AB 2036 amends Medi-Cal reimbursement rules for federally qualified health centers (FQHCs) and rural health clinics (RHCs) in Welfare and Institutions Code Section 14132.100. The bill’s main substantive change is to allow an FQHC or RHC that has multiple prospective payment system (PPS) rates to elect to consolidate those rates into a single uniform PPS rate for all services. The measure also restates and reorganizes existing provisions governing how FQHCs and RHCs are paid under Medi-Cal, including per-visit reimbursement, annual rate updates tied to the Medicare Economic Index, scope-of-service adjustments, supplemental payments for extraordinary circumstances, and rules for billing certain services separately.
The bill also continues and clarifies coverage and reimbursement rules for a wide range of services delivered by FQHCs and RHCs, including primary care, dental hygienist services, marriage and family therapy, telehealth visits, Drug Medi-Cal services, and specialty mental health services. It includes detailed provisions on when a visit counts for reimbursement, how telehealth may be billed, when audio-only or video visits may establish a new patient relationship, and how rates are adjusted when services are added, removed, or shifted out of the PPS base rate. The bill directs the Department of Health Care Services to seek any needed federal approvals and allows implementation through provider bulletins and similar guidance rather than formal regulations.
In terms of legal impact, AB 2036 would amend an existing Medi-Cal statute rather than create a new program. Its practical effect is to give certain FQHCs and RHCs more flexibility in how they structure reimbursement by consolidating multiple PPS rates into one rate if they choose, while leaving the underlying PPS framework in place. It would affect DHCS administration, FQHCs, RHCs, county Drug Medi-Cal contracting arrangements, mental health plans, and Medi-Cal beneficiaries receiving services through in-person, telehealth, or specialty behavioral health settings. The bill is operative July 1, 2026, and its implementation is contingent on federal approval and federal financial participation where required.
The overall sentiment reflected in the available record is neutral to favorable, but limited. The bill was introduced with a majority key vote designation and no fiscal committee referral, suggesting it was viewed as a relatively narrow administrative or technical measure rather than a major policy overhaul. However, the only recorded action was that the bill was set for first hearing in Assembly Health and then the hearing was canceled at the request of the author, so there is no committee debate or vote history showing broader support or opposition.
Because there are no transcripts or recorded votes, there is no documented public contention in the available materials. Based on the text alone, the most likely points of interest are the new option to consolidate multiple PPS rates, the detailed telehealth and audio-only rules, and the interaction between base PPS rates and separately reimbursed services such as Drug Medi-Cal and specialty mental health care. Those provisions could matter to providers and administrators because they affect billing structure, documentation, and rate recalculation, but no specific stakeholder objections are recorded in the provided history.
AB 2036 would amend Welfare and Institutions Code Section 14132.100, the Medi-Cal statute governing FQHC and RHC reimbursement. The bill preserves existing per-visit PPS reimbursement rules, annual Medicare Economic Index updates, scope-of-service adjustments, and special billing rules for telehealth, dental, behavioral health, Drug Medi-Cal, and specialty mental health services, while adding an express option for providers with multiple PPS rates to consolidate them into one uniform PPS rate. It would primarily affect DHCS administration and the reimbursement practices of FQHCs and RHCs, with implementation dependent on federal approvals and federal financial participation.
The available record suggests a generally neutral-to-supportive posture toward the bill, but with very limited evidence of debate. The bill carried a majority key vote designation and was treated as a non-fiscal measure, which usually indicates it was not viewed as controversial in committee. At the same time, the hearing was canceled at the author’s request, so there is no recorded committee discussion or vote showing active support or opposition.
No specific contention is documented in the provided materials because there are no committee transcripts or recorded votes. Based on the bill text, the most likely areas of concern would be the new authority to consolidate multiple PPS rates, the detailed telehealth billing and consent requirements, and the interaction between base PPS reimbursement and separately contracted services such as Drug Medi-Cal and specialty mental health care. Those provisions could raise operational or reimbursement questions for providers and DHCS, but no named opponents or disputed issues appear in the record.