AB 220 California Assembly · 2025-2026 Regular Session

Medi-Cal: subacute care services.

Summary
Existing law establishes 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 requires the department to establish a subacute care program in health facilities, as specified, to be available to patients in health facilities who meet subacute care criteria. Existing law requires that medical necessity for pediatric subacute care be substantiated by specified criteria. Existing regulations require a treatment authorization request for each admission to a subacute unit. If a provider substantiates that a patient meets any of the specified criteria for pediatric subacute care, this bill would prohibit a Medi-Cal managed care plan from imposing, or requiring the patient to meet, any additional criteria. If a standard form is developed by the department for purposes of authorization and reauthorization of pediatric or adult subacute care services, the bill would require a Medi-Cal managed care plan to deem as sufficient and accept from a provider that standard form and would prohibit a plan from creating, or requiring a provider to submit, a separate form created by the plan or any other entity. The bill would prohibit a Medi-Cal managed care plan from requiring a subsequent treatment authorization request upon a patient's return from a bed hold for acute hospitalization. The bill would authorize the department to impose sanctions on Medi-Cal managed care plans for violations of these provisions, as specified.
Bill status passed both 4 of 5 stages cleared
Introduction
Jan 2025
Committee Review
Aug 2025
Assembly Passage
May 2025
Senate Passage
Aug 2026
Governor
Introduced Jan 8, 2025 Last action Aug 30, 2026
Maddy AI version diff · 4 comparisons

What changed between versions

07/08/25 - Amended Senate 08/25/26 - Amended Senate · 4 edits · Aug 25, 2026
MODERATE
The August 2026 Senate amendment to AB 220 adds two significant new protections for patients and providers in the Medi-Cal subacute care program: a prohibition on managed care plans imposing additional criteria beyond those specified in law, and a requirement that plans accept any standard form developed by DHCS rather than requiring their own separate forms. These changes strengthen existing restrictions on plan discretion in authorizing pediatric and adult subacute care.
REQUIREMENT

New provision (f)(2) states that if a provider substantiates a patient meets any of the specified criteria for pediatric subacute care, a Medi-Cal managed care plan shall not impose or require the patient to meet any additional criteria. This closes a gap where plans could add their own requirements on top of the statutory list.

New subdivision (h) requires that if DHCS develops a standard form for authorization and reauthorization of pediatric or adult subacute care services, a Medi-Cal managed care plan must deem it sufficient and accept it from providers, and is prohibited from creating or requiring submission of a separate form created by the plan or any other entity.

TECHNICAL

The medical necessity criteria in subdivision (f) were restructured from a flat numbered list into a nested format with paragraph (1) containing subparagraphs (A) through (E) and clauses (i) through (vi), to accommodate the new paragraph (2) about additional criteria. The substantive criteria themselves are unchanged.

ENFORCEMENT

The sanctions provision was updated to reference the relettered subdivisions, now citing violations of subdivisions (h) and (i) rather than the prior (h), (i), and (j) references, reflecting the new structure of the section.

Floor votes · Senate Sep 4, 2025 · Assembly May 29, 2025

How they voted

390
Passed · 1 other
Total votes 40
Sep 4, 2025
D Democratic30
29 Yea 1
96% Yea
R Republican10
10 Yea
100% Yea
Vote distribution
All Yea All Nay Mixed No data
Full legislative history

Actions timeline

Total actions
29
Key actions
11
Committee
9
Amendments
6
Aug 30, 2026
Lower · Passed
Senate amendments concurred in. To Engrossing and Enrolling.
lower
Aug 30, 2026
Introduced
In Assembly. Concurrence in Senate amendments pending.
lower
Aug 30, 2026
Upper · Passed
Read third time. Passed. Ordered to the Assembly. (Ayes 39. Noes 0.).
upper
Aug 25, 2026
Upper · Passed
Read third time and amended. Ordered to second reading.
upper
Aug 25, 2026
Upper · Passed
Action rescinded whereby the bill was read third time, passed, and to Assembly.
upper
Sep 4, 2025
Introduced
In Assembly. Concurrence in Senate amendments pending.
lower
Sep 4, 2025
Upper · Passed
Read third time. Passed. Ordered to the Assembly. (Ayes 39. Noes 0. Page 2520.).
upper
Aug 29, 2025
Upper · Passed
From committee: Do pass. (Ayes 7. Noes 0.) (August 29).
upper
Jul 14, 2025
Committee
In committee: Referred to APPR. suspense file.
upper
Jul 8, 2025
Introduced
From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on APPR.
upper
Jun 26, 2025
Upper · Passed
From committee: Do pass and re-refer to Com. on APPR. (Ayes 11. Noes 0.) (June 25). Re-referred to Com. on APPR.
upper
Jun 16, 2025
Introduced
From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on HEALTH.
upper
Jun 11, 2025
Committee
Referred to Com. on HEALTH.
upper
May 29, 2025
Lower · Passed
Read third time. Passed. Ordered to the Senate. (Ayes 70. Noes 0. Page 1781.)
lower
May 23, 2025
Lower · Passed
From committee: Do pass. (Ayes 14. Noes 0.) (May 23).
lower
May 7, 2025
Committee
In committee: Set, first hearing. Referred to APPR. suspense file.
lower
Apr 23, 2025
Lower · Passed
From committee: Do pass and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (April 22). Re-referred to Com. on APPR.
lower
Feb 3, 2025
Committee
Referred to Com. on HEALTH.
lower
Jan 9, 2025
Lower · Passed
From printer. May be heard in committee February 8.
lower
1 primary · 1 co-sponsor

Sponsors