Federal Judge Upholds Legality of Drug Transparency Law Requiring Manufacturers to Report Drug Price Increases to Department of Insurance

By Hannah Ohman On January 4, 2021, the United States District Court for the Eastern District of California filed an order upholding the legality of a 2017 California drug price transparency law in Pharmaceutical Research & Manufacturers of America (“PhRMA”) Continue reading

Department of Managed Healthcare Issues an All Plan Letter Requiring Full-Service Health Plans to Cover COVID-19 Vaccines

By Alex Ruf On December 11, 2020, Sarah Ream, general counsel for the Department of Managed Health Care (DMHC), issued an All Plan Letter to all full-service health plans regarding health care coverage of the new COVID-19 vaccine. The Department Continue reading

Office of Administrative Law Approves Department of Managed Healthcare’s Proposed Emergency Regulation Regarding Transfer of Enrollees Pursuant to a Public Health Order

By Alex Ruf On January 12, 2021, the Department of Managed Healthcare (DMHC) published a notice of emergency rulemaking action with respect to its intent to adopt section 1300.67.02, Title 28 of the California Code of Regulations (CCR), pertaining to Continue reading

Department of Managed Health Care Issues All Plan Letter to Ensure Health Plans Comply with New Law Regarding Coverage for Mental Health and Substance Use Disorder

By Meena Kaypour On January 5, 2021, the Department of Managed Health Care (DMHC) issued All Plan Letter APL 21-002 to all Commercial Full-Service Health Plans and Specialized Health Care Service Plans Offering Behavioral Health Services, entitled “Implementation of Senate Continue reading

Department of Managed Health Care’s Financial Solvency Standards Board Quarterly Update – August 2020

By Meena Kaypour On August 19, 2020, the Department of Managed Health Care’s (DMHC) Financial Solvency Standards Board (FSSB) held its quarterly meeting via Zoom. DMHC staff provided a number of updates to FSSB, namely the Department of Health Care Continue reading

Governor Newsom Signs SB 855 Into Law, Requiring Health Plans Cover Medically Necessary Treatment of Mental Health and Substance Use Disorders

By Alex Ruf SB 855 (Wiener), as amended  August 24, 2020, and as it applies to the Department of Managed Health Care (DMHC), adds sections 1367.045 and 1374.721, and repeals and adds section 1374.72, to the Health and Safety Code Continue reading

Ninth Circuit Court of Appeals Finds Standing in Skyline Wesleyan Church’s Claims Against Department of Managed Health Care, Remands Case to District Court

By Alex Ruf On May 13, 2020, the U.S. Court of Appeals for the Ninth Circuit issued its opinion in Skyline Wesleyan Church v. California Department of Managed Health Care, 959 F.3d 341, 344 (2020), reversing the U.S. District Court Continue reading

Department of Managed Health Care Notices Amendment to Conflict of Interest Code

By Meena Kaypour On June 26, 2020, the Department of Managed Health Care (DMHC) published notice of its intent to amend Article 1, section 1000 of its Conflict-of-Interest Code pursuant to its obligations under the Political Reform Act, Government Code Continue reading

Department of Managed Health Care Orders Aetna to Pay Fine for Improper Denial of Emergency Room Claims

By Meena Kaypour On August 25, 2020, the Department of Managed Health Care (DMHC) issued a cease and desist order to Aetna Health of California, Inc. with respect to its continued failure to comply with California standards for emergency room Continue reading

Office of Administrative Law Approves Department of Managed Healthcare’s Emergency Regulation Regarding COVID-19 Diagnostic Testing

By Alex Ruf On July 15, 2020, the Department of Managed Health Care (DMHC) published a notice of emergency rulemaking action with respect to its intent to adopt section 1300.67.01, Title 28 of the California Code of Regulations (CCR), pertaining Continue reading