By Rayne Brown

On November 7, 2019, the Department of Managed Health Care’s (DMHC) Financial Solvency Standards Board held its quarterly meeting in Sacramento. At the meeting, DMHC Acting General Counsel, Sarah Ream previewed for the Board four regulations that DMHC is currently developing and intends to submit to the Office of Administrative Law (OAL) early in 2020.

The first is a regulation that would adopt a standard methodology for health plans to report their compliance with the Department’s timely access to care requirements. The second proposed regulation is being developed in response to concerns raised by consumer groups and would adopt specified time frames in which health plans must respond to consumer inquiries about their out-of-pocket maximum charges, and require health care plans to treat such as grievances so that enrollees are informed as quickly as possible about this information.

The third regulation is being developed to implement SB 1008 (Skinner) (Chapter 933, Statutes of 2018), and would develop a standard matrix for dental plans to use, allowing enrollees to compare and understand the coverage and cost of different plans. Lastly, DMHC is developing a regulation to improve the help center, correct regulation inconsistencies, and better reflect what health centers and plans actually do.  At this writing, the Department has not yet published a formal notice of these proposed regulations with OAL.

Opportunities for Action: Subscribe to CPIL’s twitter feed (@CPIL-USD) to find out when these regulations are noticed, and how to submit your comments to the Department about your proposals.