Department of Managed Healthcare Proposes Rulemaking Action on Annual, Quarterly, and Monthly Financial Reporting Requirements

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By Yusra Serhan

On December 24, 2021, the Department of Managed Health Care (DMHC) published notice of its intent to adopt Rule 1300.84.03; amend and renumber Rules 1300.84.06; amendment to Rules 1300.84.2 and 1300.84.3; and renumber Rules 1300.84.06 to 1300.84.1, of Title 28 of the California Code of Regulations (CCR) to clarify the annual, quarterly, and monthly financial reporting requirements for health plans, which is set forth in the proposed language. According to the initial statement of reasons, the proposed regulations are the Department’s efforts to update existing reporting requirements by including new reporting forms and an instruction manual to adapt the law to new technologies, health plan operation changes, and health delivery trends in order for health plans to maintain financial viability at all times to protect against claims received on behalf of health plan enrollees. The initial statement of reasons further states that “the changes proposed in this regulatory package reflect the outcome of discussions with health plans related to best practices for health plan financial reporting.”

The initial public comment period ended on February 7, 2022. On March 4, 2022, the Department provided notice of a second public comment period. The revised proposed language for the second public comment period contained minor amendments to the original proposed language that did not significantly impact the rules or the reporting forms. The comment period on the modified text expired on March 21, 2022.  At this writing, the Department has not taken further action on the regulations.

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