Bill Full Text
Home
-
Bills
-
Bill
-
Authors
-
Dates
-
Locations
-
Analyses
-
Organizations
<?xml version="1.0" ?>
<ns0:MeasureDoc xmlns:html="http://www.w3.org/1999/xhtml" xmlns:ns0="http://lc.ca.gov/legalservices/schemas/caml.1#" xmlns:ns3="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" version="1.0" xsi:schemaLocation="http://lc.ca.gov/legalservices/schemas/caml.1# xca.1.xsd">
<ns0:Description>
<ns0:Id>20250AB__216099INT</ns0:Id>
<ns0:VersionNum>99</ns0:VersionNum>
<ns0:History>
<ns0:Action>
<ns0:ActionText>INTRODUCED</ns0:ActionText>
<ns0:ActionDate>2026-02-18</ns0:ActionDate>
</ns0:Action>
</ns0:History>
<ns0:LegislativeInfo>
<ns0:SessionYear>2025</ns0:SessionYear>
<ns0:SessionNum>0</ns0:SessionNum>
<ns0:MeasureType>AB</ns0:MeasureType>
<ns0:MeasureNum>2160</ns0:MeasureNum>
<ns0:MeasureState>INT</ns0:MeasureState>
</ns0:LegislativeInfo>
<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Assembly Member Celeste Rodriguez</ns0:AuthorText>
<ns0:Authors>
<ns0:Legislator>
<ns0:Contribution>LEAD_AUTHOR</ns0:Contribution>
<ns0:House>ASSEMBLY</ns0:House>
<ns0:Name>Celeste Rodriguez</ns0:Name>
</ns0:Legislator>
</ns0:Authors>
<ns0:Title> An act to amend Section 14134.55 of the Welfare and Institutions Code, relating to Medi-Cal. </ns0:Title>
<ns0:RelatingClause>Medi-Cal</ns0:RelatingClause>
<ns0:GeneralSubject>
<ns0:Subject>Medi-Cal: lactation services.</ns0:Subject>
</ns0:GeneralSubject>
<ns0:DigestText>
<html:p>Existing law establishes the Medi-Cal program, which is 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.</html:p>
<html:p>Existing law requires the department to streamline and simplify existing Medi-Cal program procedures to improve access to lactation supports and breast pumps among Medi-Cal beneficiaries.</html:p>
<html:p>This bill would require the department to, by July 1, 2027, issue updated Medi-Cal guidance that clarifies Medi-Cal coverage for lactation services. The bill would also require the guidance to, among other things, clarify Medi-Cal coverage policies for a continuum of lactation services, including health education related to lactation,
basic lactation support, and lactation consultation. The bill would require the department to seek stakeholder input on draft guidance prior to issuing the guidance. The bill would make the implementation of these provisions contingent to the extent that federal financial participation is available and any necessary federal approvals are obtained.</html:p>
</ns0:DigestText>
<ns0:DigestKey>
<ns0:VoteRequired>MAJORITY</ns0:VoteRequired>
<ns0:Appropriation>NO</ns0:Appropriation>
<ns0:FiscalCommittee>YES</ns0:FiscalCommittee>
<ns0:LocalProgram>NO</ns0:LocalProgram>
</ns0:DigestKey>
<ns0:MeasureIndicators>
<ns0:ImmediateEffect>NO</ns0:ImmediateEffect>
<ns0:ImmediateEffectFlags>
<ns0:Urgency>NO</ns0:Urgency>
<ns0:TaxLevy>NO</ns0:TaxLevy>
<ns0:Election>NO</ns0:Election>
<ns0:UsualCurrentExpenses>NO</ns0:UsualCurrentExpenses>
<ns0:BudgetBill>NO</ns0:BudgetBill>
<ns0:Prop25TrailerBill>NO</ns0:Prop25TrailerBill>
</ns0:ImmediateEffectFlags>
</ns0:MeasureIndicators>
</ns0:Description>
<ns0:Bill id="bill">
<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
<ns0:BillSection id="id_9DD42850-2971-4B25-8248-95D1D960495C">
<ns0:Num>SECTION 1.</ns0:Num>
<ns0:ActionLine action="IS_AMENDED" ns3:type="locator" ns3:href="urn:caml:codes:WIC:caml#xpointer(%2Fcaml%3ALawDoc%2Fcaml%3ACode%2Fcaml%3ALawHeading%5B%40type%3D'DIVISION'%20and%20caml%3ANum%3D'9.'%5D%2Fcaml%3ALawHeading%5B%40type%3D'PART'%20and%20caml%3ANum%3D'3.'%5D%2Fcaml%3ALawHeading%5B%40type%3D'CHAPTER'%20and%20caml%3ANum%3D'7.'%5D%2Fcaml%3ALawHeading%5B%40type%3D'ARTICLE'%20and%20caml%3ANum%3D'4.'%5D%2Fcaml%3ALawSection%5Bcaml%3ANum%3D'14134.55.'%5D)" ns3:label="fractionType: LAW_SECTION">
Section 14134.55 of the
<ns0:DocName>Welfare and Institutions Code</ns0:DocName>
is amended to read:
</ns0:ActionLine>
<ns0:Fragment>
<ns0:LawSection id="id_86319399-2E8F-4EAF-B2D9-CD95F6C16F0E">
<ns0:Num>14134.55.</ns0:Num>
<ns0:LawSectionVersion id="id_368BC787-26F4-4700-BC62-10762515613D">
<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
The department shall streamline and simplify existing Medi-Cal program procedures in order to improve access to lactation supports and breast pumps among Medi-Cal recipients.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
By July 1, 2027, the department shall issue updated Medi-Cal guidance that clarifies Medi-Cal coverage for lactation services and does all of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
Clarifies Medi-Cal coverage policies for a continuum of lactation services, including health education
related to lactation, basic lactation support, and lactation consultation.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Clarifies standard procedures for billing and reimbursement for lactation services covered by Medi-Cal, including specifying billing codes that appropriately reflect the scope of lactation services covered by Medi-Cal.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
Clarifies Medi-Cal managed care plans’ responsibility to cover lactation services, including plans’ responsibility to reimburse for services consistent with procedures and billing codes specified by the department pursuant to paragraph (2).
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
Specifies lactation services are not subject to prior authorization and do not require a prescription or referral.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
Allows for lactation consultants certified by nationally or internationally recognized certification bodies to enroll as Medi-Cal providers and bill for lactation services, as defined by the department.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
Clarifies that managed care plans may credential and reimburse lactation consultants described in paragraph (5).
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
The department shall seek stakeholder input on draft guidance prior to issuing guidance pursuant to subdivision (b).
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, may implement, interpret, or make specific this subdivision by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time regulations are adopted.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
This section shall be implemented only to the extent that federal financial participation is available and any necessary federal approvals have been obtained.
</html:p>
</ns0:Content>
</ns0:LawSectionVersion>
</ns0:LawSection>
</ns0:Fragment>
</ns0:BillSection>
</ns0:Bill>
</ns0:MeasureDoc>