Medi-Cal: behavioral health treatment: stakeholder feedback

The law seeks to strengthen oversight of Medi-Cal-paid behavioral health treatment, including services for children with autism. It requires clearer rules on coverage and billing while incorporating provider, patient, and family feedback.

What the law does ​

• Requires Medi-Cal-enrolled behavioral health treatment providers to obtain state and national criminal background checks for employees who interact with patients by July 1, 2027.
• Requires providers to retain proof of background-check compliance and provide it to the State Department of Health Care Services on request or during an audit.
• Requires the department to use existing stakeholder forums and comment opportunities when changing behavioral health treatment coverage and billing policies.
• Directs stakeholder feedback to address clinical standards, treatment plans, service settings, supervision, managed-care documentation, contracting quality, and fingerprint-based checks.
• Requires clear department guidance on behavioral health treatment billing and coverage consistent with federal child Medicaid benefit requirements.
• Requires the department to post service-use data, policy changes informed by stakeholder feedback, and recommendations on reimbursement integrity by January 1, 2029.

Who it affects ​

• Medi-Cal-enrolled providers of behavioral health treatment, including applied behavior analysis providers.
• Employees of those providers who interact with patients.
• Medi-Cal patients under 21 receiving behavioral health treatment, including children with autism, and their families.
• Medi-Cal managed care plans and other child-service providers participating in stakeholder discussions.

Context ​

Behavioral health treatment is a Medi-Cal-covered service for eligible people under 21 when required by federal rules.