February 06, 2025
Area(s) of Interest:
Disaster Relief
What You Need to Know: CMA is urging DMHC to require plans to implement administrative flexibilities for practices affected by the SoCal wildfires.
The California Medical Association (CMA) is urging the California Department of Managed Health Care (DMHC) take additional steps to ensure that physician practices affected by the Southern California Wildfires can continue to deliver patient care without undue administrative obstacles or financial strain.
While DMHC issued an All Plan Letter (APL 25-001) directing health plans to ensure that patients have access to medically necessary care and prescription drugs, it only “encouraged” them to implement additional administrative flexibilities, such as relaxing requirements around prior authorization and referrals and extending claims filing deadlines. While some plans have implemented such measures, many have not.
Given the devastation from the wildfires, which have destroyed medical practices and displaced hundreds of physicians and their staff, CMA is urging DMHC to exercise its authority to require plans to implement certain administrative flexibilities, including:
- Suspending prior authorization requirements and extending existing prior authorizations
- Extending timely filing requirements
- Extending timeframe to dispute overpayment requests
- Suspending medical records requests
- Allowing services in alternative settings
- Expediting enrollment requirements
For More Information
Return