Bill Text: CA AR26 | 2015-2016 | Regular Session | Introduced

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Bill Title: Department of Managed Health Care.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Passed) 2015-08-17 - Read. Adopted. (Ayes 79. Noes 0. Page 2470.). [AR26 Detail]

Download: California-2015-AR26-Introduced.html

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BILL NUMBER: HR 26	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Low

                        JUNE 24, 2015

   Relative to the Department of Managed Health Care.


	LEGISLATIVE COUNSEL'S DIGEST
             HOUSE OR SENATE RESOLUTIONS DO NOT CONTAIN A DIGEST



   WHEREAS, The Department of Managed Health Care was created by
Assembly Bill 78 (Chapter 525 of the Statutes of 1999), and began
operations on January 1, 2000; and
   WHEREAS, 2015 marks the 15th anniversary of the creation of the
Department of Managed Health Care, which was created to protect the
rights of health care service plan enrollees, to educate consumers
about their rights and responsibilities, to ensure the financial
stability of the managed health care system, and to assist
Californians in navigating the changing health care landscape; and
   WHEREAS, With currently over 27 million enrollees in plans under
the department's jurisdiction, the Department of Managed Health Care
is the only state-level department in the United States focused on
regulating health maintenance organizations; and
   WHEREAS, The Department of Managed Health Care enforces California'
s landmark Knox-Keene Health Care Service Plan Act of 1975 (the
Knox-Keene Act); and
   WHEREAS, The strong patient protections contained in the
Knox-Keene Act and enforced by the Department of Managed Health Care
include the following:
   (a) Patients have the right to treatment or services that are
medically necessary, and to receive an independent medical review by
the Department of Managed Health Care if a treatment or service is
denied by a health care service plan.
   (b) Patients have the right to receive communications related to
services in their primary languages.
   (c) Patients have the right to timely access to care, which
includes limits on how long a patient must wait to get a health care
appointment.
   (d) Patients have the right to request continuity of care, for
both medicines and doctors.
   (e) Patients have the right to an expeditious process to obtain
exceptions from step therapy, and to continued access to their
prescribed medications when changing plans.
   (f) Patients have the right to know why their plan denies a
service or treatment.
   (g) Patients have the right to view a health plan's drug formulary
before signing up for the plan.
   (h) Patients have the right to receive treatment for certain
mental health conditions.
   (i) A health plan must respond within 30 days when a patient files
a complaint.
   (j) Patients have the right to receive hospice care at the end of
life; and
   WHEREAS, The Department of Managed Health Care operates and
maintains the DMHC Help Center, where patients get assistance with
obtaining services from their health plan; now, therefore, be it
   Resolved by the Assembly of the State of California,  That the
Assembly commends the Department of Managed Health Care for 15 years
of operation on behalf of California's patients; and be it further
   Resolved, that the Assembly encourages all Californians to learn
about their legal right to timely access to high quality health care;
and be it further
   Resolved, That the Chief Clerk of the Assembly transmit copies of
this resolution to the author for appropriate distribution.