AB 1231, as amended, Wood. Medi-Cal: nonmedical transportation.
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 a schedule of benefits under the Medi-Cal program, which includes medical transportation services, subject to utilization controls.
This bill would add to the schedule of benefits nonmedical transportation, as defined, for a beneficiary to obtain covered specialty care Medi-Cal services, if those services are more than 60 minutes or 30 miles from the beneficiary’s place of residence.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 14132 of the Welfare and Institutions
2Code is amended to read:
The following is the schedule of benefits under this
5(a) Outpatient services are covered as follows:
6Physician, hospital or clinic outpatient, surgical center,
7respiratory care, optometric, chiropractic, psychology, podiatric,
8occupational therapy, physical therapy, speech therapy, audiology,
9acupuncture to the extent federal matching funds are provided for
10acupuncture, and services of persons rendering treatment by prayer
11or healing by spiritual means in the practice of any church or
12religious denomination insofar as these can be encompassed by
13federal participation under an approved plan, subject to utilization
15(b) (1) Inpatient hospital services, including, but not limited
16to, physician and podiatric services, physical therapy and
17occupational therapy, are covered subject to utilization controls.
18(2) For Medi-Cal fee-for-service beneficiaries, emergency
19services and care that are necessary for the treatment of an
20emergency medical condition and medical care directly related to
21the emergency medical condition. This paragraph shall not be
22construed to change the obligation of Medi-Cal managed care
23plans to provide emergency services and care. For the purposes of
24this paragraph, “emergency services and care” and “emergency
25medical condition” shall have the same meanings as those terms
26are defined in Section 1317.1 of the Health and Safety Code.
27(c) Nursing facility services, subacute care services, and services
28provided by any category of intermediate care facility for the
29developmentally disabled, including podiatry, physician, nurse
30practitioner services, and prescribed drugs, as described in
31subdivision (d), are covered subject to utilization controls.
32Respiratory care, physical therapy, occupational therapy, speech
33therapy, and audiology services for patients in nursing facilities
34and any category of intermediate care facility for the
35developmentally disabled are covered subject to utilization controls.
36(d) (1) Purchase of prescribed drugs is covered subject to the
37Medi-Cal List of Contract Drugs and utilization controls.
P3 1(2) Purchase of
drugs used to treat erectile dysfunction or any
2off-label uses of those drugs are covered only to the extent that
3federal financial participation is available.
4(3) (A) To the extent required by federal law, the purchase of
5outpatient prescribed drugs, for which the prescription is executed
6by a prescriber in written, nonelectronic form on or after April 1,
72008, is covered only when executed on a tamper resistant
8prescription form. The implementation of this paragraph shall
9conform to the guidance issued by the federal Centers for Medicare
10and Medicaid Services but shall not conflict with state statutes on
11the characteristics of tamper resistant prescriptions for controlled
12substances, including Section 11162.1 of the Health and Safety
13Code. The department shall provide providers and beneficiaries
14with as much flexibility in implementing these rules as allowed
15by the federal government. The department shall notify and consult
16with appropriate stakeholders in implementing, interpreting, or
17making specific this paragraph.
18(B) Notwithstanding Chapter 3.5 (commencing with Section
1911340) of Part 1 of Division 3 of Title 2 of the Government Code,
20the department may take the actions specified in subparagraph (A)
21by means of a provider bulletin or notice, policy letter, or other
22similar instructions without taking regulatory action.
23(4) (A) (i) For the purposes of this paragraph, nonlegend has
24the same meaning as defined in subdivision (a) of Section
acetaminophen-containing products, with the
27exception of children’s acetaminophen-containing products,
28selected by the department are not covered benefits.
29(iii) Nonlegend cough and cold products selected by the
30department are not covered benefits. This clause shall be
31implemented on the first day of the first calendar month following
3290 days after the effective date of the act that added this clause,
33or on the first day of the first calendar month following 60 days
34after the date the department secures all necessary federal approvals
35to implement this section, whichever is later.
36(iv) Beneficiaries under the Early and Periodic Screening,
37Diagnosis, and Treatment Program shall be exempt from clauses
38(ii) and (iii).
39(B) Notwithstanding Chapter 3.5 (commencing with Section
4011340) of Part 1 of Division 3 of Title 2 of the Government Code,
P4 1the department may take the actions specified in subparagraph (A)
2by means of a provider bulletin or notice, policy letter, or other
3similar instruction without taking regulatory action.
4(e) Outpatient dialysis services and home hemodialysis services,
5including physician services, medical supplies, drugs and
6equipment required for dialysis, are covered, subject to utilization
8(f) Anesthesiologist services when provided as part of an
9outpatient medical procedure, nurse anesthetist services when
10rendered in an inpatient or outpatient setting under conditions set
11forth by the director, outpatient laboratory services, and X-ray
12services are covered, subject to utilization controls. Nothing in
13this subdivision shall be construed to require prior authorization
14for anesthesiologist services provided as part of an outpatient
15medical procedure or for portable X-ray services in a nursing
16facility or any category of intermediate care facility for the
18(g) Blood and blood derivatives are covered.
19(h) (1) Emergency and essential diagnostic and restorative
20dental services, except for orthodontic, fixed bridgework, and
21partial dentures that are not necessary for balance of a complete
22artificial denture, are covered, subject to utilization controls. The
23utilization controls shall allow emergency and essential diagnostic
24and restorative dental services and prostheses that are necessary
25to prevent a significant disability or to replace previously furnished
begin delete whichend delete are lost or destroyed due to circumstances
27beyond the beneficiary’s control. Notwithstanding the foregoing,
28the director may by regulation provide for certain fixed artificial
29dentures necessary for obtaining employment or for medical
30conditions that preclude the use of removable dental prostheses,
31and for orthodontic services in cleft palate deformities administered
32by the department’s California Children Services Program.
33(2) For persons 21 years of age or older, the services specified
34in paragraph (1) shall be provided subject to the following
36(A) Periodontal treatment is not a benefit.
37(B) Endodontic therapy is not a benefit except for vital
39(C) Laboratory processed crowns are not a benefit.
P5 1(D) Removable prosthetics shall be a benefit only for patients
2as a requirement for employment.
3(E) The director may, by regulation, provide for the provision
4of fixed artificial dentures that are necessary for medical conditions
5that preclude the use of removable dental prostheses.
6(F) Notwithstanding the conditions specified in subparagraphs
7(A) to (E), inclusive, the department may approve services for
8persons with special medical disorders subject to utilization review.
9(3) Paragraph (2) shall become inoperative July 1, 1995.
10(i) Medical transportation is covered, subject to utilization
12(j) Home health care services are covered, subject to utilization
14(k) Prosthetic and orthotic devices and eyeglasses are covered,
15subject to utilization controls. Utilization controls shall allow
16replacement of prosthetic and orthotic devices and eyeglasses
17necessary because of loss or destruction due to circumstances
18beyond the beneficiary’s control. Frame styles for eyeglasses
19replaced pursuant to this subdivision shall not change more than
20once every two years, unless the department so directs.
21Orthopedic and conventional shoes are covered when provided
22by a prosthetic and orthotic supplier on the prescription of a
23physician and when at least one of the shoes will be attached to a
24prosthesis or brace, subject to utilization controls. Modification
25of stock conventional or orthopedic shoes when medically
26indicated, is covered subject to utilization controls. When there is
27a clearly established medical need that cannot be satisfied by the
28modification of stock conventional or orthopedic shoes,
29custom-made orthopedic shoes are covered, subject to utilization
31Therapeutic shoes and inserts are covered when provided to
32beneficiaries with a diagnosis of diabetes, subject to utilization
33controls, to the extent that federal financial participation is
35(l) Hearing aids are covered, subject to utilization controls.
36Utilization controls shall allow replacement of hearing aids
37necessary because of loss or destruction due to circumstances
38beyond the beneficiary’s control.
39(m) Durable medical equipment and medical supplies are
40covered, subject to utilization controls. The utilization controls
P6 1shall allow the replacement of durable medical equipment and
2medical supplies when necessary because of loss or destruction
3due to circumstances beyond the beneficiary’s control. The
4utilization controls shall allow authorization of durable medical
5equipment needed to assist a disabled beneficiary in caring for a
6child for whom the disabled beneficiary is a parent, stepparent,
7foster parent, or legal guardian, subject to the availability of federal
8financial participation. The department shall adopt emergency
9regulations to define and establish criteria for assistive durable
10medical equipment in accordance with the rulemaking provisions
11of the Administrative Procedure Act (Chapter 3.5 (commencing
12with Section 11340) of Part 1 of Division 3 of Title 2 of the
14(n) Family planning services are covered, subject to utilization
15 controls. However, for Medi-Cal managed care plans, any
16utilization controls shall be subject to Section 1367.25 of the Health
17and Safety Code.
18(o) Inpatient intensive rehabilitation hospital services, including
19respiratory rehabilitation services, in a general acute care hospital
20are covered, subject to utilization controls, when either of the
21following criteria are met:
22(1) A patient with a permanent disability or severe impairment
23requires an inpatient intensive rehabilitation hospital program as
24described in Section 14064 to develop function beyond the limited
25amount that would occur in the normal course of recovery.
26(2) A patient with a chronic or progressive disease requires an
27inpatient intensive rehabilitation hospital program as described in
28Section 14064 to maintain the patient’s present functional level as
29 long as possible.
30(p) (1) Adult day health care is covered in accordance with
31Chapter 8.7 (commencing with Section 14520).
32(2) Commencing 30 days after the effective date of the act that
33added this paragraph, and notwithstanding the number of days
34previously approved through a treatment authorization request,
35adult day health care is covered for a maximum of three days per
37(3) As provided in accordance with paragraph (4), adult day
38health care is covered for a maximum of five days per week.
P7 1(4) As of the date that the director makes the declaration
2described in subdivision (g) of Section 14525.1, paragraph (2)
3shall become inoperative and paragraph (3) shall become operative.
4(q) (1) Application of fluoride, or other appropriate fluoride
5treatment as defined by the department, and other prophylaxis
6treatment for children 17 years of age and under are covered.
7(2) All dental hygiene services provided by a registered dental
8hygienist, registered dental hygienist in extended functions, and
9registered dental hygienist in alternative practice licensed pursuant
10to Sections 1753, 1917, 1918, and 1922 of the Business and
11Professions Code may be covered as long as they are within the
12scope of Denti-Cal benefits and they are necessary services
13provided by a registered dental hygienist, registered dental
14hygienist in extended functions, or registered dental hygienist in
16(r) (1) Paramedic services performed by a city, county, or
17special district, or pursuant to a contract with a city, county, or
18special district, and pursuant to a program established under
19 Article 3 (commencing with Section 1480) of Chapter 2.5 of
20Division 2 of the Health and Safety Code by a paramedic certified
21pursuant to that article, and consisting of defibrillation and those
22services specified in subdivision (3) of Section 1482 of the
24(2) All providers enrolled under this subdivision shall satisfy
25all applicable statutory and regulatory requirements for becoming
26a Medi-Cal provider.
27(3) This subdivision shall be implemented only to the extent
28funding is available under Section 14106.6.
29(s) In-home medical care services are covered when medically
30appropriate and subject to utilization controls, for beneficiaries
31who would otherwise require care for an extended period of time
32in an acute care hospital at a cost higher than in-home medical
33care services. The director shall have the authority under this
34section to contract with organizations qualified to provide in-home
35medical care services to those persons. These services may be
36provided to patients placed in shared or congregate living
37arrangements, if a home setting is not medically appropriate or
38available to the beneficiary. As used in this section, “in-home
39medical care service” includes utility bills directly attributable to
P8 1continuous, 24-hour operation of life-sustaining medical equipment,
2to the extent that federal financial participation is available.
3As used in this subdivision, in-home medical care services
4include, but are not limited to:
5(1) Level-of-care and cost-of-care evaluations.
6(2) Expenses, directly attributable to home care activities, for
8(3) Physician fees for home visits.
9(4) Expenses directly attributable to home care activities for
10shelter and modification to shelter.
directly attributable to additional costs of special
12diets, including tube feeding.
13(6) Medically related personal services.
14(7) Home nursing education.
15(8) Emergency maintenance repair.
16(9) Home health agency personnel benefits
begin delete whichend delete permit
17coverage of care during periods when regular personnel are on
18vacation or using sick leave.
19(10) All services needed to maintain antiseptic conditions at
20stoma or shunt sites on the body.
21(11) Emergency and nonemergency medical transportation.
22(12) Medical supplies.
23(13) Medical equipment, including, but not limited to, scales,
24gurneys, and equipment racks suitable for paralyzed patients.
25(14) Utility use directly attributable to the requirements of home
begin delete whichend delete are in addition to normal utility use.
27(15) Special drugs and medications.
28(16) Home health agency supervision of visiting staff
begin delete whichend delete
29 is medically necessary, but not included in the home health
31(17) Therapy services.
32(18) Household appliances and household utensil costs directly
33attributable to home care activities.
34(19) Modification of medical equipment for home use.
35(20) Training and orientation for use of life-support systems,
36including, but not limited to, support of respiratory functions.
37(21) Respiratory care practitioner services as defined in Sections
383702 and 3703 of the Business and Professions Code, subject to
39prescription by a physician and surgeon.
P9 1Beneficiaries receiving in-home medical care services are entitled
2to the full range of services within the Medi-Cal scope of benefits
3as defined by this section, subject to medical necessity and
4applicable utilization control. Services provided pursuant to this
5subdivision, which are not otherwise included in the Medi-Cal
6schedule of benefits, shall be available only to the extent that
7federal financial participation for these services is available in
8accordance with a home- and community-based services waiver.
9(t) Home- and community-based services approved by the
10United States Department of Health and Human Services are
11covered to the extent that federal financial participation is available
12for those services under the state plan or waivers granted in
13accordance with Section 1315 or 1396n of Title 42 of the United
14States Code. The director may seek waivers for any or all home-
15and community-based services approvable under Section 1315 or
161396n of Title 42 of the United States Code. Coverage for those
17services shall be limited by the terms, conditions, and duration of
18the federal waivers.
19(u) Comprehensive perinatal services, as provided through an
20agreement with a health care provider designated in Section
2114134.5 and meeting the standards developed by the department
22pursuant to Section 14134.5, subject to utilization controls.
23The department shall seek any federal waivers necessary to
24implement the provisions of this subdivision. The provisions for
25which appropriate federal waivers cannot be obtained shall not be
26implemented. Provisions for which waivers are obtained or for
27which waivers are not required shall be implemented
28notwithstanding any inability to obtain federal waivers for the
29other provisions. No provision of this subdivision shall be
30implemented unless matching funds from Subchapter XIX
31(commencing with Section 1396) of Chapter 7 of Title 42 of the
32United States Code are available.
33(v) Early and periodic screening, diagnosis, and treatment for
34any individual under 21 years of age is covered, consistent with
35the requirements of Subchapter XIX (commencing with Section
361396) of Chapter 7 of Title 42 of the United States Code.
37(w) Hospice service
begin delete whichend delete is Medicare-certified hospice
38service is covered, subject to utilization controls. Coverage shall
39be available only to the extent that no additional net program costs
P10 1(x) When a claim for treatment provided to a beneficiary
2includes both services
begin delete whichend delete are authorized and reimbursable
3under this chapter, and services
begin delete whichend delete are not reimbursable
4under this chapter, that portion of the claim for the treatment and
5services authorized and reimbursable under this chapter shall be
7(y) Home- and community-based services approved by the
8United States Department of Health and Human Services for
9beneficiaries with a diagnosis of AIDS or ARC, who require
10intermediate care or a higher level of care.
11Services provided pursuant to a waiver obtained from the
12Secretary of the United States Department of Health and Human
13Services pursuant to this subdivision, and which are not otherwise
14included in the Medi-Cal schedule of benefits, shall be available
15only to the extent that federal financial participation for these
16services is available in accordance with the waiver, and subject to
17the terms, conditions, and duration of the waiver. These services
18shall be provided to individual beneficiaries in accordance with
19the client’s needs as identified in the plan of care, and subject to
20medical necessity and applicable utilization control.
21The director may under this section contract with organizations
22qualified to provide, directly or by subcontract, services provided
23for in this subdivision to eligible beneficiaries. Contracts or
24agreements entered into pursuant to this division shall not be
25subject to the Public Contract Code.
26(z) Respiratory care when provided in organized health care
27systems as defined in Section 3701 of the Business and Professions
28Code, and as an in-home medical service as outlined in subdivision
30(aa) (1) There is hereby established in the department, a
31program to provide comprehensive clinical family planning
32services to any person who has a family income at or below 200
33percent of the federal poverty level, as revised annually, and who
34is eligible to receive these services pursuant to the waiver identified
35in paragraph (2). This program shall be known as the Family
36Planning, Access, Care, and Treatment (Family PACT) Program.
37(2) The department shall seek a waiver in accordance with
38Section 1315 of Title 42 of the United States Code, or a state plan
39amendment adopted in accordance with Section
401396a(a)(10)(A)(ii)(XXI) of Title 42 of the United States Code,
P11 1which was added to Section 1396a of Title 42 of the United States
2Code by Section 2303(a)(2) of the federal Patient Protection and
3Affordable Care Act (PPACA) (Public Law 111-148), for a
4program to provide comprehensive clinical family planning
5services as described in paragraph (8). Under the waiver, the
6program shall be operated only in accordance with the waiver and
7the statutes and regulations in paragraph (4) and subject to the
8terms, conditions, and duration of the waiver. Under the state plan
9amendment, which shall replace the waiver and shall be known as
10the Family PACT successor state plan amendment, the program
11shall be operated only in accordance with this subdivision and the
12statutes and regulations in paragraph (4). The state shall use the
13standards and processes imposed by the state on January 1, 2007,
14including the application of an eligibility discount factor to the
15extent required by the federal Centers for Medicare and Medicaid
16Services, for purposes of determining eligibility as permitted under
17Section 1396a(a)(10)(A)(ii)(XXI) of Title 42 of the United States
18Code. To the extent that federal financial participation is available,
19the program shall continue to conduct education, outreach,
20enrollment, service delivery, and evaluation services as specified
21under the waiver. The services shall be provided under the program
22only if the waiver and, when applicable, the successor state plan
23amendment are approved by the federal Centers for Medicare and
24Medicaid Services and only to the extent that federal financial
25participation is available for the services. Nothing in this section
26shall prohibit the department from seeking the Family PACT
27successor state plan amendment during the operation of the waiver.
28(3) Solely for the purposes of the waiver or Family PACT
29successor state plan amendment and notwithstanding any other
begin delete provision ofend delete law, the collection and use of an individual’s social
31security number shall be necessary only to the extent required by
33(4) Sections 14105.3 to 14105.39, inclusive, 14107.11, 24005,
34and 24013, and any regulations adopted under these statutes shall
35apply to the program provided for under this subdivision. No other
36provision of law under the Medi-Cal program or the State-Only
37Family Planning Program shall apply to the program provided for
38under this subdivision.
39(5) Notwithstanding Chapter 3.5 (commencing with Section
4011340) of Part 1 of Division 3 of Title 2 of the Government Code,
P12 1the department may implement, without taking regulatory action,
2the provisions of the waiver after its approval by the federal
begin delete Health
3Care Financing Administrationend delete
5all-county letter or similar instruction to providers. Thereafter, the
6department shall adopt regulations to implement this section and
7the approved waiver in accordance with the requirements of
8Chapter 3.5 (commencing with Section 11340) of Part 1 of Division
93 of Title 2 of the Government Code. Beginning six months after
10the effective date of the act adding this subdivision, the department
11shall provide a status report to the Legislature on a semiannual
12basis until regulations have been adopted.
13(6) In the event that the Department of Finance determines that
14the program operated under the authority of the waiver described
15in paragraph (2) or the Family PACT successor state plan
16amendment is no longer cost effective, this subdivision shall
17become inoperative on the first day of the first month following
18the issuance of a 30-day notification of that determination in
19writing by the Department of Finance to the chairperson in each
20house that considers appropriations, the chairpersons of the
21committees, and the appropriate subcommittees in each house that
22considers the State Budget, and the Chairperson of the Joint
23Legislative Budget Committee.
24(7) If this subdivision ceases to be operative, all persons who
25have received or are eligible to receive comprehensive clinical
26family planning services pursuant to the waiver described in
27paragraph (2) shall receive family planning services under the
28Medi-Cal program pursuant to subdivision (n) if they are otherwise
29eligible for Medi-Cal with no share of cost, or shall receive
30comprehensive clinical family planning services under the program
31established in Division 24 (commencing with Section 24000) either
32if they are eligible for Medi-Cal with a share of cost or if they are
33otherwise eligible under Section 24003.
34(8) For purposes of this subdivision, “comprehensive clinical
35family planning services” means the process of establishing
36objectives for the number and spacing of children, and selecting
37the means by which those objectives may be achieved. These
38means include a broad range of acceptable and effective methods
39and services to limit or enhance fertility, including contraceptive
40methods, federal Food and Drug Administration approved
P13 1contraceptive drugs, devices, and supplies, natural family planning,
2abstinence methods, and basic, limited fertility management.
3Comprehensive clinical family planning services include, but are
4not limited to, preconception counseling, maternal and fetal health
5counseling, general reproductive health care, including diagnosis
6and treatment of infections and conditions, including cancer, that
7threaten reproductive capability, medical family planning treatment
8and procedures, including supplies and followup, and
9informational, counseling, and educational services.
10 Comprehensive clinical family planning services shall not include
11abortion, pregnancy testing solely for the purposes of referral for
12abortion or services ancillary to abortions, or pregnancy care that
13is not incident to the diagnosis of pregnancy. Comprehensive
14clinical family planning services shall be subject to utilization
15control and include all of the following:
16(A) Family planning related services and male and female
17sterilization. Family planning services for men and women shall
18include emergency services and services for complications directly
19related to the contraceptive method, federal Food and Drug
20Administration approved contraceptive drugs, devices, and
21supplies, and followup, consultation, and referral services, as
22indicated, which may require treatment authorization requests.
23(B) All United States Department of Agriculture, federal Food
24and Drug Administration approved contraceptive drugs, devices,
25and supplies that are in keeping with current standards of practice
26and from which the individual may choose.
27(C) Culturally and linguistically appropriate health education
28and counseling services, including informed consent, that include
29all of the following:
30(i) Psychosocial and medical aspects of contraception.
36(vii) Reproductive health care.
37(viii) Preconception and nutrition counseling.
38(ix) Prevention and treatment of sexually transmitted infection.
P14 1(x) Use of contraceptive methods, federal Food and Drug
2Administration approved contraceptive drugs, devices, and
4(xi) Possible contraceptive consequences and followup.
5(xii) Interpersonal communication and negotiation of
6relationships to assist individuals and couples in effective
7contraceptive method use and planning families.
8(D) A comprehensive health history, updated at the next periodic
9visit (between 11 and 24 months after initial examination) that
10includes a complete obstetrical history, gynecological history,
11contraceptive history, personal medical history, health risk factors,
12and family health history, including genetic or hereditary
14(E) A complete physical examination on initial and subsequent
16(F) Services, drugs, devices, and supplies deemed by the federal
17Centers for Medicare and Medicaid Services to be appropriate for
18inclusion in the program.
19(9) In order to maximize the availability of federal
20participation under this subdivision, the director shall have the
21discretion to implement the Family PACT successor state plan
22amendment retroactively to July 1, 2010.
23(ab) (1) Purchase of prescribed enteral nutrition products is
24covered, subject to the Medi-Cal list of enteral nutrition products
25and utilization controls.
26(2) Purchase of enteral nutrition products is limited to those
27products to be administered through a feeding tube, including, but
28not limited to, a gastric, nasogastric, or jejunostomy tube.
29Beneficiaries under the Early and Periodic Screening, Diagnosis,
30and Treatment Program shall be exempt from this paragraph.
31(3) Notwithstanding paragraph (2), the department may deem
32an enteral nutrition product, not administered through a feeding
33tube, including, but not limited to, a gastric, nasogastric, or
34jejunostomy tube, a benefit for patients with diagnoses, including,
35but not limited to, malabsorption and inborn errors of metabolism,
36if the product has been shown to be neither investigational nor
37experimental when used as part of a therapeutic regimen to prevent
38serious disability or death.
39(4) Notwithstanding Chapter 3.5 (commencing with Section
4011340) of Part 1 of Division 3 of Title 2 of the Government Code,
P15 1the department may implement the amendments to this subdivision
2made by the act that added this paragraph by means of all-county
3letters, provider bulletins, or similar instructions, without taking
5(5) The amendments made to
this subdivision by the act that
6added this paragraph shall be implemented June 1, 2011, or on the
7first day of the first calendar month following 60 days after the
8date the department secures all necessary federal approvals to
9implement this section, whichever is later.
10(ac) Diabetic testing supplies are covered when provided by a
11pharmacy, subject to utilization controls.
12(ad) (1) Nonmedical transportation is covered for a beneficiary
13to obtain covered specialty care Medi-Cal services, if those services
14are more than 60 minutes or 30 miles from the beneficiary’s place
16(2) “Nonmedical transportation”
begin delete meansend delete roundtrip transportation for a beneficiary to obtain
18covered specialty care Medi-Cal services by passenger car, taxicab,
19or any other form of public or private conveyance. Nonmedical
20transportation does not include the transportation of sick, injured,
21invalid, convalescent, infirm, or otherwise incapacitated
22beneficiaries by ambulances, litter vans, or wheelchair vans
23licensed, operated and equipped in accordance with state and local
24statutes, ordinances or regulations. Nonmedical transportation
25includes, but is not limited to, mileage reimbursement for
26conveyance by private vehicle, bus passes, taxi vouchers, or train
28(3) Nonmedical transportation shall be provided in a form and
29manner that is
begin delete the most beneficial andend delete
accessible, in terms of
30physical and geographic accessibility, for the
begin delete beneficiary.end delete
P16 1 The department may seek approval of any necessary state
2plan amendments to implement this subdivision.
4 This subdivision shall be implemented only to the extent
5that federal financial participation is available and any necessary
6federal approvals have been obtained.