- Is Medi-Cal Connect intended to support the adoption of internal
policies and procedures, or does it also help correlate preventive practices
with member behavior?
Medi-Cal Connect is designed to support both, the adoption of internal
policies and procedures, and help correlate preventive practices with member
behavior. It enables better coordination of whole-person care and is intended
to be integrated into internal policies and procedures by Managed Care Plans (MCPs). - What identifier is used to determine the correct member in an application programming interface (API) request?
MCPs will be issued secure authentication tokens by DHCS to identify
their organization. Upon verification, data access will be granted based on
attributed members. Detailed instructions will be provided to Technical
Representatives during onboarding. - Will the Quality Measures Dashboard include all Behavioral Health Access and Standards (BHAS) metrics for which Behavioral Health Plans (BHPs) are accountable (e.g., Follow-up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA), Follow-up After Emergency Department Visit for Mental Illness (FUM), Pharmacotherapy for Opioid Use Disorder (POD))?
Not all BHAS metrics will be included initially; however, many will be
represented. A full list of included measures will be made available during
upcoming stakeholder engagements.
Will the dashboards include measures from the California Technical Specifications (CaTS) recently introduced to align HEDIS-like measures across DHCS programs?
The inclusion of CaTS measures is currently under development and is being considered for a future release.
Will delegated entities of MCPs be permitted access to dashboards, specifically the Longitudinal Member Record (LMR) dashboard?
No. Access will be limited to prime plans beginning in July 2025. Delegated entities will not have access at this time.
When will Medi-Cal Connect be required for specialty Mental Health Services?
County Behavioral Health Plans (BHPs) are scheduled for onboarding in Release 4, targeted for Fall 2025. While only MCPs are mandated to use Medi-Cal Connect for identifying and addressing high-risk members, the platform includes features that will assist BHPs in care delivery and performance measurement.
When will API connection instructions be made available?
API configuration will not be available until July 18, 2025. Technical Representatives will receive detailed implementation guidance during onboarding.
Will updates continue to be made to the existing MCP Monitoring Dashboard?
No changes to the current public-facing dashboards are planned as a result of Medi-Cal Connect. The existing MCP Monitoring Dashboard will remain unchanged.
What are the plans for Behavioral Health Plans' access to and use of Medi-Cal Connect?
DHCS is working to integrate Behavioral Health Transformation (BHT) and BH-CONNECT into Medi-Cal Connect. Additional features, such as the Quality Measures Dashboard and the Longitudinal Member Record, are designed to support BHPs in service delivery and data reporting.
Will Medi-Cal Connect provide APIs for 834 Eligibility/Enrollment data exchange?
At this time, there are no definitive plans to implement an API for 834/ Eligibility/Enrollment data. Should such an API become available, it would adhere to the Fast Healthcare Interoperability Resources (FHIR) standard. For now, the 834 will remain in use. Updates will be shared as they become available.
Will the quality measures required for BHPs be National Committee for Quality Assurance (NCQA) certified?
Medi-Cal Connect utilizes a HEDIS-certified engine, operated by Arcadia, to produce quality rates for measures included in the BH-CONNECT Incentive Program.
Are onboarding dates scheduled for MCPs?
Specific onboarding dates have not yet been finalized. Additional information will be provided during upcoming All Plan Engagements in June 2025.
How does Medi-Cal Connect align with the Data Exchange Framework (DxF)?
Medi-Cal Connect operates within the parameters of the DxF. As the framework continues to evolve, Medi-Cal Connect will play a key role in facilitating secure, standardized data exchange.
Will there be changes to existing data exchange mechanisms with DHCS, including 834, 274, and All-Payer Claims Database Common Data Layout
(APCD-CDL) files? Will APIs be adopted for all formats?
While the transition to API-based data exchange is under consideration across the healthcare industry, several factors influence this shift—particularly for HIPAA-mandated transactions such as the X12 834 and 837. These transactions are governed by federal requirements, including the CORE Operating Rules, which complicate immediate conversion to API formats. For data files that are not federally mandated—such as APCD-CDL—API-based exchange may be more feasible over time. However, DHCS currently has no definitive plans to implement APIs for any of the formats mentioned. Should such a transition occur, DHCS will provide advance notice, detailed guidance, and implementation timelines. At this time, any move to API-based exchange is expected to be several years away.
