California Children's Services Program: providers.

Existing law prohibits denying eligibility or aid under the program because an otherwise eligible person is receiving treatment services under specified teaching programs provided that treatment services are under the general supervision of a CCS Program panel physician and surgeon. Existing law requires those panel members to be board certified and have expertise in the care of children. Existing law requires prior authorization for CCS services provided pursuant to these provisions, contingent on the determination by the department or its designee of specified criteria, including that the provider of the services is approved in accordance with the standards of the program.

This bill would authorize the department to approve an advanced practice provider's, defined as a nurse practitioner, physician assistant, or certified registered nurse that meet specified qualifications, request to be CCS paneled. The bill would require eligible applicants to submit an application through the CCS internet website. The bill would require the department to acknowledge receipt of the application within 5 business days and would require the department to approve, deny, or return the application for additional information within 10 business days of submission.

The bill would require the advanced practice provider to be paneled prior to providing care, and once paneled, would authorize the advanced practice provider to perform initial or continuing care without the need of a cosignature for specified professional services. The bill would also authorize those paneled providers enrolled as Medi-Cal ordering, referring, and prescribing only providers to bill Medi-Cal directly for independent office and inpatient visits.

The bill would also expand the meaning of a provider to include physician certified by their respective specialty board, except when in the opinion of the specialist, treatment may be delegated or shared with a family physician and advanced practice providers, as defined, who meet specified criteria.