Managed Care All Plan Letters - 1998 to Current

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

2022 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 22-001	2022-2023 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule	01/11/2022
APL 22-002	Alternative Format Selection for Members with Visual Impairments Alternative Format Selection Technical Guidance for Medi-Cal Managed Care Health Plans Alternative Format Data Process Guide Alternative Format Selection Application User Guide	03/14/2022
APL 22-003	Medi-Cal Managed Care Health Plan Responsibility to Provide Services to Members with Eating Disorders	03/17/2022
APL 22-004	Strategic Approaches for Use By Managed Care Plans to Maximize Continuity of Coverage as Normal Eligibility and Enrollment Operations Resume	03/17/2022
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

2021 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 21-001	2021-2022 Medi-Cal Managed Care Health Plan Meds/834 Cutoff and Processing Schedule	01/07/2021
APL 21-002	Cost Avoidance and Post-Payment Recovery for Other Health Coverage (Supersedes Policy Letter 08-011) Appendix A Appendix B FAQs	02/25/2021 Revised 07/14/2021
APL 21-003	Medi-Cal Network Provider and Subcontractor Terminations (Supersedes APL 16-001) Attachment A: Exclusionary Databases and Lists Attachment B: Facility Decertification Member Notice Template APL 21-003 Frequently Asked Questions	03/03/2021
APL 21-004	Standards for Determining Threshold Languages, Nondiscrimination Requirements, and Language Assistance Services (Supersedes APL 17-011 and Policy Letters 99-003 and 99-004) Threshold and Concentration Languages for All Counties Notice of Nondiscrimination Template Taglines Template Statement of Nondiscrimination for Small Sized Notices Template	04/08/2021 Revised 05/03/2022
APL 21-005	California Children’s Services Whole Child Model Program (Supersedes APL 18-023)	04/15/2021 Revised 12/10/2021
APL 21-006	Network Certification Requirements (Supersedes APL 20-003) Attachment A: Network Adequacy Standards (PDF) Attachment B: Annual Network Certification Instruction Manual (PDF) Attachment C: Alternative Access Standard (AAS) Request Template (.xls)	04/27/2021
APL 21-007	Third Party Tort Liability Reporting Requirements (Supersedes APLs 01-002, 11-012 AND 17-021) AP 21-007 Attachments: Attachment A: DHCS Excel Template Attachment B: Secure File Transfer Protocol (SFTP) User Manual	05/10/2021
APL 21-008	Tribal Federally Qualified Health Center Providers APL 21-008 Attachments: Attachment 1: Rates for Tribal Federally Qualified Health Centers Attachment 2: List of Tribal Federally Qualified Health Center Providers	05/12/2021 Revised: 04/19/2022
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) APL 21-011 Member Notices: Notice of Action (NOA) Deny Delay Modify Carve-Out Terminate NOA Your Rights (Knox-Keene) NOA Your Rights (Non Knox-Keene) Notice of Appeal Resolution (NAR) Overturn Uphold NAR Your Rights (Knox-Keene) NAR Your Rights (Non Knox-Keene) State Hearing Form	08/31/2021
APL 21-012	Enhanced Care Management Requirements Attachment 1: Enhanced Care Management Population of Focus Eligibility Criteria	09/15/2021
APL 21-013	Dispute Resolution Process Between Mental Health Plans and Medi-Cal Managed Care Health Plans (Supersedes APL 15-007)	10/04/2021
APL 21-014	Alcohol and Drug Screening, Assessment, Brief Interventions and Referral to Treatment (Supersedes APL 18-014)	10/11/2021
APL 21-015	Benefit Standardization and Mandatory Managed Care Enrollment Provisions of the California Advancing and Innovating Medi-Cal Initiative Attachment 1: Mandatory Managed Care Enrollment Requirements Attachment 2: Major Organ Transplant Requirements	10/18/2021
APL 21-016	California Advancing and Innovating Medi-Cal Incentive Payment Program Attachment 1: Measures Reporting Template	10/27/2021
APL 21-017	Community Supports Requirements	11/05/2021 Revised 03/01/2022
APL 21-018	Public and Private Hospital Directed Payment Programs for State Fiscal Years 2017-18 and 2018-19, the Bridge Period, and Calendar Year 2021	12/23/2021

2020 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 20-001	2020-2021 Medi-Cal Managed Care Health Plan Meds/834 Cutoff And Processing Schedule	01/03/2020
APL 20-002	Non-Contract Ground Emergency Medical Transport Payment Obligations	01/31/2020
APL 20-003	Network Certification Requirements (Supersedes APL 19-002) APL 20-003 Attachments: Attachment A: Network Adequacy Standards Attachment B: Annual Network Certification Instruction Manual Attachment C: Alternative Access Standard (AAS) Request Template	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: 09/09/2021
APL 20-005	Extension of the Adult Expansion Risk Corridor for State Fiscal Year 2017-18	03/26/2020
APL 20-006	Site Reviews: Facility Site Review and Medical Record Review (Supersedes PLs 14-004 and 03-002, and APL 03-007) Attachment A: Application for DHCS Site Review Master Trainer Certification	03/04/2020
APL 20-007 (Revised)	Policy Guidance for Community-Based Adult Services in Response to COVID-19 Public Health Emergency	03/30/2020 Revised: 04/13/2020
APL 20-008	Mitigating Health Impacts of Secondary Stress Due to the COVID-19 Emergency Attachment A: Sources of Reference for Negative Outcomes as a Result of Secondary Health Effects	04/07/2020
APL 20-009	Preventing Isolation of and Supporting Older and Other At-Risk Individuals to Stay Home and Stay Healthy During COVID-19 Efforts	04/15/2020
APL 20-010	*RETRACTED*
APL 20-011 (Revised)	Governor's Executive Order N-55-20 in Response to COVID-19	06/12/2020 Revised 07/08/2021
APL 20-012	Private Duty Nursing Case Management Responsibilities tor Medi-Cal Eligible Members Under the Age of 21	05/15/2020
APL 20-013	Proposition 56 Directed Payments for Family Planning Services	05/13/2020
APL 20-014	Proposition 56 Value-Based Payment Program Directed Payments	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	11/04/2020
APL 20-021 (Revised)	Acute Hospital Care at Home	12/28/2020 Revised 01/19/2021
APL 20-022 (Revised)	COVID-19 Vaccine Administration	12/28/2020 Revised 01/20/2022

2019 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 19-001	Medi-Cal Managed Care Health Plan Guidance on Network Provider Status APL 19-001 Attachment A: Network Provider Agreement Boilerplate Checklist	01/17/2019
APL 19-002	Network Certification Requirements (Supersedes APL 18-005) APL 19-002 Attachments: Attachment A: Network Adequacy Standards Attachment B: Annual Network Certification Checklist Attachment C: Alternative Access Standards Request Template Attachment D: Alternative Access Standard Renewal Template	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	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)	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	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)	08/14/2019
APL 19-011	Health Education and Cultural and Linguistic Population Needs Assessment (Supersedes APL 17-002)	09/30/2019
APL 19-012	Federal Drug Utilization Review Requirements Designed to Reduce Opioid Related Fraud, Misuse and Abuse	09/30/2019 Revised: 11/15/2019
APL 19-013	Proposition 56 Hyde Reimbursement Requirements for Specified Services	10/17/2019
APL 19-014	Responsibilities for Behavioral Health Treatment Coverage for Members Under the Age of 21 (Supersedes APL 18-006)	11/12/2019
APL 19-015	Proposition 56 Directed Payments for Physician Services (Supersedes APL 19-006)	12/24/2019
APL 19-016	Proposition 56 Directed Payments for Developmental Screening Services	12/26/2019
APL 19-017	Quality and Performance Improvement Requirements (Supersedes APL 17-014) Supplement to APL 19-017: Quality and Performance Improvement Adjustments Due to COVID-19	12/26/2019
APL 19-018	Proposition 56 Directed Payments for Adverse Childhood Experiences Screening Services	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)	01/31/2018
APL 18-006	Responsibilities for Behavioral Health Treatment Coverage for Members Under the Age of 21 (Supersedes APL 15-025)	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)	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)	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
APL 18-010	Proposition 56 Directed Payment Expenditures for Specified Services for State Fiscal Year 2017-18	05/01/2018
APL 18-011	California Children’s Services Whole Child Model Program	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)	08/14/2018
APL 18-014	Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care (Supersedes APL 17-016)	09/14/2018
APL 18-015	Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans APL 18-015 Attachments: Attachment 1: Title 9 – Rehabilitative and Developmental Services, Chapter 11 – Medi-Cal Specialty Mental Health Services Attachment 2: Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans and County Mental Health Plans	09/19/2018
APL 18-016	Readability and Suitability of Written Health Education Materials (Supersedes APL 11-018) APL 18-016 Attachments: Document A: Definitions and Requirements Document B: Readability and Suitability Checklist for Written Health Education Materials	10/05/2018
APL 18-017	Blood Lead Screening of Young Children (Supersedes PL 02-01)	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)	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)	02/03/2017
APL 17-003	Treatment of Recoveries Made by the Managed Care Health Plan of Overpayments to Providers	03/30/2017
APL 17-004	Subcontractual Relationships and Delegation	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) Supplement to APL 17-006: Emergency State Fair Hearing Timeframe Changes APL 17-006 Member Notices: 1557 Notices Language Assistance Taglines Nondiscrimination Notice Notice of Action (NOA) Deny Delay Modify Carve-Out Terminate NOA Your Rights (Knox-Keene) NOA Your Rights (non Knox-Keene) Notice of Appeal Resolution (NAR) Overturn Uphold NAR Your Rights (Knox-Keene) NAR Your Rights (non Knox-Keene) State Hearing Form	05/09/2017
APL 17-007	Continuity of Care for New Enrollees Transitioned to Managed Care After Requesting a Medical Exemption and Implementation of Monthly Medical Exemption Review Denial Reporting (Supersedes All Plan Letter 15-001) APL 17-007 Attachment B: Monthly MER Denial Report Template	05/11/2017
APL 17-008	Requirement to Participate in the Medi-Cal Drug Utilization Review Program	05/10/2017
APL 17-009	Reporting Requirements Related To Provider Preventable Conditions (Supersedes All Plan Letter 16-011)	05/23/2017
APL 17-010 (Revised)	Non-Emergency Medical and Non-Medical Transportation Services APL 17-010 Frequently Asked Questions	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)	06/30/2017
APL 17-012	Care Coordination Requirements for Managed Long - Term Services and Supports (Supersedes APL 14-010)	07/11/2017
APL 17-013	Requirements for Health Risk Assessment of Medi-Cal Seniors and Persons with Disabilities (Supersedes PL 14-005)	07/11/2017
APL 17-014	Quality and Performance Improvement Requirements (Supersedes APL 16-018)	09/11/2017
APL 17-015	Palliative Care and Medi-Cal Managed Care	10/19/2017
APL 17-016	Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care (Supersedes APL 14-004)	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)	10/27/2017
APL 17-019	Provider Credentialing / Recredentialing and Screening / Enrollment (Supersedes APL 16-012) Medi-Cal Managed Care Provider Enrollment Frequently Asked Questions (FAQs)	11/14/2017
APL 17-020	American Indian Health Programs APL 17-020 Attachment #1: List of American Indian Health Program Providers APL 17-020 Attachment #2: Rates for American Indian Health Program Providers	12/15/2017 Revised: 04/19/2022
APL 17-021	Workers’ Compensation – Notice of Change to Workers’ Compensation Recovery Program; Reporting and Other Requirements (Supersedes APL 04-004)	12/26/2017

2016 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 16-001	Medi-Cal Provider and Subcontract Suspensions, Terminations, and Decertifications (Supersedes APL 06-007)	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	08/31/2016 Revised: 12/23/2016
APL 16-010	Medi-Cal Managed Care Health Plan Pharmaceutical Formulary Comparability Requirement	09/06/2016
APL 16-011	Reporting Requirements Related to Provider Preventable Conditions (Supersedes APL 15-006)	09/20/2016
APL 16-012	Provider Credentialing and Recredentialing (Supersedes PL 02-003)	09/27/2016
APL 16-013)	Ensuring Access to Medi-Cal Services for Transgender Beneficiaries (Supersedes APL 13-011)	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	12/07/2016
APL 16-017	Provision of Certified Nurse Midwife and Alternative Birth Center Facility Services (Supersedes APL 15-017)	12/09/2016
APL 16-018	Quality and Performance Improvement Requirements (Supersedes APL 15-024)	12/22/2016
APL 16-019	Managed Care Provider Data Reporting Requirements (Supersedes APL 14-006)	12/28/2016

2015 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 15-001	Continuity of Care for New Enrollees Transitioned to Managed Care After Requesting a Medical Exemption APL 15-001 Attachment C: Report Template Superseded by APL 17-007	01/14/2015
APL 15-002	Multipurpose Senior Services Program Complaint, Grievance, Appeal, and State Hearing Responsibilities in Coordinated Care Initiative Counties	01/22/2015
APL 15-003	Podiatric and Chiropractic Services at Federally Qualified Health Centers and Rural Health Clinics	01/26/2015
APL 15-004	Medi-Cal Managed Care Health Plan Requirements for Nursing Facility Services in Coordinated Care Initiative Counties For Beneficiaries not Enrolled in Cal Mediconnect	02/12/2015
APL 15-005	Data Request Requirements for Child Health Disability Prevention Report Contained in Policy Letter 10-013 (Supersedes PL 10-013)	02/12/2015
APL 15-006	Reporting Requirements Related to Provider Preventable Conditions (Supersedes APL 13-007)	03/11/2015
APL 15-007	Dispute Resolution Process for Mental Health Services	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)	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	05/11/2015
APL 15-012	Dental Services - Intravenous Sedation and General Anesthesia Coverage (Supersedes Policy Letter 13-002)	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	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	06/29/2015
APL 15-017	Provision of Certified Nurse Midwife and Alternative Birth Center Facility Services	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)	08/26/2015
APL 15-020	Abortion Services (Supersedes PL 99-08)	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	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)	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)	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	01/14/2014
APL 14-004	Screening, Brief Intervention, and Referral to Treatment for Misuse of Alcohol	02/10/2014
APL 14-005	New Benefit - Voluntary Inpatient Detox	03/11/2014
APL 14-006	Ongoing Provider File Submission Requirements (Supersedes APL 11-020)	03/12/2014
APL 14-007	Dual-Eligible Special Needs Plans	06/26/2014
APL 14-008	Standards for Determining Threshold Languages	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	09/10/2014
APL 14-011	Interim Policy for the Provision of Behavioral Health Treatment Coverage for Children Diagnosed with Autism Spectrum Disorder	09/15/2014
APL 14-012	Call Center Report Template APL 14-012 Attachment: DHCS Call Center Report Template (MS Excel)	09/25/2014
APL 14-013	Grievance Report Template APL 14-013 Attachment: DHCS Grievance Report Template (MS Excel)	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	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	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)	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	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	02/12/2013
APL 13-005	Quality & Performance Improvement Program Requirements for 2013 (Supersedes APL 11-021)	04/12/2013
APL 13-006	Encounter Data Element for Medi-Cal Managed Care Health Plans, Version 2.0.	05/30/2013
APL 13-007	Reporting Encounter Data Related to Provider Preventable Conditions Secure Online Reporting Portal	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	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	10/04/2013
APL 13-013	Continuity of Care for New Enrollees Transitioned to Managed Care after Requesting a Medical Exemption APL 13-013 Attachment C MER Denial and Continuity of Care (Excel) Superseded by APL 15-001	10/04/2013 Revised: 4/3/2014
APL 13-014	Hospice Services and Medi-Cal Managed Care	10/28/2013
APL 13-015	Marketing Requirements for Medi-Cal and Covered California	10/29/2013
APL 13-016	Proper use of and Billing for Makena	11/14/2013
APL 13-017	Staying Healthy Assessment/Individual Health Education Behavioral Assessment for Enrollees from Low-Income Health Program	11/18/2013
APL 13-018	Memorandum of Understanding Requirements for Medi-Cal Managed Care Plans	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	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	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	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	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	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	09/21/2011
APL 11-021	Quality and Performance Improvement Program Requirements for 2012	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	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	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	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	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	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	09/18/2006
APL 06-008	Contraceptive Devices	10/26/2006
APL 06-009	Supplemental Data Request 06-009 Attachment: CA Information Request (Excel) 06-009 Attachment: Lookup Table (Excel)	10/23/2006
APL 06-010	Quality and Performance Improvement Requirements for 2007	11/30/2006
APL 06-011	Same Day Banking	11/01/2006
APL 06-012	2007-2008 Managed Care Plan MEDS/FAME Cutoff and Processing Schedule	12/06/2006

2005 - All plan letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 05-001	Summary of 2003 and 2004 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans	01/06/2005
APL 05-002	New Process for Transmitting Enrollment/Disenrollment Data	03/28/2005
APL 05-003	Hospice Services and Medi-Cal Managed Care	03/25/2005
APL 05-004	Personal Injury Inquiry Letter	04/11/2005
APL 05-006	HIPAA Requirements: Plans’ Reporting Responsibilities	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	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	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	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	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	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	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	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	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	02/21/2001
APL 01-003	Mifepristone (RU-486) As a Medi-Cal Benefit	07/25/2001
APL 01-004	Health Plan Choice Reminders (Annual Renotifications)	08/21/2001
APL 01-005	Implementation of a New Process Which Will Reject Encounter Data At Record Level	11/26/2001
APL 01-006	2002 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule	12/24/2001
APL 01-007	Summary of 2001 Chaptered Legislation Impacting or of Interest to Medi-Cal Managed Care Plans	12/17/2001
APL 01-008	Breast and Cervical Cancer Treatment Program	12/17/2001

2000 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 00-001	2000 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule	02/03/2000
APL 00-002	Medi-Cal Managed Care Medical Exemptions	02/29/2000
APL 00-003	Policy and Procedure Revisions	03/07/2000
APL 00-004	California Children’s Services (CCS) Policy Regarding the Requirement That All CCS Applicants Shall Make Application to the Medi-Cal Program (Health and Safety Code Section 123995)	04/14/2000
APL 00-005	Invitation to All Plan Meeting on Year 2000 Proposed Contract Amendments	05/09/2000
APL 00-006	Maximus Warehouse Relocation	06/05/2000
APL 00-007	Potential Increase in New Enrollees Due to Changes in the Section 1931(b) Program	07/05/2000
APL 00-008	Importance of Increased Outreach to New Eligibles Under the Section 1931(b) Program	08/15/2000
APL 00-009	Percent of Poverty Population	09/15/2000
APL 00-010	Draft 2000 Medi-Cal Managed Care Contract Amendments Package 00-01	09/13/2000
APL 00-011	Ensuring Beneficiaries Receive Laboratory Services From CLIA Certified Laboratories	10/17/2000
APL 00-012	Utilization Review of Initial Risk Assessments for Pregnant Women	12/22/2000
APL 00-013	Amended Regulations for Enrollment and Disenrollment for Two-Plan Model Plans	12/28/2000
APL 00-014	2001 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule	12/29/2000

1999 - All Plan Letters

Letter Number	Title (Subject) of Letter	Date of Issue
APL 99-001	Managed Care Plan Utilization of Therapeutic Pharmaceutical Agents-Certified Optometrists	01/21/1999
APL 99-002	1999 Managed Care Plan (MCP) MEDS/FAME Cut-off and Processing Schedule	01/21/1999
APL 99-003	Year 2000 Readiness Certification and Business Continuation Plan	01/27/1999
APL 99-004	New Laws from the 1997-98 Session of the California Legislature Affecting the Medi-Cal Program	02/17/1999
APL 99-005	Cultural Competency in Health Care - Meeting the Needs of a Culturally and Linguistically Diverse Population	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

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