How AB 220 changes current law

AI-generated reading aid from the bill's amendatory text — verify against the official bill.

This bill amends 1 section(s) of the California codes: Section 14132.25 of the Welfare and Institutions Code.

• Section 14132.25 of the Welfare and Institutions Code

  (1) (2) subparagraphs (B) to (F), (A) (B) (C) (D) (E) (F) (3) subparagraphs (A) to (F), paragraph (2). (4) subparagraphs (A) to (F), paragraph (2). (5) hours airway subparagraphs (A) to (E), paragraph (2). (h)(1)A provider seeking authorization for pediatric subacute care services pursuant to this section shall submit with a treatment authorization request, including an electronic treatment authorization request, a completed form DHCS 6200, “Information For Authorization/Reauthorization of Subacute Care Services—Pediatric Subacute Program,” or a successor form, when requesting authorization for pediatric subacute care services.(2)A Medi-Cal managed care plan shall not develop or use its own criteria to substantiate medical necessity for pediatric subacute care services with a condition or standard not enumerated in the form DHCS 6200, “Information For Authorization/Reauthorization of Subacute Care Services—Pediatric Subacute Program,” or a successor form.(i)(1)A provider seeking authorization for adult subacute care services pursuant to this section shall submit with a treatment authorization request, including an electronic treatment authorization request, a completed form DHCS 6200A, “Information For Authorization/Reauthorization of Subacute Care Services—Adult Subacute Program,” or a successor form, when requesting authorization for adult subacute care services. (2)A Medi-Cal managed care plan shall not develop or use its own criteria to substantiate medical necessity for adult subacute care services with a condition or standard not enumerated in the form DHCS 6200A, “Information For Authorization/Reauthorization of Subacute Care Services—Adult Subacute Program,” or a successor form. (j) (k) (h), (i), and (j). → (1) (A) (B) clauses (ii) to (vi), (i) (ii) (iii) (iv) (v) (vi) (C) clauses (i) to (vi), subparagraph (B). (D) clauses (i) to (vi), subparagraph (B). (E) hours, airway, clauses (i) to (vi), subparagraph (B). (2) If a provider substantiates that a patient meets any of the criteria under paragraph (1), a Medi-Cal managed care plan shall not impose, nor require the patient to meet, any additional criteria. paragraph (1) of (h) If a standard form is developed by the department for purposes of authorization and reauthorization of pediatric or adult subacute care services, the following shall apply: (1) A Medi-Cal managed care plan shall deem as sufficient and accept from a provider the standard form developed by the department for purposes of authorization and reauthorization for pediatric or adult subacute care services. (2) A Medi-Cal managed care plan shall not create, nor require a provider to submit, a separate form created by the Medi-Cal managed care plan or any other entity for purposes of authorization and reauthorization for pediatric or adult subacute care services. (i) (j) (h) and (i).

  amended