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- December 18, 2019
Advocate Fact Sheet: Evaluating Mental Health Plans’ Provision of Medi-Cal Specialty Mental Health Services
Read moreMedi-Cal beneficiaries in California receive mental health services through two separate managed care systems. Medi-Cal Managed Care Plans (MCPs) are responsible for providing non-specialty mental health services and County Mental Health Plans (MHPs) are responsible for providing specialty mental health services (SMHS). This bifurcated system often serves as a…
- October 21, 2019
Internal and External Review: Medi-Cal Managed Care Plans Managed Care in California Series Issue No. 4 (Revised October, 2019)
Read moreFederal and state law and the state and federal Constitutions require that enrollees in Medi-Cal managed care plans receive notice, and grievance and appeal rights when they are denied access to medically necessary services. Frequently, however, enrollees fail to receive the required notice, get an inadequate notice, or do not…
- October 10, 2019
Pre-Convening Paper: Overview of Medi-Cal’s Behavioral Health System & Necessary Safeguards for an Integrated System
Read moreIn anticipation of potential proposals to create a more integrated Medi-Cal behavioral health system, this paper provides an overview of the current trifurcated delivery system, evaluates strengths and weaknesses of the current system, and discusses necessary protections and safeguards that a transition to an integrated system must ensure.
- August 7, 2019
Beyond the Law: The Challenge of Marketplace Coverage of Abortions
Read moreFrom the Fall of 2017 to Spring of 2018, the National Health Law Program (NHeLP) examined if and how Marketplace plans cover abortion services in the states that do not prohibit such coverage. Our research only looked at publicly available information, principally the plans’ Summary of Benefits and Evidence…
- June 16, 2019
Medi-Cal Managed Care Toolkit for Accessing Family Planning Services and Abortion Care
Read moreMedi-Cal, California’s Medicaid program, is a cornerstone of reproductive and sexual health in the state. Under federal law, all states must cover certain low-income people, including pregnant women and very low-income parents. In the 37 states like California that have expanded Medicaid under the Affordable Care Act, most previously…
- April 1, 2019
National Health Law Program Joins Advocates in Urging Appeals Court to Uphold Constitutionality of Affordable Care Act
Read moreHealth care advocates including, Families USA, Community Catalyst, National Health Law Program, Center on Budget and Policy Priorities, and Services Union Employees International, filed an amici curiae brief in April in support of California and numerous other state attorneys general who urging the 5th U.S. Circuit Court of Appeals…