Welfare and Institutions Code § 14148.04

Current Version

Amended by Stats. 2023, Ch. 42, Sec. 150. (AB 118) Effective July 10, 2023. Conditionally inoperative on or after July 1, 2024, by its own provisions. Repealed as of January 1 following the inoperative date. See later operative version added by Sec. 151 of Stats. 2023, Ch. 42.

(a)The department shall adopt, as specified in this section, an electronic process for families to enroll a deemed eligible newborn in the Medi-Cal program from hospitals that have elected to participate in the process. The electronic enrollment process adopted pursuant to this section shall be known as the Newborn Hospital Gateway.

(b)With respect to the enrollment of a child under one year of age who is deemed to have applied and is deemed eligible for Medi-Cal benefits under Section 1396a(e)(4) of Title 42

of the United States Code, the enrollment procedures of the Newborn Hospital Gateway shall specifically include procedures for confirming the eligibility of, and issuing a Medi-Cal card to, that child.

(c)In developing the Newborn Hospital Gateway required by this section, the department shall consult with consumer, provider, county, and health plan representatives.

(d)The Newborn Hospital Gateway may not be adopted until both of the following occur:

(1)Sufficient moneys have been deposited in the Special Funds Account of the Gateway Fund to defray the costs of developing the Newborn Hospital Gateway.

(2)Sufficient new staff, not to exceed a total of three personnel years, is available at the department for the purposes of this section and Section

14148.03 and is funded through nonstate General Fund sources. Notwithstanding any other provision of law, the department may hire staff necessary to implement this section.

(e)The department shall implement the Newborn Hospital Gateway within 12 months after the date upon which both of the conditions required under subdivision (d) have occurred.

(f)To implement this section, the department may contract with public or private entities, or utilize existing health care service provider enrollment and payment mechanisms, including the Medi-Cal program’s fiscal intermediary, only if services provided under the program are specifically identified and reimbursed in a manner that appropriately claims federal financial reimbursement. Contracts, including the Medi-Cal fiscal intermediary contract for the Child Health and Disability Prevention Program and including any contract amendment,

any system change pursuant to a change order, and any project or systems development notice shall be exempt from Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code,

Section 19130 of the Government Code, and any policies, procedures, or regulations authorized by these laws.

(g)This section shall become inoperative on July 1, 2024, or the effective date for implementation of the Children’s Presumptive Eligibility Program portal pursuant to Section 14011.7, whichever is later, and shall be repealed on January 1 directly following that date.

Future Version

Repealed (in Sec. 150) and added by Stats. 2023, Ch. 42, Sec. 151. (AB 118) Effective July 10, 2023. Conditionally operative on or after July 1, 2024, by its own provisions.

(b)All qualified Medi-Cal providers participating in presumptive eligibility programs shall use the Newborn Hospital Gateway system to report a Medi-Cal eligible newborn born in their facilities, including hospitals, birthing centers, or other birthing settings, within 72 hours after birth, or one business day after discharge, whichever is

sooner.

(c)With respect to the enrollment of a child under one year of age who is deemed to have applied and is deemed eligible for Medi-Cal benefits under Section 1396a(e)(4) of Title 42 of the United States Code, the enrollment procedures of the Newborn Hospital Gateway shall specifically include procedures for confirming the eligibility of, and issuing a Medi-Cal card to, that child.

(d)In developing the Newborn Hospital Gateway required by this section, the department shall consult with consumer, provider, county, and health plan representatives.

(e)To implement this section, the department may contract with public or private entities, or utilize existing health care service provider enrollment and payment mechanisms, including the Medi-Cal program’s fiscal intermediary, only if services provided under the

program are specifically identified and reimbursed in a manner that appropriately claims federal financial reimbursement. Contracts, including the Medi-Cal fiscal intermediary contract for presumptive eligibility programs and including any contract amendment, any system change pursuant to a change order, and any project or systems development notice shall be exempt from Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, Section 19130 of the Government Code, and any policies, procedures, or regulations authorized by these laws.

(f)This section shall become operative on July 1, 2024, or the effective date for implementation of the Children’s Presumptive Eligibility Program portal pursuant to Section 14011.7, whichever is later.