Department of Managed Health Care Issues All Plan Letter Regarding Populations Vulnerable to Coronavirus

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By Rayne Brown

On March 27, 2020, the Department of Managed Health Care (DMHC) issued the latest of five all plan letters regarding COVID-19, the global pandemic that has brought several nations to a standstill. All plan letters serve as informational memoranda and guidelines to health plans regulated by DMHC and usually address current events or regulatory adjustments. The most recent all plan letters have attempted to address rapidly changing circumstances surrounding the virus and instruct health plans in the delivery of health care within the context of restrictive government orders.

The March 27, 2020, All Plan Letter, which only applies to full-service commercial, full-service Medi-Cal, and full-service Medicare Advantage Plans, identifies people with chronic conditions, disabled people, and people over 65 as especially vulnerable to coronavirus. These populations are at a much greater risk of suffering from serious illness or dying from the virus. The letter reminds health care service plans that they must “actively engag[e] with enrollees in these groups to ensure the enrollees continue to receive the care they need while practicing appropriate social distancing.”

The letter requires health plans to file a report to DMHC by the end of the day Tuesday, March 31, 2020, with the following information:

  1. A description of the steps the health plan is taking to contact vulnerable enrollees and ensure they receive the care they need.
  2. An approximation of the number of enrollees the health plan has contracted in each of the three vulnerable categories (over 65 years old, disabled, chronic health conditions), counting enrollees who fall into multiple categories only once.

According to the California Department of Public Health, there have been 8,155 confirmed cases of coronavirus and 171 deaths in California as of March 31, 2020. On April 1, 2020, Governor Gavin Newsom signed Executive Order N-41-20, which allows the expenditure of funds from California’s Disaster Response-Emergency Operations Account. The Account is part of the Special Fund for Economic Uncertainties in the state budget.

Patients who experience any difficulty accessing care, and are unable to receive help from their health plan, can contact the DMHC Help Center at www.HealthHelp.ca.gov or 1-888-466-2219.

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