AB 974: Medi-Cal managed care plans: enrollees with other health care coverage.

The bill aims to simplify the process of billing for Medi-Cal managed care plans. It requires the Department of Health Care Services to ensure that providers not contracted with the plan do not face excessive administrative requirements when billing for Medi-Cal services to enrollees with other health coverage. Enrollees who have both Medi-Cal and other health coverage would not be required to contract with the managed care plan to bill for Medi-Cal services. However, the plan may require a letter of agreement under certain circumstances, such as prior authorization or if the service is not covered by the other coverage. The Department would solicit input from stakeholders to coordinate payment for services between Medi-Cal and other commercial coverage, with a focus on regional center services. The Department would also provide educational resources to enrollees needing assistance with…