1. Coverage for Telehealth Services

• Expanded coverage for telehealth services under Medi-Cal, Medicare and commercial health plans
• Permitted additional types of “originating” and “distant” sites
• Granted flexibility on telehealth technology and privacy rules, including by expanding the types of permissible telehealth platforms













 
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• Enhance coverage across all payers for established telehealth modalities (video and telephone) in clinically appropriate circumstances
• Evaluate additional remote modalities, such as texting-based services
• Establish telehealth reimbursement policies that promote patient choice and incentivize the right care at the right place at the right time
• Eliminate unnecessary administrative barriers to telehealth access, such as restrictions on originating and distant sites or requirements for written consent
• Develop an expedited licensure pathway for out-of-state psychiatrists seeking to deliver telepsychiatry services to California residents






 
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2. Medi-Cal’s Cost-Based Reimbursement System

• Allowed counties to pay providers a fixed amount each month, subject to subsequent reconciliation based on actual volume and costs
• Added new types of reimbursable costs and raised the cap on administrative costs
• Substantially increased reimbursement rates for certain behavioral health services





 
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• Move away from a cost-based system toward a more flexible system that minimizes administrative burden, incentivizes value-based care, and supports financial stability for counties and providers in times of crisis








 
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3. Controlled Substances and Prescription Drugs

• Enhanced flexibility for treatment of opioid use disorder, including Narcotic Treatment Programs (NTPs), with respect to telehealth assessments and counseling, take-home dosing, and hand delivery of medications
• For non-opioid controlled substances (including certain psychotropic drugs), created new flexibility for practitioners to prescribe drugs based on telehealth evaluations
• Relaxed dispensing limits and prior authorization procedures for prescription drugs under Medi-Cal and Medicare





 
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• Evaluate policies to decrease the number of required in-person interactions in NTPs, such as increased use of telehealth and take-home dosing in appropriate circumstances











 
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4. Provider Licensure and Operating Standards

• Granted flexibility for providers to modify hours of service
• Streamlined procedures for provider enrollment in Medi-Cal and Medicare
• Delayed on-site provider inspections and offered the option of virtual inspections
• Suspended requirements for practitioner license renewals and continuing education
• Extended the time for trainees to complete their qualifying exams and other licensure requirements

• Reconsider California’s documentation requirements for behavioral health services, particularly with respect to patient signature requirements, treatment plans and progress notes
• Streamline the procedures for Medi-Cal provider certification
• Align Medi-Cal’s provider certification and service delivery standards across mental health and substance use disorder services
• Increase the use of desk reviews and virtual inspections in lieu of on-site provider surveys, when appropriate