Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services pursuant to a schedule of benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.

Subject to an appropriation by the Legislature for this purpose, this bill would expand the schedule of benefits to include an annual cognitive health assessment for Medi-Cal beneficiaries who are 65 years of age or older if they are otherwise ineligible for a similar assessment as part of an annual wellness visit under the Medicare Program. The bill would make a Medi-Cal provider eligible to receive the payment for this benefit only if they comply with certain requirements, including completing cognitive health assessment training. The bill would require the department to determine specified training and validated tools in consultation with prescribed entities, including the State Department of Public Health’s Alzheimer’s Disease Program. By January 1, 2024, and every 2 years thereafter, the bill would require the department to consolidate and analyze data related to the benefit, and to post information on the utilization of, and payment for, the benefit on its internet website. The bill would authorize the department to implement these provisions by various means, including all-plan letters, without taking regulatory action, and would condition the implementation of these provisions to the extent federal approvals are obtained and federal financial participation is available.