Bill Text: CA AB618 | 2025-2026 | Regular Session | Amended
Bill Title: Medi-Cal: behavioral health: data sharing.
Sponsorship: Partisan Bill (Democrat 2)
Status: (Engrossed) 2025-08-29 - In committee: Held under submission. [AB618 Detail]
Download: California-2025-AB618-Amended.html
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Amended
IN
Senate
June 23, 2025 |
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Amended
IN
Assembly
May 23, 2025 |
CALIFORNIA LEGISLATURE—
2025–2026 REGULAR SESSION
Assembly Bill
No. 618
| Introduced by Assembly Member Krell (Coauthor: Assembly Member Gipson) |
February 13, 2025 |
An act to add Section 14021.36 to the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 618, as amended, Krell.
Medi-Cal: behavioral health: data sharing.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services, through fee-for-service or managed care delivery systems. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
Under existing Medi-Cal provisions, behavioral health services, including specialty mental health services and substance use disorder treatment, are provided under the Medi-Cal Specialty Mental Health Services Program, the Drug Medi-Cal Treatment Program, and the Drug Medi-Cal organized delivery system (DMC-ODS) program, as specified.
This bill would require each Medi-Cal managed care plan, county specialty mental health plan, Drug Medi-Cal certified program,
and DMC-ODS program to electronically provide data for members of the respective entities to support member care. The bill would require the California Health and Human Services Agency department to determine minimum data elements and the frequency and format of data sharing through a stakeholder process and guidance, with final guidance to be published by the State Department of Health Care Services department by January 1, 2027, in compliance with privacy laws.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NOBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 14021.36 is added to the Welfare and Institutions Code, immediately following Section 14021.35, to read:14021.36.
(a) It is the intent of the Legislature that this section serve to improve the treatment and care coordination of individuals receiving services from a Medi-Cal managed care plan, a county specialty mental health plan, the Drug Medi-Cal Treatment Program, or the Drug Medi-Cal organized delivery system (DMC-ODS) program, in order to support the goals and objectives of the California Advancing and Innovating Medi-Cal (CalAIM) Act and the Behavioral Health Services Act.(b) Effective 180 days after the issuance of the guidance described in subdivision (c), each Medi-Cal managed care plan, county specialty mental health plan, Drug Medi-Cal certified program, and
DMC-ODS program shall electronically provide data for members of the respective entities to support member care. The California Health and Human Services Agency department shall determine minimum data elements and the frequency and format of data sharing through a stakeholder process and the guidance described in subdivision (c). (c), in consultation with the California Health and Human Services Agency to ensure alignment with its Data Exchange Framework.
(c) (1) By March 1, 2026, the State
Department of Health Care Services department shall consult with representatives of Medi-Cal managed care plans, county specialty mental health plans, Drug Medi-Cal certified programs, and DMC-ODS programs DMC-ODS programs, and the California Health and Human Services Agency to develop implementing guidance to assist Medi-Cal managed care plans, county specialty mental health plans, Drug Medi-Cal certified programs, and DMC-ODS programs in meeting the requirements of this section. Final guidance shall be published by January 1, 2027, and shall include requirements for timely health information exchange, minimum data elements,
and data format as required to implement this section in a manner that is compliant with all relevant privacy protections described in subdivision (d).
(2) The State Department of Health Care Services 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 Medi-Cal managed care plans, county specialty mental health plans, Drug Medi-Cal certified programs, and DMC-ODS programs to exchange information consistent with the requirements of this section, including the recommendations developed under the consultation of those entities as described in
paragraph (1).
(d) (1) This section shall not be construed as diminishing or undermining the privacy protections under federal laws, including, but not limited to, the Health Insurance Portability and Accountability Act (HIPAA) privacy rule (Parts 160 and 164 of Title 45 of the Code of Federal Regulations) and the Confidentiality of Substance Use Disorder Patient Records regulations (Part 2 of Title 42 of the Code of Federal Regulations).
(2) Guidance developed pursuant to this section shall adhere to state privacy rules for sharing of health care information, including permissible uses for data exchange as outlined in subdivision (d) of Section 14197.71.
