Family Planning, Access, Care, and Treatment Program.

Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and 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. Under existing law, the Medi-Cal program administers the Family Planning, Access, Care, and Treatment (Family PACT) Program within the department to provide comprehensive clinical family planning services to a person with a family income at or below 200% of the federal poverty level. Existing law requires reimbursement rates for office visits billed as comprehensive clinical family planning services by Family PACT providers or Medi-Cal providers to receive a rate augmentation equal to the weighted average of at least 80% of the amount that the federal Medicare program reimburses for the same or similar office visits. This bill would, subject to an appropriation by the Legislature and any potential draw down of federal matching funds, require an office visit to a Family PACT provider or Medi-Cal provider for specified services for uninsured, income-eligible patients, or patients with health care coverage who have confidentiality concerns, who are not at risk of experiencing or causing an unintended pregnancy, and who are not in need of contraceptive services, to be reimbursed at the same rate as comprehensive clinical family planning services. The bill would require the department to issue a report to the Legislature on certain information such as the total number of persons treated under this provision and the total cost, among other things. Existing law, under specified conditions, includes in the benefits for Medi-Cal and the Family PACT program home test kits for sexually transmitted diseases and the laboratory testing required to process those kits that are deemed medically necessary or appropriate and ordered directly by a health care provider or furnished through a standing order for patient use based on clinical guidelines and individual patient health needs. Existing law requires that a home test kit be sent by the enrolled Medi-Cal or Family PACT provider to a laboratory. This bill would leave unspecified who would be required to send the home test kits. This bill would incorporate additional changes to Section 14132 of the Welfare and Institutions Code proposed by AB 1929 and SB 912 to be operative only if this bill, AB 1929, and SB 912 are enacted and this bill is enacted last.