AMENDED IN SENATE JUNE 22, 2026

AMENDED IN SENATE JUNE 9, 2026

AMENDED IN ASSEMBLY APRIL 16, 2026

AMENDED IN ASSEMBLY MARCH 2, 2026

CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION

95

Introduced by Assembly Member Ahrens

(Coauthors: Assembly Members Schiavo, Ta, Alanis, Alvarez, Castillo, Hadwick, Harabedian, Macedo, McKinnor, Ortega, Michelle Rodriguez, and Schultz)

February 20, 2026

An act to add Section 14132.916 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, 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 by, and funded pursuant to, federal Medicaid program provisions.

Under existing law, certain vision care benefits are covered under the Medi-Cal program, relating to, among other things, optometric and optician services and eyeglasses, as specified.

This bill would require the department, by no later than January 1, 2028, to establish a list of performance measures to ensure that the vision services under the Medi-Cal program meet quality and access criteria. The bill would require that the performance measures be designed to evaluate utilization, access, and availability of Medi-Cal vision services.

The bill would require certain information within the performance measures, relating to providers and examinations, among other factors. The bill would require the department, when evaluating performance measures, to consider certain criteria, including trended data and other state performance and quality measures.

The bill would require the department to report on each performance measure only to the extent that the department has existing data sources from which to calculate the applicable measure, as specified.

The bill would specify a timeline for the posting of performance measures and data on the department’s internet website. The bill would also require the department to establish benchmarks for each performance measure and to annually prepare a summary report on complaints and grievances, as specified.

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

SECTION 1.

The Legislature finds and declares all of the following:

(a) Vision is essential to a child’s learning, development, and academic success. Research demonstrates that up to 80 percent of what a child learns is processed visually.

(b) Vision problems among children are both common and underdiagnosed. At least one in four schoolage children has a vision condition that can interfere with learning, and some studies suggest that the prevalence may be significantly higher.

(c) According to a statewide report covering the years 2022 to 2024, only one in six schoolage children enrolled in the Medi-Cal program receives basic primary care services, indicating that approximately 84 percent of these children may not be receiving necessary vision care.

(d) Uncorrected vision problems in children are frequently misidentified as learning disabilities, attention disorders, or behavioral issues, leading to inappropriate interventions and avoidable academic struggles.

(e) School-based vision screenings, while valuable, are not a substitute for comprehensive eye examinations.

(f) Children from low-income and rural communities face disproportionate barriers to accessing comprehensive eye care, increasing the risk of undetected and untreated vision conditions.

(g) Myopia has reached epidemic levels. The prevalence of myopia in the United States has nearly doubled over the past 30 years, and projections indicate that, by 2050, approximately one-half of the global population will be myopic.

(h) A 2018 study of children in southern California found that 41.9 percent of children 5 to 19 years of age, inclusive, were myopic, underscoring the scope of the problem within this state.

(i) High myopia significantly increases the lifetime risk of serious eye diseases, including retinal detachment, glaucoma, cataracts, and macular degeneration, resulting in increased health care costs and preventable vision loss.

(j) Evidence-based interventions can slow the progression of myopia and address other vision conditions when identified early. However, many children are not screened comprehensively or provided timely access to appropriate care.

(k) California currently lacks consistent, transparent, and publicly available data regarding the provision of vision care services to children enrolled in Medi-Cal, limiting the state’s ability to assess access, identify gaps, and improve outcomes.

SEC. 2.

It is the intent of the Legislature to collect and report data on vision care services provided to children enrolled in Medi-Cal in order to do all of the following:

(a) Improve transparency and accountability within the Medi-Cal program.

(b) Identify disparities in access to comprehensive eye examinations and vision treatment.

(c) Inform evidence-based policy decisions to improve early detection and treatment of vision conditions.

(d) Support better educational, developmental, and long-term health outcomes for California’s children.

SEC. 3.

Section 14132.916 is added to the Welfare and Institutions Code, immediately following Section 14132.915, to read:

14132.916.

(a) (1) By no later than January 1, 2028, the department shall establish a list of performance measures to ensure that the vision services under the Medi-Cal program meet quality and access criteria required by the department. The performance measures shall be designed to evaluate utilization, access, and availability of Medi-Cal vision services.

(2) The performance measures established by the department to monitor the vision services for children and adults shall include, but not be limited to, all of the following:

(A) Overall utilization of vision services, presented both in the aggregate and on a per-provider basis.

(B) For eyeglasses fabricated by the California Correctional Training and Rehabilitation Authority, the average time elapsed between eye examination and receipt of eyeglasses by the beneficiary.

(C) Total number of rendering providers on an annual basis, including the number of claims billed per provider, and the credentials of each of the providers. The rendering providers shall include all providers that provide vision services, including, but not limited to, optometrists, ophthalmologists, pediatricians, physician assistants, and nurse practitioners.

(D) Number of annual refractive error diagnoses.

(E) For each provider, all of the following:

(i) Number of annual eye examinations.

(ii) Number of annual vision screening tests of visual acuity and instrument-based ocular screening eye examinations.

(iii) Number of annual eyeglasses prescribed.

(iv) Number of annual eyeglasses dispensed.

(3) (A) The performance measures shall be reported as aggregate numbers and as percentages, if appropriate, using standards that are as equivalent to those used by managed care entities as feasible.

(B) The performance measures shall apply to both fee-for-service and managed care, including information from specialized managed care plans. plans that provide vision services.

(C) The performance measures shall be reported with an equity framework that includes stratification by available geographic and demographic factors, including, but not limited to, race, ethnicity, primary language, age, and gender, to understand inequities and disparities in care.

(D) The performance measures shall include all rendering providers as set forth in subparagraph (C) of paragraph (2).

(4) The department shall report on each performance measure listed in paragraph (2) only to the extent that the department has existing data sources from which to calculate the applicable measure. This subdivision shall not require the department to develop a new data collection data-collection mechanism or to collect additional data to report on a performance measure if the department does not have an existing data source from which to calculate the applicable measure.

(b) To ensure that the vision health needs of Medi-Cal beneficiaries are met, the department shall, when evaluating performance measures for retention of, addition to, or deletion from the list of performance measures, consider all of the following criteria:

(1) Annual and multiyear Medi-Cal vision services trended data.

(2) Other state and national vision program performance and quality measures.

(3) Other state and national performance ratings.

(c) By January 1, 2029, the list of performance measures established by the department and the corresponding performance data for calendar year 2026 shall be posted on the department’s internet website. Medi-Cal vision performance data shall be posted on the department’s internet website annually thereafter for each subsequent performance period.

(d) (1) Following the initial three reporting years beginning in calendar year 2026, as described in subdivision (c), the department shall evaluate performance data and trends and establish an initial set of benchmarks for each performance measure by no later than July 1, 2029, for use beginning in calendar year 2030. Every subsequent year, the department shall utilize performance measure data to inform the establishment of annual benchmarks for each performance measure to track and facilitate improvement in utilization, access, and availability of vision services in the Medi-Cal program.

(2) In establishing and updating the performance measures and benchmarks, the department shall consult health plan and vision plan representatives and other stakeholders, including representatives from counties, local optometric and ophthalmologic societies, nonprofit entities, legal aid entities, and other interested parties.

(e) (1) The department shall annually prepare a summary report of the nature and types of complaints and grievances regarding access to, and quality of, vision services, including the outcome. Commencing on January 1, 2029, for the 2026 calendar year, and annually thereafter, for each preceding calendar year, this report shall be posted on the department’s internet website.

(2) The department shall include in the report data on complaints and grievances from existing sources accessible by the department. This subdivision shall not require the department to develop a new data collection data-collection mechanism or to collect additional data to prepare this report.