Medi-Cal is California’s Medicaid program which is administered by the Department of Health Care Services (DHCS).
Medi-Cal provides health care services to low-income individuals including families with children, seniors, persons with disabilities, foster care, pregnant women and low income people with specific diseases such as tuberculosis, breast cancer or HIV/AIDS. Funding comes equally from the State and federal governments.
With the passage of the Telehealth Advancement Act of 2011 (AB 415), Medi-Cal was required to update their policies regarding telehealth. While AB 415 allowed Medi-Cal to administratively decide to expand services and reimbursement for telehealth delivered services, DHCS opted not to follow this route. To see Medi-Cal’s current policy, visit California’s page of CCHP’s 50 state map.
Currently, California is transitioning their Medi-Cal enrollees into managed care plans. Managed care payers are allowed to set their own policies with regard to telehealth. However, while some payers have incorporated telehealth into their policies, not all have. Additionally, some payers have reproduced some of the limitations Medi-Cal has in place around telehealth.
Advocates continue to work with DHCS and payers to create policies that allow for telehealth to be used to its fullest capacity.