Medi-Cal: vision services: performance measures

The new measures aim to expose gaps and disparities in eye care for Medi-Cal beneficiaries, including children, and support improvements in access to examinations, treatment, and eyeglasses.

What the law does ​

• Requires the State Department of Health Care Services to establish Medi-Cal vision performance measures by January 1, 2028.
• Requires measures on service use, provider supply and activity, eye examinations and screenings, refractive-error diagnoses, eyeglasses prescribed and dispensed, and eyeglass delivery time when glasses are made by the California Correctional Training and Rehabilitation Authority.
• Requires reporting across fee-for-service and managed care, with available geographic and demographic breakdowns to identify inequities.
• Limits reporting to measures that can be calculated from the department’s existing data sources, without requiring new data collection.
• Requires public posting of the measures and 2026 data by January 1, 2029, followed by annual updates.
• Requires benchmarks beginning for calendar year 2030 and annual public summaries of vision-service complaints and grievances beginning January 1, 2029.

Who it affects ​

• Children and adults enrolled in Medi-Cal who use or need vision services.
• Vision-service providers, including optometrists, ophthalmologists, pediatricians, physician assistants, and nurse practitioners.
• Medi-Cal managed care and specialized vision plans.

Context ​

The law requires consultation with health and vision plans, counties, professional societies, nonprofit organizations, legal-aid entities, and other stakeholders when measures and benchmarks are updated.