[California] Monthly state APL update — Action required

REQUIREMENTS: By April 30, 2026 (or per individual APL effective dates): 1. BILLING TEAM: Download and review all six linked APL documents: - DHCS APL26-001: Initial Health Appointment - DHCS APL26-002: Medi-Cal Managed Care Plan Responsibilities for Non-Specialty MH Services (supersedes APL 22-006) - DHCS APL26-003: Quality Measures For Encounter Data 2.0 (supersedes APL 14-020) - DHCS APL26-004: Medi-Cal Managed Care Plan Responsibilities For BH Data-Sharing - DMHC APL26-001: NCQA Accreditation Compliance Filing - DMHC APL26-002: Delegation of risk for COVID-19 testing or immunizations (SB510) 2. BILLING TEAM: Identify which APLs apply to your practice based on specialty and services offered. 3. BILLING TEAM: Document specific operational impacts from each applicable APL, including prior authorization requirements, billing procedures, encounter data submission rules, and data-sharing obligations. 4. BILLING TEAM: Update billing software configuration and prior authorization workflows to reflect any new or changed requirements in the APLs. 5. BILLING TEAM & PROVIDERS: Distribute relevant APL updates to impacted internal teams: - Billing/coding team (billing and claims submission changes) - Authorization/pre-certification team (prior authorization changes) - Front office staff (member communication/administrative changes) - Mental health/behavioral health providers (if affected by mental health/BH-specific APLs) 6. BILLING TEAM: Update applicable internal policies and procedures documentation to reflect APL requirements. 7. PROVIDERS: Implement documentation and clinical workflow changes as required by the APLs (e.g., initial health appointment scheduling, mental health service coordination, behavioral health data reporting). CONSEQUENCES OF INACTION: Failure to comply with state-mandated APL requirements will result in claim processing delays, claim denials, and potential compliance violations with California state regulations.