CHA News

CHA Urges Department of Managed Health Care to Clarify Exceptions to New Licensing Requirements

For CEOs, CFOs, COOs, Government Relations Executives

This post has been archived and contains information that may be out of date.

Yesterday, CHA submitted comments on the Department of Managed Health Care’s (DMHC) draft guidance implementing its recently finalized Knox-Keene licensure regulation. The regulation greatly expands the types of financial arrangements requiring a license, and hospitals are encouraged to consult with counsel to determine how the new requirements will impact their organization.

CHA’s comments urge DMHC to:

  • Clarify the types of arrangements that are presumptively exempt from the regulation’s scope.
  • Extend the phase-in period to July 1, 2020, to allow additional education for both DMHC and providers on the regulation’s scope and the types of arrangements that should be exempt.
  • Clarify that all exemptions granted would remain in effect unless and until there is a material change in the type of payment arrangements in which the person or organization is engaged.
  • Clarify that, for health plan contracts already filed with DMHC, providers do not need to submit the contract for review.
  • Automatically treat the entirety of all contracts submitted as confidential, without the need for a separate request.

CHA’s letter also outlines topics for continued discussions with DMHC and other stakeholders over the next few weeks and months, including quantitative standards for exemption and the exemption process.

In an effort to obtain further clarification on DMHC’s exemption process, CHA is sponsoring legislation — Senate Bill 714 (Umberg, D-Orange County) — that would specify the types of arrangements that would be presumptively exempt and provide certainty around the exemption process.

DMHC anticipates finalizing its draft guidance by the end of this month; CHA will continue to provide updates via CHA News.