CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 2472
Introduced by Assembly Member Wood

February 14, 2018

An act to amend Section 1368.03 of the Health and Safety Code, relating to health care service plans.


LEGISLATIVE COUNSEL'S DIGEST

AB 2472, as introduced, Wood. Health care service plans.
Existing law provides for the licensing and regulation of health care service plans by the Department of Managed Health Care. Existing law authorizes the department to require enrollees and subscribers of health care service plans to participate in a plan’s grievance process for up to 30 days before pursuing a grievance through the department or the independent medical review system, and authorizes the department to refer a grievance issue unrelated to compliance with the laws governing health care service plans to the appropriate governmental entity.
This bill would make technical, nonsubstantive changes to that provision.
Digest Key Vote: MAJORITY   Appropriation: NO   Fiscal Committee: NO   Local Program: NO  
Bill Text
The people of the State of California do enact as follows:
SECTION 1. Section 1368.03 of the Health and Safety Code is amended to read:
1368.03. (a) The department may require enrollees and subscribers to participate in a plan’s grievance process for up to 30 days before pursuing a grievance through the department or the independent medical review system. However, the department may not impose this waiting period for expedited review cases covered by subdivision (b) of Section 1368.01 or in any other case where the department determines that an earlier review is warranted.
(b) Notwithstanding subdivision (a), the department may refer any a grievance issue that does not pertain to compliance with this chapter to the State Department of Health Care Services, the California Department of Aging, the federal Health Care Financing Administration, Centers for Medicare and Medicaid Services, or any other appropriate governmental entity for investigation and resolution.

(c)This section shall become operative on January 1, 2001, and then only if Assembly Bill 55 of the 1999–2000 Regular Session is enacted.