Medi-Cal: specialty mental health services: documentation requirements.

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, including specialty mental health services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. The department is responsible for conducting investigations and audits of claims and reimbursements for expenditures for specialty mental health services provided by mental health plans to Medi-Cal eligible individuals. This bill would limit the scope of the service billing documentation requirements the department may apply when conducting an audit of Medi-Cal specialty mental health services to criteria that is clearly and explicitly set forth in specified state regulations, letters, and directives, federal Medicaid terms and conditions, and the Medicaid state plan. The bill would require the department to allow counties and county contract providers of behavioral health services to incorporate by reference any information in a patient's existing case record in subsequent documentation and would prohibit the department from requiring any unchanged information in a patient's existing case record to be copied or reentered into specified treatment documents, unless required by a federal directive. The bill would require the department to consider further revisions to its service billing documentation requirements, and to prepare, in consultation with counties, providers, and other stakeholders, and submit to the Legislature, a proposal to accomplish those objectives, as specified.