Medi-Cal enrollees with other health care coverage: billing and provider agreements.

This bill adds provisions to the Welfare and Institutions Code regarding Medi-Cal enrollees who also have other health care coverage. It mandates that providers not contracted with Medi-Cal managed care plans billing for Medi-Cal allowable costs not paid by other coverage face no more administrative requirements than billing the Medi-Cal fee-for-service system. It also allows Medi-Cal managed care plans to require agreements with providers for certain services.

Medi-Cal enrollees with other health care coverage: billing and provider agreements.

This bill adds provisions to the Welfare and Institutions Code regarding Medi-Cal enrollees who also have other health care coverage. It mandates that providers not contracted with Medi-Cal managed care plans billing for Medi-Cal allowable costs not paid by other coverage face no more administrative requirements than billing the Medi-Cal fee-for-service system. It also allows Medi-Cal managed care plans to require agreements with providers for certain services.