CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION

99

Introduced by Assembly Member Castillo

(Coauthors: Assembly Members DeMaio, Ellis, Gallagher, Macedo, Sanchez, and Tangipa)

February 20, 2026

An act to add Section 14124.06 to the Welfare and Institutions Code, relating to Medi-Cal.

Vote: majority   Appropriation: no   Fiscal committee: yes   Local program: no

LEGISLATIVE COUNSEL’S DIGEST

Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services and under which health care services are provided to qualified low-income persons pursuant to a state plan. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.

This bill would, upon appropriation by the Legislature, require the department to convene a task force of specified members by no later than January 1, 2027, to conduct a comprehensive assessment of fraud risks in the Medi-Cal program. The bill would require the task force, within 6 months of formation, to review current fraud prevention tools, analyze data-sharing gaps, and evaluate how best practices from the federal government and other states could be applied in California. The bill would require the task force to submit specified recommendations based on this assessment to the appropriate policy and fiscal committees of the Legislature by no later than January 1, 2028.

The people of the State of California do enact as follows:

SECTION 1.

Section 14124.06 is added to the Welfare and Institutions Code, to read:

14124.06.

(a) Upon appropriation by the Legislature for this purpose, the department shall convene a task force by no later than January 1, 2027, to conduct a comprehensive assessment of fraud risks in the Medi-Cal program. As part of its assessment, the task force shall review current fraud prevention tools, analyze data-sharing gaps, and evaluate how best practices from the federal government and other states could be applied in California. The task force shall complete its assessment within six months of formation.

(b) The task force shall include representatives from the Department of Managed Health Care, the Department of Insurance, county welfare departments, managed care plans, provider groups, and law enforcement.

(c) (1) Based on the fraud risk assessment conducted pursuant to subdivision (a), the task force, by no later than January 1, 2028, shall submit recommendations to the appropriate policy and fiscal committees of the Legislature on all of the following:

(A) Uniform statewide protocols for fraud prevention.

(B) Proposed regulatory changes.

(C) Technology and data analytics improvements.

(D) Effective fraud response strategies.

(E) Efficient fund recovery strategies.

(2) The recommendations submitted to the Legislature pursuant to paragraph (1) shall comply with Section 9795 of the Government Code.