Section 14005.18 - Eligibility for pregnancy-related and postpartum services; eligibility when diagnosed with a maternal mental health condition(a)(1) An individual is eligible, to the extent required by federal law, as though the individual was pregnant, for all pregnancy-related and postpartum services for a 60-day period beginning on the last day of pregnancy.(2) For purposes of paragraph (1), "postpartum services" means those services provided after childbirth, child delivery, or miscarriage.(b)(1) Notwithstanding subdivision (a), Section 15840, the income eligibility requirements specified in Section 15832, and the annual redetermination requirements described in Section 14005.37, a pregnant individual who is receiving health care coverage under a program identified in subdivision (d) and who is diagnosed with a maternal mental health condition shall remain eligible for the Medi-Cal program under their current eligibility category for a period of one year following the last day of the individual's pregnancy if the individual complies with the requirements specified in subdivision (c) and is otherwise eligible for the Medi-Cal program.(2) For purposes of this section, "maternal mental health condition" means a mental health condition that occurs during pregnancy or during the postpartum period and, includes, but is not limited to, postpartum depression.(c)(1) An individual, or a designee of the individual, who seeks to extend Medi-Cal program coverage pursuant to this section shall submit to a county eligibility worker a note from that individual's treating health care provider stating that the health care provider has diagnosed the individual with a maternal mental health condition within 60 days following the last day of the individual's pregnancy.(2) Notwithstanding paragraph (1), an individual who has had Medi-Cal coverage discontinued within the 60-day period beginning on the last day of pregnancy, but who is diagnosed with a maternal mental health condition more than 60 days following the last day of pregnancy and within the time limit described in subdivision (i) of Section 14005.37, may be reinstated to their previous Medi-Cal eligibility pursuant to subdivision (i) of Section 14005.37 by submitting a note, as described in paragraph (1), from the individual's treating health care provider within the timeframe described in that subdivision.(d) For purposes of this section, "Medi-Cal program" refers to any of the following programs: (1) The Medi-Cal Access Program, as described in Chapter 2 (commencing with Section 15810) of Part 3.3.(2) The Medi-Cal program, as described in this article.(3) The Perinatal Services Program, as described in Article 4.7 (commencing with Section 14148).(e) This section does not limit the ability of a qualified individual to apply for and purchase a qualified health plan in Covered California pursuant to Title 22 (commencing with Section 100500) of the Government Code if the qualified individual is otherwise eligible for coverage pursuant to that title.(f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section by means of all-county letters, provider bulletins, or similar instructions, without taking regulatory action.(g) Implementation of this section is subject to an appropriation in the annual Budget Act for these purposes.(h) This section shall become inoperative commencing on the date that Section 14005.185 is implemented. If made inoperative, this section shall become operative again if, and upon the date that, Section 14005.185 is no longer implemented. The department shall determine the implementation status of Section 14005.185 and shall post, on the department's internet website, notice of its determination.Ca. Welf. and Inst. Code § 14005.18
Amended by Stats 2021 ch 143 (AB 133),s 362, eff. 7/27/2021.Amended by Stats 2020 ch 370 (SB 1371),s 284, eff. 1/1/2021.Amended by Stats 2019 ch 67 (SB 104),s 6, eff. 7/9/2019.