14197.08.
(a) In enacting this section, it is the intent of the Legislature to improve the treatment and care coordination of individuals receiving services from both Medi-Cal managed care plans and county specialty mental health plans. (b) (1) Effective 180 days after the issuance of the guidance required pursuant to subdivision (f), each county mental health plan shall electronically provide, on a monthly basis, and in a standard data format that is mutually agreed upon by the county mental health plan and the Medi-Cal managed care plan, to the Medi-Cal managed care plans or plan providing services in that county a list that identifies the members of the respective Medi-Cal managed care plans provided pursuant to paragraph (2)
who are receiving, or have received, any specialty mental health services within that month.
(2) A Medi-Cal managed care plan shall furnish, on a monthly basis, and in a standard data format that is mutually agreed upon by the Medi-Cal managed care plan and the county mental health plan, to the county mental health plan a list of its members for purposes of meeting the requirement of paragraph (1).
(c) For purposes of complying with paragraph (1) of subdivision (b), each county mental health plan shall include, as part of the transferred data, all of the following information:
(1) The name of the patient.
(2) The patient’s date of birth.
(3) The patient’s Medi-Cal beneficiary
identification number or social security number.
(4) The patient’s current mental health diagnosis.
(5) The patient’s current medication, if known by the plan.
(6) The date of service in the reporting period and services provided.
(7) The patient’s contact information, including residential address and telephone number, if known.
(8) The provider’s contact information, including telephone number, email address, and office address, if known.
(9) Any additional data elements selected by the department, as necessary, for managed care plans to implement, calculate, or monitor quality measures established by the department.
(d) (1) Following the exchange of information between the plans as described in subdivision (b), each Medi-Cal managed care plan shall electronically provide, on a monthly basis, and in a standard data format that is mutually agreed upon by the Medi-Cal managed care plan and the county mental health plan, to the county mental health plan both of the following:
(A) A list of those members of the Medi-Cal managed care plan who are also receiving specialty mental health services from the county mental health plan based on the information provided pursuant to subdivision (b).
(B) The information specified in subdivision (e) relating to those members of the Medi-Cal managed care plan who are also receiving specialty mental health services from the county mental health plan.
(2) Effective 180 days after the issuance of the guidance required pursuant to subdivision (f), each Medi-Cal managed care plan shall comply with the requirements specified in paragraph (1).
(e) For purposes of complying with paragraph (2) of subdivision (b) and subdivision (d), each Medi-Cal managed care plan shall include, as part of the transferred data, all of the following information:
(1) The name of the patient.
(2) The patient’s date of birth.
(3) The patient’s Medi-Cal beneficiary identification number or social security number.
(4) The patient’s current physical health diagnosis, including any chronic health
conditions, such as diabetes and hypertension.
(5) The patient’s current mental health diagnosis.
(6) The patient’s prescription medication that is known to the Medi-Cal managed care plan.
(7) The patient’s contact information, including residential address and telephone number, if known.
(8) The name, telephone number, email address, and office address, if known, of the patient’s primary care provider and date of the most recent primary care visit.
(9) Any additional data elements selected by the department, as necessary, for county mental health plans to implement, calculate, or monitor performance measures established by the department.
(f) (1) The department shall consult with subject matter experts who represent county mental health plans, Medi-Cal beneficiary advocates, and Medi-Cal managed care plans to develop implementing guidance to assist county mental health plans and Medi-Cal managed care plans in meeting the requirements of this section. The guidance shall include recommendations for timely health information exchange as required to implement this section in a manner that is compliant with all relevant privacy protections described in subdivision (g).
(2) Notwithstanding the data elements required for transfer contained in subdivisions (c) and (e), the department, following consultation with stakeholders pursuant to paragraph (1), may reduce or modify those data elements required to be provided pursuant to subdivisions (c) and (e).
(3) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, by July 1, 2020, the department shall implement, interpret, or make specific this section by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions that direct county mental health plans and Medi-Cal managed care plans to exchange information consistent with the requirements of this section, including the recommendations developed through the stakeholder consultation process described in paragraph (1).
(g) This section shall not be construed to diminish or undermine the privacy protections under the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), the Health Insurance Portability and Accountability Act privacy rule (Part 160 and Subparts A and E of Part 164 of Title 45 of the Code of Federal Regulations),
or under any other state or federal law.