AB2160 - Medi-Cal: lactation services.

Enrolled August 26, 2026 Passed IN Senate August 20, 2026 Passed IN Assembly August 24, 2026 Amended IN Senate June 16, 2026 Amended IN Assembly May 18, 2026 Amended IN Assembly April 09, 2026 CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION Assembly Bill No. 2160 Introduced by Assembly Member Celeste Rodriguez February 18, 2026 An act to amend Section 14134.55 of the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGEST AB 2160, Celeste Rodriguez. Medi-Cal: lactation services. Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law requires the department to streamline and simplify existing Medi-Cal program procedures to improve access to lactation supports and breast pumps among Medi-Cal beneficiaries. This bill would require the department to, by July 1, 2027, issue updated Medi-Cal guidance that clarifies Medi-Cal coverage for lactation services. The bill would also require the guidance to, among other things, clarify Medi-Cal coverage policies for a continuum of lactation services, including health education related to lactation, basic lactation support, and clinical lactation consultation. The bill would require the department to seek stakeholder input on draft guidance prior to issuing the guidance. The bill would make the implementation of these provisions contingent to the extent that federal financial participation is available and any necessary federal approvals are obtained. Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill Text The people of the State of California do enact as follows: SECTION 1. Section 14134.55 of the Welfare and Institutions Code is amended to read: 14134.55. (a) The department shall streamline and simplify existing Medi-Cal program procedures in order to improve access to lactation supports and breast pumps among Medi-Cal recipients. (b) By July 1, 2027, the department shall issue updated Medi-Cal guidance that clarifies Medi-Cal coverage for lactation services and does all of the following: (1) Clarifies Medi-Cal coverage policies for a continuum of lactation services, including health education related to lactation, basic lactation support, and clinical lactation consultation. (2) Clarifies standard procedures for billing and reimbursement for lactation services covered by Medi-Cal, including specifying billing codes that appropriately reflect the scope of lactation services covered by Medi-Cal. (3) Clarifies Medi-Cal managed care plans’ responsibility to cover lactation services, including plans’ responsibility to reimburse for services consistent with procedures and billing codes specified by the department pursuant to paragraph (2). (4) Specifies lactation services are not subject to prior authorization and do not require a prescription or referral. (5) Requires a Medi-Cal managed care plan to report to the department the number of International Board Certified Lactation Consultants that are accessible within the plan network to plan members who require clinical lactation consultation services. (c) The department shall seek stakeholder input on draft guidance prior to issuing guidance pursuant to subdivision (b). (d) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department, without taking any further regulatory action, may implement, interpret, or make specific this subdivision by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions until the time regulations are adopted. (e) This section shall be implemented only to the extent that federal financial participation is available and any necessary federal approvals have been obtained.