Today's Law As Amended

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AB-990 Medi-Cal managed care plans: financial incentives.(2019-2020)

As Amends the Law Today


 Section 14197.25 is added to the Welfare and Institutions Code, immediately following Section 14197.2, to read:

 (a) A Medi-Cal managed care plan contract entered into, or amended, on or after January 1, 2021, shall require the contracting Medi-Cal managed care plan to offer financial incentives to its existing enrollees for the purpose of promoting participation in preventive health or wellness activities.
(b) The Medi-Cal managed care plan may link the financial incentives to either of the following activities, or any other preventive health or wellness activities:
(1) Participating in a health promotion program, including, but not limited to, a diabetes prevention program or a tobacco cessation program.
(2) Receiving a preventive health service, including, but not limited to, an annual physical examination or recommended screenings.
(c) The financial incentive offered to an enrollee may be in any form, but shall have a value of at least one hundred dollars ($100) annually per participating enrollee. The Medi-Cal managed care plan shall offer the financial incentive at regular intervals.
(d) The Medi-Cal managed care plan shall annually evaluate its financial incentive programs developed pursuant to this section. The evaluation may include, but is not limited to, either of the following:
(1) For enrollees who participated in the financial incentive program, surveys on how much the reward influenced their behavior.
(2) For enrollees who did not participate in the financial incentive program, surveys on those enrollees’ reasons for not participating.
(e) The Medi-Cal managed care plan shall submit an annual report to the department on its financial incentive programs, the programs’ utilization, and the evaluation prepared under this section.
(f) Before January 1, 2026, the department, in consultation with the Department of Managed Health Care, shall submit a report to the Legislature, in compliance with Section 9795 of the Government Code, detailing the financial incentive programs and their utilization and evaluation data, based on the information received pursuant to subdivision (e).
(g) This section shall be implemented only if all necessary federal approvals have been obtained, and only to the extent permitted by federal law.
(h) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.