Family PACT
Family Planning, Access, Care, and Treatment
Providing comprehensive family planning services to eligible California residents
Providers
Clients
News and Updates
Update: Systems Upgrades Scheduled for August 2024
Required system upgrades to the California Medicaid Management Information System (CA-MMIS) was originally scheduled to take place on August 18, 2024. It will now take place on August 25, 2024. The upgrade will go into an extended maintenance period, which begins at midnight on Sunday, August 25, 2024, and may continue through 6:00 p.m. Sunday, August 25, 2024.
The following Medi-Cal Providers website applications may experience intermittent issues during this window.
- Single and Multiple Subscriber Eligibility
- Share of Cost
- Medical Reservation Services (Medi-Services)
- Lab Service Reservation
- Family Planning, Access, Care, and Treatment (Family PACT)
- Electronic Treatment Authorization Request (eTAR)
Additionally, the following transactions also may experience intermittent issues.
- Automated Eligibility Verification System (AEVS) transactions
- Point of Service (POS) network eligibility transactions from Core Connectivity, Leased Line vendors and Case Management Information and Payrolling System (CMIPS)
Please return to this System Status page for future updates.
If the above link does not take you to the System Status page, then simply copy and paste the following link into your browser.
Family PACT Provider Enrollment and Responsibilities Policy Updated
Effective July 16, 2024, the Department of Health Care Services has updated the Family Planning, Access, Care, and Treatment (Family PACT) Program’s provider enrollment and responsibilities policy with respect to Site Certifiers role and responsibilities and the Provider Orientation and required trainings for Site Certifiers and practitioners.
Additional information about Provider Enrollment and Responsibilities is available on the Family PACT Provider Enrollment webpage and in the Family PACT Policies, Procedures and Billing Instructions (PPBI) Manual, Provider Enrollment and Responsibilities section.
Family PACT Provider Enrollment and Responsibilities Policy Updated
Effective April 15, 2024, DHCS has expanded the clinicians eligible to be a Family Planning, Access, Care, and Treatment (Family PACT) Program site certifier to include Physician Assistants and has made updates to the required provider training requirements.
Additional information about Provider Enrollment and Responsibilities is available on the Family PACT Provider Enrollment webpage and in the Family PACT Policies, Procedures and Billing Instructions (PPBI) Manual, Provider Enrollment and Responsibilities section.
Family PACT Program Update: 2024 Income Eligibility Guidelines
Effective for dates of service on or after April 1, 2024, providers are to use the following income guidelines when determining recipient eligibility for the Family PACT Program.
Federal Income Guidelines
200 Percent of Poverty by Family Size
Effective April 1, 2024
Number of Persons in Family/Household | Monthly Income | Annual Income |
1 | $2,510 | $30,120 |
2 | $3,407 | $40,880 |
3 | $4,303 | $51,640 |
4 | $5,200 | $62,400 |
5 | $6,097 | $73,160 |
6 | $6,993 | $83,920 |
7 | $7,890 | $94,680 |
8 | $8,787 | $105,440 |
For each additional member, add: | $897 | $10,760 |
Opill® Available Over-the-Counter under Medi-Cal Rx Prescription
The Department of Health Care Services (DHCS) would like to inform pharmacy providers and prescribers about the addition of over-the-counter (OTC) oral contraceptive, Opill® (norgestrel 0.075 mg). This update will be reflected in the April 1, 2024, publication of the Medi-Cal Rx Family PACT Pharmacy Formulary.
Please refer to the Medi-Cal Pharmacy Bulletin for additional information.
Department of Health Care Services Expands Adult Full Scope Medi-Cal for Qualifying Individuals Ages 26 through 49
Medi-Cal is changing its rules so more people can get covered. Starting January 1, 2024, more adults will be eligible for full Medi-Cal benefits. Immigration status doesn’t matter. Even if you’ve been denied full Medi-Cal recently, you could be eligible now. Learn more about the rule changes and apply today at GetMedi-CalCoverage.dhcs.ca.gov!
Family PACT Teleheath Policy Update
The Department of Health Care Services (DHCS) published revisions to the telehealth policy for the Family PACT Program.
The policy has been updated to include:
- Patient Choice of Telehealth Modality; and
- Right to In-Person Services
Providers who offer Family PACT covered benefits and services via telehealth modalities must offer Family PACT clients the choice between telehealth modalities and the ability to opt for in-person services, if desired or clinically appropriate. These options ensure that Family PACT clients can select the most suitable modality for accessing their Family PACT benefits and services based upon individualized preferences, needs and circumstances. For more information, please review the Family PACT Program’s Policies, Procedures and Billing Instructions (PPBI) manual, Benefits: Clinical Services Overview section.
Transition to New CalHEERS Family PACT Portal – January 2025
The Family PACT client eligibility and enrollment transaction services will transition from the Health Access Programs Client Eligibility System to the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS), Family PACT portal in early 2025. Updates regarding the implementation of CalHEERS Family PACT portal will be published in future bulletins.
Non-Billing for One Year
The Office of Family Planning would like to remind providers that per California Welfare and Institutions Code (W&I Code) section 24005, subdivision (i)(3): “The department shall deactivate,… the provider numbers used by a provider to obtain reimbursement from the program when… a provider has not submitted a claim for reimbursement from the program for one year…” Beginning in September, letters will be mailed to providers who did not submit a claim for reimbursement from the Program from January 1, 2022 through July 1, 2023, to notify them of their impending deactivation from the Family PACT Program for non-billing. Providers receiving these letters will have 30 days to respond prior to being deactivated from the Family PACT Program.
Family PACT Program Regulations
DHCS anticipates that proposed Family PACT regulations will be on the rulemaking calendar for 2025. For more information on the DHCS rulemaking process, please visit the DHCS’ Office of Regulations webpage.
California's Reproductive Health Access Demonstration (CalRHAD)
On June 8, DHCS submitted a new demonstration project under Section 1115 of the Social Security Act, entitled California’s Reproductive Health Access Demonstration (CalRHAD), to the Centers for Medicare & Medicaid Services. This demonstration will play a key role in advancing California’s progress in providing access to comprehensive sexual and reproductive health services for individuals enrolled in Medi-Cal and other individuals who need access to quality, affordable care.
Visit DHCS CalRHAD Webpage for more information.
Keeping Your Community Covered
Implementing the Next Steps for the End of the Continuous Coverage Requirement
The COVID-19 public health emergency ended, and about 15 million Medi-Cal members will need to renew their Medi-Cal during the next year. DHCS’ top goal is to minimize Medi-Cal member burden and support continuity of coverage and access to equitable, coordinated care.
How You as a Community Member Can Help
- Sign up and Become a DHCS Coverage AmbassadorAS a DHCS coverage Ambassador, you and/or your organization are committing outreach to Medi-Cal members in culturally and linguistically appropriate ways. DHCS will provide resources to help connect Medi-Cal members in your community with targeted and impactful information. You will be empowered to:
- Educate: Raise awareness of actions Medi-Cal members need to take, and when they need to take them to maintain coverage.
- Engage: Provide community partners with the necessary tools/resources for reaching members. When requested, provide feedback on outreach materials and Medi-Cal member notifications.
- Provide Consistency: Create a consistent voice across community partners, one message that alleviates confusion among Medi-Cal members.
- Raise Awareness and Keep Your Community CoveredIf you cannot commit to being a DHCS Coverage Ambassador, you can still use and share the resources we have created to inform Medi-Cal members about the eligibility renewal process.
For more information, visit DHCS website.
Upcoming Trainings and Events
Provider Orientations
Upcoming orientations:
- December 12, 2024
- February 13, 2025
Visit the Online Training Center webpage for registration information.
Webinars
Chosen Family: Contraception for Transgender and Gender Diverse People
- October 29, 2024, 10:00 a.m. to 11:30 a.m. PDT
You can view our archived webinars here.