Bill
SB 530
SB 530 extends Medi-Cal time and distance standards until 2029, ensuring low-income Californians access timely healthcare services, including in-person and telehealth options.
Bill Number: SB 530
Introduced: February 20, 2025
Status: Chaptered by Secretary of State. Chapter 418, Statutes of 2025.
Subject: Medi-Cal, Time and Distance Standards
SB 530 aims to enhance the accessibility of healthcare services for Medi-Cal beneficiaries by extending existing time and distance standards for managed care plans. The bill seeks to ensure that low-income individuals enrolled in Medi-Cal can access necessary healthcare services in a timely manner, aligning with federal Medicaid regulations.
Extension of Standards: The bill extends the current time and distance standards for Medi-Cal managed care services from January 1, 2026, to January 1, 2029.
Subcontractor Compliance: Managed care plans must ensure that all subcontractor networks comply with appointment time standards and demonstrate compliance to the State Department of Health Care Services (DHCS).
Telehealth Provisions: While telehealth can be used to meet time and distance standards, managed care plans must still provide beneficiaries with access to in-person services, including transportation, if preferred.
Alternative Access Standards: Starting January 1, 2027, the DHCS will consider the adequacy of payment rates when evaluating requests for alternative access standards.
Documentation Requirements: Managed care plans that fail to meet time or distance standards must submit documentation of their efforts to contract with providers.
Enrollee Information: Effective January 1, 2026, plans must inform enrollees about their options to use telehealth, transportation services, or out-of-network providers if their healthcare provider is outside the established time or distance standards.
Annual Evaluations: The DHCS is required to evaluate compliance with time and distance standards annually and publish findings.
Enhanced Standards: The DHCS may implement more stringent time and distance standards in contracts with managed care plans, ensuring consistency across similar geographic areas.
Stakeholder Engagement: The DHCS must publish a workplan by January 1, 2027, and convene a stakeholder workgroup for public comment on network adequacy standards.
Implementation of Federal Rules: The bill allows the DHCS to amend contracts to comply with federal Medicaid regulations, with provisions becoming inoperative on January 1, 2029.
SB 530 represents a significant step towards improving healthcare access for low-income Californians, ensuring that Medi-Cal beneficiaries receive timely and adequate care.
Compiled from official sources — confirm details with the bill’s official record.
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