-032	09/15/2021
APL 21-013	Dispute Resolution Process Between Mental Health Plans and Medi-Cal Managed Care Health Plans (Supersedes APL 15-007)	10/04/2021
APL 21-014	Alcohol and Drug Screening, Assessment, Brief Interventions and Referral to Treatment (Supersedes APL 18-014)	10/11/2021
APL 21-015	Benefit Standardization and Mandatory Managed Care Enrollment Provisions of the California Advancing and Innovating Medi-Cal Initiative Attachment 1: Mandatory Managed Care Enrollment Requirements Attachment 2: Major Organ Transplant Requirements	10/18/2021 Revised 10/14/2022
APL 21-016	California Advancing and Innovating Medi-Cal Incentive Payment Program Attachment 1: Measures Reporting Template Superseded by 23-003	10/27/2021
APL 21-017	Community Supports Requirements	11/05/2021 Revised 03/01/2022
APL 21-018	Public and Private Hospital Directed Payment Programs for State Fiscal Years 2017-18 and 2018-19, the Bridge Period, and Calendar Year 2021	12/23/2021

2020 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 20-001	2020-2021 Medi-Cal Managed Care Health Plan Meds/834 Cutoff And Processing Schedule	01/03/2020
APL 20-002	Non-Contract Ground Emergency Medical Transport Payment Obligations	01/31/2020
APL 20-003	Network Certification Requirements (Supersedes APL 19-002) APL 20-003 Attachments: Attachment A: Network Adequacy Standards Attachment B: Annual Network Certification Instruction Manual Attachment C: Alternative Access Standard (AAS) Request Template Superseded by 21-006	02/27/2020
APL 20-004 (Revised)	Emergency Guidance for Medi-Cal Managed Care Health Plans in Response to COVID-19	06/08/2020 Revised: 04/04/2023
APL 20-005	Extension of the Adult Expansion Risk Corridor for State Fiscal Year 2017-18	03/26/2020
APL 20-006	Site Reviews: Facility Site Review and Medical Record Review (Supersedes PLs 14-004 and 03-002, and APL 03-007) Attachment A: Application for DHCS Site Review Master Trainer Certification 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 20-008	Mitigating Health Impacts of Secondary Stress Due to the COVID-19 Emergency Attachment A: Sources of Reference for Negative Outcomes as a Result of Secondary Health Effects	04/07/2020
APL 20-009	Preventing Isolation of and Supporting Older and Other At-Risk Individuals to Stay Home and Stay Healthy During COVID-19 Efforts	04/15/2020
APL 20-010	*RETRACTED*
APL 20-011 (Revised)	Governor's Executive Order N-55-20 in Response to COVID-19	06/12/2020 Revised 07/08/2021
APL 20-012	Private Duty Nursing Case Management Responsibilities tor Medi-Cal Eligible Members Under the Age of 21	05/15/2020
APL 20-013	Proposition 56 Directed Payments for Family Planning Services Superseded by 22-011	05/13/2020
APL 20-014	Proposition 56 Value-Based Payment Program Directed Payments Superseded by 22-019	05/15/2020
APL 20-015	State 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 20-017	Requirements for Reporting Managed Care Program Data (Supersedes APLs 14-013 (Revised) and 14-012)	10/14/2020
APL 20-018	Ensuring Access to Transgender Services (Supersedes APL16-013)	10/26/2020
APL 20-019	*RETRACTED*
APL 20-020	Governor’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 - *RETIRED*	12/28/2020 Revised 10/06/2022

2019 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 19-001	Medi-Cal Managed Care Health Plan Guidance on Network Provider Status APL 19-001 Attachment A: Network Provider Agreement Boilerplate Checklist	01/17/2019
APL 19-002	Network Certification Requirements (Supersedes APL 18-005) APL 19-002 Attachments: Attachment A: Network Adequacy Standards Attachment B: Annual Network Certification Checklist Attachment C: Alternative Access Standards Request Template Attachment D: Alternative Access Standard Renewal Template Superseded by 20-003	01/30/2019
APL 19-003	Providing Informing Materials to Medi-Cal Beneficiaries in an Electronic Format	05/02/2019
APL 19-004	Provider 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 19-006	Proposition 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 19-007	Non-Contract Ground Emergency Medical Transport Payment Obligations for State Fiscal Year 2018-19	06/14/2019
APL 19-008	Rate 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 Supplement to APL 19-009 (Revised): Emergency Telehealth Guidance – COVID-19 Pandemic Superseded by 23-007	08/05/2019 Revised: 03/18/2020
APL 19-010	Requirements 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 19-011	Health Education and Cultural and Linguistic Population Needs Assessment (Supersedes APL 17-002) Superseded by 23-021	09/30/2019
APL 19-012	Federal 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 19-013	Proposition 56 Hyde Reimbursement Requirements for Specified Services Superseded by 23-015	10/17/2019
APL 19-014	Responsibilities for Behavioral Health Treatment Coverage for Members Under the Age of 21 (Supersedes APL 18-006) Superseded by 23-010	11/12/2019
APL 19-015	Proposition 56 Directed Payments for Physician Services (Supersedes APL 19-006) Superseded by 23-019	12/24/2019
APL 19-016	Proposition 56 Directed Payments for Developmental Screening Services Superseded by 23-016	12/26/2019
APL 19-017	Quality and Performance Improvement Requirements (Supersedes APL 17-014) Supplement to APL 19-017: Quality and Performance Improvement Adjustments Due to COVID-19	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 Letter	Date of Issue
APL 18-001	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 18-003	Administrative and Financial Sanctions (Supersedes APL 15-014)	01/25/2018
APL 18-004	Immunization Requirements (Supersedes PL 96-013 and APL 07-015) Superseded by 24-008	01/31/2018
APL 18-006	Responsibilities for Behavioral Health Treatment Coverage for Members Under the Age of 21 (Supersedes APL 15-025) Superseded by 19-014	03/02/2018
APL 18-007	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) 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 18-009	Memorandum 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 18-010	Proposition 56 Directed Payment Expenditures for Specified Services for State Fiscal Year 2017-18 Superseded by 19-006	05/01/2018
APL 18-011	California Children's Services Whole Child Model Program Superseded by 18-023	06/07/2018
APL 18-012	Health Homes Program Requirements	06/28/2018
APL 18-013	Hepatitis C Virus Treatment Policy Update (Supersedes APL 15-016) - RETIRED	08/14/2018
APL 18-014	Alcohol 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: Attachment 1: Title 9 – Rehabilitative and Developmental Services, Chapter 11 – Medi-Cal Specialty Mental Health Services Attachment 2: Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and County Mental Health Plans	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: Document A: Definitions and Requirements Document B: Readability and Suitability Checklist for Written Health Education Materials	10/05/2018
APL 18-017	Blood Lead Screening of Young Children (Supersedes PL 02-01) Superseded by 20-016	10/22/2018
APL 18-018	Diabetes Prevention Program	11/16/2018
APL 18-019	Family Planning Services Policy for Self-Administered Hormonal Contraceptives (Supersedes APL 16-003)	11/21/2018
APL 18-020	Palliative Care (Supersedes APL 17-015)	12/07/2018
APL 18-021	2019-2020 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule	12/19/2018
APL 18-022	Access Requirements for Freestanding Birth Centers and the Provision of Midwife Services (Supersedes APL 16-017)	12/19/2018
APL 18-023	California 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 Letter	Date of Issue
APL 17-001	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 17-003	Treatment of Recoveries Made by the Managed Care Health Plan of Overpayments to Providers Superseded by 23-011	03/30/2017
APL 17-004	Subcontractual Relationships and Delegation Superseded by 23-006	04/18/2017
APL 17-005	Certification of Document and Data Submissions	05/02/2017
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 17-007	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 All Plan Letter 15-001) APL 17-007 Attachment B: Monthly MER Denial Report Template	05/11/2017
APL 17-008	Requirement to Participate in the Medi-Cal Drug Utilization Review Program	05/10/2017
APL 17-009	Reporting 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 APL 17-010 Frequently Asked Questions Superseded by 22-008	06/29/2017 Revised: 09/08/2020
APL 17-011	Standards 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 17-013	Requirements for Health Risk Assessment of Medi-Cal Seniors and Persons with Disabilities Superseded by 22-024	07/11/2017
APL 17-014	Quality and Performance Improvement Requirements (Supersedes APL 16-018) Superseded by 19-017	09/11/2017
APL 17-015	Palliative Care and Medi-Cal Managed Care Superseded by 18-020	10/19/2017
APL 17-016	Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care (Supersedes APL 14-004) Superseded by 18-014	10/27/2017
APL 17-017	Long Term Care Coordination and Disenrollment (Supersedes APL 03-003)	10/27/2017
APL 17-018	Medi-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) Medi-Cal Managed Care Provider Enrollment Frequently Asked Questions (FAQs) Superseded by 19-004	11/14/2017
APL 17-020	American Indian Health Programs APL 17-020 Attachment #1: List of American Indian Health Program Providers APL 17-020 Attachment #2: Rates for American Indian Health Program Providers	12/15/2017 Revised: 9/2/2025
APL 17-021	Workers’ 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 Letter	Date of Issue
APL 16-001	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 Schedule	01/19/2016
APL 16-003	Family 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 Act	06/08/2016
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 16-010	Medi-Cal Managed Care Health Plan Pharmaceutical Formulary Comparability Requirement - RETIRED	09/06/2016
APL 16-011	Reporting Requirements Related to Provider Preventable Conditions (Supersedes APL 15-006) Superseded by 17-009	09/20/2016
APL 16-012	Provider 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 16-014	Comprehensive Tobacco Prevention and Cessation Services for Medi-Cal Beneficiaries (Supersedes PL 14-006)	11/30/2016
APL 16-015	Acupuncture Services	12/01/2016
APL 16-016	Rate 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 16-017	Provision of Certified Nurse Midwife and Alternative Birth Center Facility Services (Supersedes APL 15-017) Superseded by 18-022	12/09/2016
APL 16-018	Quality 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 Letter	Date of Issue
APL 15-001	Continuity of Care for New Enrollees Transitioned to Managed Care After Requesting a Medical Exemption APL 15-001 Attachment C: Report Template 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 Counties	01/22/2015
APL 15-003	Podiatric and Chiropractic Services at Federally Qualified Health Centers and Rural Health Clinics	01/26/2015
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 Mediconnect	02/12/2015
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 Services	04/16/2015
APL 15-009	Proper Use and Billing for Makena (Supersedes APL 13-016) - RETIRED	04/16/2015
APL 15-010	Affordable Care Act Section 1202 Increased Payments for Medi-Cal Primary Care Services – Revised Guidance and Contractual Requirements	05/01/2015
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 15-013	Requirements for Medi-Cal Managed Care Health Plans and Qualified Agency Contract	05/22/2015
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 Facilities	06/12/2015
APL 15-016	Hepatitis C Virus Treatment Policy Update Superseded by 18-013	06/29/2015
APL 15-017	Provision 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 Components	07/09/2015
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 Providers	10/28/2015
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 Fraud	12/30/2015

2014 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date 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 14-008	Standards 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 APL 14-012 Attachment: DHCS Call Center Report Template (MS Excel) Superseded by 20-017	09/25/2014
APL 14-013	Grievance Report Template APL 14-013 Attachment: DHCS Grievance Report Template (MS Excel) 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 Counties	10/10/2014
APL 14-015	Primary Care Provider Assignment in Medi-Cal Managed Care for Dual-Eligible Beneficiaries - *RETIRED*	11/24/2014
APL 14-016	Summary of 2014 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Health Plans	11/24/2014
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 Schedule	12/19/2014
APL 14-019	Encounter Data Submission Requirements	12/19/2014
APL 14-020	Quality Measures for Encounter Data APL 14-020 Attachment: DHCS Quality Measures for Encounter Data	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 Letter	Date 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 Secure Online Reporting Portal 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 APL 13-013 Attachment C MER Denial and Continuity of Care (Excel) 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 Letter	Date 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 12-005	2013-2014 Managed Care Plan MEDS/834 Cutoff and Processing Schedule	12/27/2012

2011 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date 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 Number	Title (Subject) of Letter	Date 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 Number	Title (Subject) of Letter	Date 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 Number	Title (Subject) of Letter	Date 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 Number	Title (Subject) of Letter	Date 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 Number	Title (Subject) of Letter	Date 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 06-009 Attachment: CA Information Request (Excel) 06-009 Attachment: Lookup Table (Excel)	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 Number	Title (Subject) of Letter	Date 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 Number	Title (Subject) of Letter	Date 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 Number	Title (Subject) of Letter	Date 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	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 Number	Title (Subject) of Letter	Date 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 Number	Title (Subject) of Letter	Date 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	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 Number	Title (Subject) of Letter	Date 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	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 Number	Title (Subject) of Letter	Date 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 Letter	Date 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

Last modified date: 10/21/2025 4:04 PM

2025 - All Plan Le​tters​

2024 - All Plan Le​tters​

​​2023 - All Plan Letters​​​

2022 - All Plan Letters

2021 - All Plan Letters

2020 - All Plan Letters​

​2019 - All Plan Letters

2018​ - All Plan Letters

2017​ - All Plan Letters

​ 2016​ - All Plan Letters​

2015​ - All Plan Letters

2014​ - All Plan Letters

2013​ - All Plan Letters

2012 - All Plan Letters

2011 - All Plan Letters

2010 - All Plan Letters

2009 - All Plan Letters

200​8​ - All Plan Letters

2007 - All Plan Letters

2006 - All Plan Letters

2005 - All plan letters

2004 - All Plan Letters

2003 - All Plan Letters

2002 - All Plan Letters

2001 - All Plan Letters

2000 - All Plan Letters

1999 - All Plan Letters

199​​8​ - All Plan Letters

2025 - All Plan Letters

2024 - All Plan Letters

2023 - All Plan Letters

2020 - All Plan Letters

2019 - All Plan Letters

2018 - All Plan Letters

2017 - All Plan Letters

2016 - All Plan Letters

2015 - All Plan Letters

2014 - All Plan Letters

2013 - All Plan Letters

2008 - All Plan Letters

1998 - All Plan Letters