Bill Text

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. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law provides for the suspension of Medi-Cal benefits to an inmate of a public institution, which ends on the date they are no longer an inmate of a public institution or one year from the date they become an inmate of a public institution, whichever is sooner. Existing law generally requires a county to redetermine a Medi-Cal beneficiary’s eligibility to receive Medi-Cal benefits every 12 months and whenever the county receives information about changes in a beneficiary’s circumstances that may affect their eligibility for Medi-Cal benefits.

This bill would make an individual who is incarcerated in a state prison or county jail eligible for the Medi-Cal program for 30 days before the date they are released from that correctional facility. facility if they otherwise meet Medi-Cal eligibility criteria but for their commitment in a correctional facility. The bill would require the department to send an annual report to the Legislature on the implementation of these provisions, would authorize the department to implement these provisions by various means, including provider bulletins, and, by January 1, 2026, would require the department to promulgate regulations. The bill would require the department to seek federal approvals, including amendments to the state plan, necessary to implement these provisions, and would condition the implementation of these provisions on the department obtaining necessary federal approvals, and to the extent that federal matching funds are obtained. Because counties are required to make Medi-Cal eligibility determinations, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.