Local News

Defining Medical Necessity for Children in Medi-Cal

SB 1287, which clarifies California's definition of medical necessity for children enrolled in Medi-Cal, was signed into law by Governor Jerry Brown in September. The definition is now aligned with federal standards; it will allow children to get broader coverage than adults for a variety of physical, mental, and dental health services. Previously children had been denied necessary services because some Medi-Cal providers mistakenly use eligibility rules meant for adults instead of the broader standard for children under Medicaid's Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. To read more, go to https://bit.ly/2E9Wq3A.