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Notices of Proposed Changes to Medi-Cal Program

Responses to questions about proposed State Plan Amendments and Waivers are developed at the time of submission; subsequent policy changes may impact these responses.  Please contact DHCS for updates.

Public Health Emergency Proposals Related to COVID-19 

Tribal/Designee NotificationsTitleRelease Date
Demonstration Amendment Under Section 1115 of the Social Security Act Request for Section 1115 Demonstration Authority Related to the COVID-19 Public Health Emergency04/13/20
SPA 20-0024 Medicaid Disaster Relief for the COVID-19 National Emergency 04/17/20
SPA 20-0006 (Addendum)
 Expansion of Medi-Cal Beneficiary Access to Substance Use Disorder Services 05/27/20
Demonstration Amendment Under Section 1115 of the Social Security ActRequest for Section 1115 Demonstration Authority Related to the COVID-19 Public Health Emergency - Vaccine Distribution12/21/20
SPA 20-0040Medicaid Disaster Relief for the COVID-19 National Emergency - Vaccine Administration Fee 12/21/20
Demonstration Amendment Under Section 1115 of the Social Security ActRequest for Section 1115 Demonstration Authority Related to COVID-19 Testing in Schools01/04/21
SPA 20-0046 Reimbursement for COVID-19 testing-only encounters for Medi-Cal children in Transitional Kindergarten (TK) to 12th grade 01/04/21
SPA 22-0004

 Coverage for COVID-19 tests, counseling-only visits for COVID-19 vaccines for children and adults, counseling-only visits for non-COVID 19 pediatric vaccines, and reimbursement for eligible pharmacies administering COVID-19 tests.
01/28/22

Update to the Statewide Transition Plan

Tribal/Designee Notifications Title Release Date
Statewide Transition Plan Notice
An update to the Home and Community Based Settings (HCBS) Statewide Transition Plan
10/10/2022
Revised Statewide Transition Plan

An update to the Home and Community Based Settings (HCBS) Statewide Transition Plan05/20/2021

Quarter Ending March 30, 2023

Tribal/Designee Notifications
Title
Release Date
Tribal/Designee Notifications: Demonstration Under Section 1115 of the Social Security Act
Notice of Intent to Submit CalRHAD Section 1115 Application
03/16/2023
SPA 23-0011

Coverage of Virtual Communication Services 
02/23/2023
SPA 23-0015

Modification of the DHCS reimbursement methodology for Medi-Cal Behavioral Health services
02/23/2023
SPA 23-0010

Alternate Payment Methodology for
Dyadic Services
02/22/2023

Quarter Ending December 31, 2022

Tribal/Designee Notifications
Title
Release Date
SPA 22-0014 (Addendum)
Continue certain flexibilities following the end of the COVID-19 Public Health Emergency (PHE)
11/22/2022
SPA 22-0051 

Doula services, associate marriage and family therapists (AMFTs) and associate clinical social workers (ACSWs) as covered services/benefits under the Alternative Benefit Plan (ABP)
11/18/2022
SPA 22-0067 (Addendum)

Continue supplemental payments for COVID-19 vaccine-only visits following the end of the Public Health Emergency (PHE)
11/16/2022

Quarter Ending September 30, 2022

Tribal/Designee Notifications
Title
Release Date
SPA 22-0002
Doula services as a covered benefit
09/09/2022
SPA 22-0062

Expedited Notice - Reimbursement rates for mpox (MPX) vaccine administration
08/23/2022
SPA 22-0043
Community-based mobile crisis intervention services
08/23/2022
CalAIM 1115 and 1915(b) Waiver MCP Model Change Amendment Tribal Notice

CalAIM 1115 and 1915(b) Waiver MCP Model Change Amendment
08/12/2022
SPA 22-0040

Continuation of the Ground Emergency Medical Transport Program - Quality Assurance Fee
08/09/2022

Quarter Ending June 30, 2022

Tribal/Designee Notifications
Title
Release Date
SPA 22-0044
Expands the list of providers who can prescribe
physical therapy
5/18/2022
SPA 22-0019
Adds community health worker (CHW) services,
asthma preventive services, and routine patient costs associated with participation in qualifying clinical trials as Medi-Cal covered benefits in the Alternative Benefit Plan (ABP)
5/18/2022
SPA 22-0017
Routine patient costs associated with participation in qualifying clinical trials as a covered benefit
5/18/2022
SPA 22-0015

Public Provider Ground Emergency Medical
Transportation Intergovernmental Transfer (PP-GEMT IGT) program
5/18/2022
SPA 22-0003 (Addendum)
Asthma preventive services as a covered benefit 
4/12/2022

Quarter Ending March 30, 2022

Tribal/Designee Notifications
Title
Release Date
SPA 22-0023
Updating references and definitions, clarifying requirements, and removing outdated information for Medi-Cal Rehabilitative Mental Health Services
2/23/2022
SPA 22-0024
Revision of the definition of Peer Support Specialists
2/23/2022
SPA 22-0014
 Expansion of the definition of a health care “visit” at Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), and Tribal Health Programs (THP)

The effective date of this SPA has been changed to “one day after the COVID-19 Public Health Emergency (PHE) ends.” Please note that the PHE is currently scheduled to end on April 16, 2022.
 2/23/2022
SPA 22-0001 (Addendum)
 Adding Community Health Worker services as a covered benefit
 2/18/2022

Quarter Ending December 31, 2021

Tribal/Designee Notifications
Title
Release Date
SPA 21-0069
Victim Compensation Program protection following the death of the Medi-Cal member
11/19/2021
SPA 22-0009 (previously SPA 21-0010)
Extension of Proposition 56 supplemental payments for Non-Emergency Medical Transportation (NEMT) services
11/19/2021

Quarter Ending September 30, 2021

Tribal/Designee Notifications Title Release Date
SPA 21-0063Medication Therapy Management (MTM) in the Alternative Benefit Plan (ABP) 8/26/2021
SPA 21-0045Supplemental Incentive Payments to Support Developmental and Trauma Screenings8/26/2021
SPA 21-0051 (Addendum)Medi-Cal Rehabilitative Mental Health Services 10/20/2021
SPA 21-0058 (Addendum)Drug Medi-Cal Organized Delivery System (DMC-ODS) expanded substance use disorder services10/20/2021
SPA 21-0019New dental benefits and Pay-for-Performance (P4P) payments for dental services07/28/2021

Quarter Ending June 30, 2021

Tribal/Designee Notifications TitleRelease Date

CalAIM Section 1115 Demonstration Application & Cover Letter

CalAIM Section 1115 Demonstration Amendment and Renewal Application06/30/2021
CalAIM Section 1915(b) Waiver Application; Cover Letter; Attachments; Appendix: Cost Effectiveness BH SMHS & DMC-ODS; Appendix: Cost Effectiveness MCMC & Dental MC 
CalAIM Section 1915(b) Waiver Amendment and Renewal Application06/30/2021
SPA 21-0017Continuation of the Ground Emergency Medical Transport Program - Quality Assurance Fee05/26/2021
SPA 21-0028Adding Medication Therapy Management (MTM) as a covered service 05/25/2021
SPA 21-0018Termination of all active SPAs associated with
the Health Homes Program (HHP) and transition HHP enrollees to the Enhanced Care Management (ECM) benefit		05/25/2021
Demonstration Amendment and Renewal Under Section 1115 of the Social Security Act; Waiver Overview Under Section 1915(b) of the Social Security ActNotice of Intent to Submit Section 1115 Demonstration Amendment and Renewal and Section 1915(b) Waiver Related to Medi-Cal authorization04/07/2021

Quarter Ending March 30, 2021

Tribal/Designee Notifications TitleRelease Date
SPA 21-0015Time-limited Supplemental Payment Program for Qualifying Non-Hospital 340B Community Clinics02/05/21

Quarter Ending December 31, 2020

Tribal/Designee NotificationsTitleRelease Date
SPA 20-0039Pharmacy Changes10/29/20
SPA 20-0044

Establishment of Tribal FQHC Provider Type

08/26/20

Quarter Ending September 30, 2020

Tribal/Designee NotificationsTitleRelease Date
Medi-Cal 2020 Section 1115 Waiver & 1915(b) Specialty Mental Health Section Waiver 12-month extension request for the Medi-Cal 2020 Section 1115 waiver and 1915(b) specialty mental health services waiver 07/22/20
SPAs 20-0035 and 20-0036

Home Health Services

08/26/20

Quarter Ending June 30, 2020

Tribal/Designee NotificationsTitleRelease Date
1915(b) Waiver AmendmentMedi-Cal Specialty Mental Health Services (SMHS) Section 1915(b) Waiver Amendment03/25/20

Quarter Ending March 31, 2020

Tribal/Designee NotificationsTitleRelease Date
SPA 20-0007Clarification of Services Eligible for the Time Limited Supplement Payment Program of Non-Emergency Medical Transportation02/18/20
SPA 20-0009 Continuation of the Ground Emergency Medical Transport Program - Quality Assurance Fee 02/18/20

 

Quarter Ending December 31, 2019

Tribal/Designee NotificationsTitleRelease Date
SPA 19-0049SUPPORT Act DUR Requirements 11/14/19

 

Quarter Ending September 30, 2019

Tribal/Designee Notifications
TitleRelease Date
SPAs 19-0013 and 19-0037Health Homes Program
7/26/19

SPA 19-0044
Time Limited Supplement Payment Program for Non-Emergency Medical Transportation
8/9/19
SPA 19-0014Expansion of Medi-Cal Beneficiary Access to Substance Use Disorder Services8/26/19
SPA 19-0041
Time-limited Supplemental Payment Program to Support Ongoing Developmental Screenings for Children8/26/19
SPA 19-0046 and 19-0047Restoration of Certain Optional Benefits for All populations in All Settings 8/26/19
SPA 19-0048Time-limited Supplemental Payment Program to Support Trauma Screenings for Children and Adults 8/26/19

 

Quarter Ending June 30, 2019

Tribal Designee Notifications

Title
Release Date
Ground Emergency Transport Program -Quality Assurance Fee
5/22/19
SPA 19-0017Pharmacists Services for the New Adult Group5/24/19

 

Quarter Ending March 31, 2019

Tribal/Designee Notifications
Title
Release Date
Licensed Professional Clinical Counselors (LPCCs)
12/5/18
SPA 19-001 & 19-002Changes to the Health Homes Program (HHP)1/24/19
SPA 19-0004 & HCBS Waiver Amendment

SPA and Waiver Amendment for Home and Community Based Services (HCBS) for Persons with Developmental Disabilities

1/29/19

 

Quarter Ending December 31, 2018

Tribal/Designee Notifications
Title
Release Date
Clarification on Payment Policies for Federally Qualified Health Centers and Rural Health Clinics
9/26/18
SPA 18-0054Community Crises Homes11/5/18
SPA 18-0040 & 18-0041Diabetes Prevention Program (DPP)11/20/18

 

Quarter Ending September 30, 2018

Tribal/Designee Notifications
Title
Release Date
Pharmacist Services
6/29/18
SPA 18-007Supplemental Payments for Ground Emergency Medical Transportation (GEMT) Services Program
8/8/18

 

Quarter Ending June 30, 2018

Tribal/Designee Notifications
Title
Release Date
Expedited Notice - Health Homes Program
4/16/18
SPA 18-0019 & 18-0020Health Homes Program5/23/18
SPA 18-0025Dental Rates and Periodontal Maintenance5/25/18
SPA 18-0027ABP Pulmonary and Cardiac Rehabilitation5/25/18
SPA 18-0032

Expedited Notice - FQHC/RHC Sponsored Graduate Medical Education Program

6/8/18

 

Quarter Ending March 31, 2018

Tribal/Designee Notifications

Title
Release Date

SPA 18-002

Proposed Changes to the Alternative Benefit Plan (ABP)

2/23/18
SPA18-003

Clarifies Reimbursement Policies for Federally Qualified Health Center (FQHC) and Rural Health Clinics (RHC), and Adds Marriage and Family Therapists as a New FQHC/RHC Billable Provider

2/22/18
SPA 18-004GEMT QAF2/23/18

Additional Information

To view the current DHCS State Plan and view recently approved amendments, please visit the California State Plan webpage.

Last modified date: 3/16/2023 10:57 AM