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
2026 – All Plan Letters
| Letter Number | Title (Subject) of Letter | Date of Issue |
|---|---|---|
| APL 26-001 | Initial Health Appointment | 1/7/2026 |
| APL 26-002 | Medi-Cal Managed Care Plan Responsibilities for Non-Specialty Mental Health Services (Supersedes APL 22-006) | 2/2/2026 |
| APL 26-003 | Quality Measures For Encounter Data Update: Quality Measures For Encounter Data 2.0 (Supersedes APL 14-020) | 3/13/2026 |
| APL 26-004 | Medi-Cal Managed Care Plan Responsibilities For Behavioral Health Data-Sharing | 3/16/2026 |
| APL 26-005 | Maternity Services for Pregnant and Postpartum Medi-Cal Members (Supersedes APLs 00-012, 18-022, and Policy Letters 98-006, 98-010, and 12-003) | 3/25/2026 |
| APL 26-006 | Skilled Nursing Facility Workforce Quality Incentive Program (Supersedes APL 25-002) | 3/20/2026 |
| APL 26-007 | Medi-Cal Managed Care Plan Guidance on Network Provider Agreements (Supersedes APL 19-001) | 4/24/2026 |
| APL 26-008 | Interoperability Final Rules, Including Prior Authorization Requirements (Supersedes APL 22-026) | 05/12/2026 |
| APL 26-009 | Private Duty Nursing Case Management Responsibilities For Medi-Cal Eligible Members Under The Age of 21 (Supersedes APL 20-012) | 6/01/2026 |
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| APL 25-002 | Skilled Nursing Facility Workforce Quality Incentive Program (Superseded by APL 26-006) | 1/13/2025 |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 Revised 11/18/2025 |
| APL 25-007 | Enforcement Actions: Corrective Action Plans, Administrative and Monetary Sanctions (Supersedes APL 23-012) | 4/25/2025 |
| APL 25-008 | Hospice Services and Medi-Cal Managed 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) | 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 |
| APL 25-016 | Alternative Format Selection For Members With Visual Impairments (Supersedes APL 22-002) | 11/13/2025 |
| APL 25-017 | 2025-2027 Medi-Cal Managed Care Health Plan MEDS/834 Cutoff and Processing Schedule | 12/26/2025 |
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 And Directly Related Medical Services And Supplies | 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 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)
| 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)(Superseded by 25-007) | 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 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 | 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 | 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) Superseded by APL 26-002 | 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- 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) | 07/11/2022 Revised 12/30/2022 |
| APL 22-013 | Provider Credentialing/Re-Credentialing and Screening/Enrollment (Supersedes APL 19-004) | 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) | 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 Superseded by APL 26-008 | 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 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) 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: 12/10/2021 |
| APL 21-006 | Network Certification Requirements (Supersedes APL 20-003)
| 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: Attachment 1: Rates for Tribal Federally Qualified Health Centers Attachment 2: List of Tribal Federally Qualified Health Center Providers | 05/12/2021 Revised: 04/09/2026 |
| 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) Notice of Appeal Resolution (NAR) State Hearing FormState Hearing Form – Large Print | 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
| 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:
| 02/27/2020 |
| APL 20-004 (Revised) | Emergency Guidance for Medi-Cal Managed Care Health Plans in Response to COVID-19 – RETIRED | 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 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 | 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 Superseded by APL 26-009 | 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 (Superseded by APL 27-007) | 01/17/2019 |
| APL 19-002 | Network Certification Requirements (Supersedes APL 18-005) APL 19-002 Attachments:
| 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) | 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: | 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) Superseded by APL 26-005 | 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
Notice of Action (NOA)
Notice of Appeal Resolution (NAR)
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 ServicesSuperseded 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: 04/09/2026 |
| 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 |
|---|---|---|
| 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 ExemptionSuperseded 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
| 09/25/2014 |
| APL 14-013 | Grievance Report Template
| 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 Superseded by APL 26-003 | 12/23/2014 Revised: 8/8/2018 |
| APL 14-021 | Continuity of Care for Medi-Cal Beneficiaries Who Transition into Medi-Cal Managed Care (Supersedes APL 13-023) Superseded by 15-019 | 12/29/2014 |
2013 – All Plan Letters
| Letter Number | Title (Subject) of 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 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 ExemptionSuperseded 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
| 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 – RETIRED | 08/27/2003 |
| APL 03-010 | Medi-Cal Managed Care Plan Requirements for Provision of Contraceptive Drug Services and Supplies – RETIRED | 09/12/2003 |
| APL 03-011 | Fraud Referral Procedure to Audits and Investigations (A&I) | 10/22/2003 |
| APL 03-012 | Medi-Cal Providers on Probation | 10/24/2003 |
| APL 03-013 | Non Contracted Emergency Room Rate Schedule | 12/12/2003 |
| APL 03-014 | Delmarva Foundation for Medical Care, Inc. | 12/12/2003 |
| APL 03-015 | Use of Services Measures | 12/17/2003 |
2002 – All Plan Letters
| Letter 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- RETIRED | 07/25/2001 |
| APL 01-004 | Health Plan Choice Reminders (Annual Renotifications) | 08/21/2001 |
| APL 01-005 | Implementation of a New Process Which Will Reject Encounter Data At Record Level | 11/26/2001 |
| APL 01-006 | 2002 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule | 12/24/2001 |
| APL 01-007 | Summary of 2001 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans | 12/17/2001 |
| APL 01-008 | Breast and Cervical Cancer Treatment Program | 12/17/2001 |
2000 – All Plan Letters
| Letter 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 RelocationSuperseded by APL 14-017 | 06/05/2000 |
| APL 00-007 | Potential Increase in New Enrollees Due to Changes in the Section 1931(b) Program | 07/05/2000 |
| APL 00-008 | Importance of Increased Outreach to New Eligibles Under the Section 1931(b) Program | 08/15/2000 |
| APL 00-009 | Percent of Poverty Population | 09/15/2000 |
| APL 00-010 | Draft 2000 Medi-Cal Managed Care Contract Amendments Package 00-01 | 09/13/2000 |
| APL 00-011 | Ensuring Beneficiaries Receive Laboratory Services From CLIA Certified Laboratories | 10/17/2000 |
| APL 00-012 | Utilization Review of Initial Risk Assessments for Pregnant Women Superseded by APL 26-005 | 12/22/2000 |
| APL 00-013 | Amended Regulations for Enrollment and Disenrollment for Two-Plan Model Plans | 12/28/2000 |
| APL 00-014 | 2001 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule | 12/29/2000 |
1999 – All Plan Letters
| Letter 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 |