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2025 - All Plan Le​tters​

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​​
​2/7/2025
​APL 25-005​
​Standards For Determining Threshold Languages, Nondiscrimination Requirements, Language Assistance Services, And Alternative Formats (Supersedes APL 21-004)
​2/12/2025
​APL 25-006​
​Timely Access Requirements
​4/25/2025

2024 - All Plan Le​tters​

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)
​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)
​01/06/2023
APL 23-002​

2023-2024 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff an​d 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)
​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​ (Supers​edes 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)​

​05/0​4/2023

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)
​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​
(Supersedes APL 15-012)
​10/03/2023
​​APL 23-029​
​Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and Third-Party Entities
​10/11/2023










Revised
01/08/2025
​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 LetterDate 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 ​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)
​05/18/2022
​APL 22-009
​COVID-19 Guidance for Medi-Cal Managed Care Health Plans​
​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)
​07/11/2022

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

Revi​sed
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)
​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)​


​12/06/2022
​​APL 22-028
​Adult and Youth Screening and Transition of Care Tools for Medi-Cal Mental Health Services​
​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)
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)
​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) ​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)
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:
​05/10/2021
​APL 21-008​​

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

Revised:
12/16/2024
​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​
​8/13/2021

Revised:
03/07/2022 ​
​​APL 21-011​​
​Grievance 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 21-012
​Enhanced Care Management Requirements

​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

​10/18/2021

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

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

Revised
03/01/2022
​APL 21-018​
​Pu​blic 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 LetterDate of Issue
APL 20-001​
2020-2021 Medi-Cal Managed Care Health Plan Meds/834 Cutoff And Processing Schedule​

01/03/2020
​APL 20-002​
​N​on-Contract Ground Emergency Medical Transport Payment Obligations
​01/31/2020
​APL 20-003
​Network 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 
​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)​
Superseded by 22-017
​03/04/2020
​​APL 20-007 (Revised)

​Policy Guidance for Community-Based Adult Services in Response t​​o 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

 


​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
​12/28/2020

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
01/17/2019
​APL 19-002​Network Certification Requirements (Supersedes APL 18-005)
APL 19-002 Attachments:
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

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 (Supersede​s 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 18-003​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:

​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 18-017​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 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 17-003​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) ​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

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)

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

​American Indian Health Programs

​12/15/2017

Revised: 

12/16/2024

​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 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 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 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 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 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 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 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

200​8​ - 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

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

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

Superseded by APL 18-017

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

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

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 Mana​​​ged 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

199​​8​ - 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​

 
Last modified date: 4/30/2025 10:02 AM