New DHCS Guidance Covers Emergency COVID-19 Treatment For All Medi-Cal Enrollees

The California’s Department of Health Care Services (DHCS) issued new guidance on the coverage of emergency COVID-19 inpatient or outpatient services in Medi-Cal. The new directive states that for all Medi-Cal beneficiaries, including those in restricted scope Medi-Cal, all testing and treatment of COVID-19 related emergencies will be covered by Medi-Cal, whether that treatment occurs in a hospital or a community clinic.

Previously, DHCS had announced that all screening and testing of COVID-19 would be covered for Medi-Cal beneficiaries, but the new guidance expands this to cover all treatment related to a COVID-19 emergency, including if that testing or treatment is in an outpatient setting like a community clinic.

This will benefit not just the 13 million Californians currently enrolled in Medi-Cal, but also the one million undocumented Californians in “restricted-scope” Medi-Cal.

Our Medi-Cal program is a lifeline for millions of Californians, who can go to a hospital or a community clinic to get tested and treated for COVID-19 without facing a financial penalty. With this announcement, Medi-Cal extends coverage for testing and even emergency treatment, in not just hospitals but clinics as well, to around one million more Californians on restricted scope Medi-Cal.

If we want to contain the coronavirus and emerge from this crisis, all Californians, regardless of income, insurance, or immigration status, need to be able to get tested and treated without a cost barrier.

While this announcement does not serve as a replacement for comprehensive, ongoing coverage for those excluded from full-scope Medi-Cal, we applaud California for making the commitment even in advance of federal approval.

We need to extend coverage to ensure Californians are financially protected for care, providers are paid, and the public health advanced. The cost of treatment without this emergency coverage could be hundreds of dollars for testing, and at least tens of thousands of dollars for a hospital stay on a ventilator. This emergency coverage is crucial, but all Californians still need comprehensive coverage that covers follow-up care and care for the flu, pneumonia, and other related conditions that will be exacerbated by this coronavirus.

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