Bill > SB449

This bill amends Section 1367 of the Health and Safety Code, which governs health care service plans regulated by the Department of Managed Health Care, to make technical, nonsubstantive changes to existing requirements for health care service plans. The bill clarifies various provisions related to plan operations, including requirements that facilities be licensed, personnel be certified, and equipment be properly registered. It emphasizes that services should be readily available at reasonable times and consistently accessible to enrollees, including through telehealth services when appropriate. The bill also reinforces provisions about fair and reasonable contracts, mandating that plans have dispute resolution mechanisms for providers and annually report on these mechanisms. Additionally, the bill maintains existing requirements that plans provide basic health care services, allows for copayments and deductibles, and permits plans to set coverage limitations with director approval. The legislation also specifies that plans cannot require optometrists to register under the federal Controlled Substances Act and clarifies that the director cannot establish rates for health care services. Importantly, the bill stipulates that a plan's obligation to comply with the chapter cannot be waived even when services are delegated to medical groups or other contracting entities.

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260SB449