Directed Payment for Organ and Bone Marrow Transplant Services
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In accordance with State law (Calif. Welfare & Institutions Code § 14184.201(d)(2)), for organ and bone marrow transplant services transitioning into the managed care delivery system effective January 1, 2022, the State will direct Medi-Cal managed care health plans (MCPs) to reimburse providers of these transitioning services at the same levels that would have been paid within the Medi-Cal fee-for-service (FFS) delivery system. This directed payment arrangement will serve as a time-limited financial protection to allow for the successful transitioning of a subset of organ and bone marrow transplant services currently covered in the Medi-Cal FFS delivery system into the Medi-Cal managed care delivery system.