Aurelio Rojas of the Sacramento Bee had a good Sunday story on the long saga of the timely access to care regulations at the Department of Managed Health Care.
As has been reported on this blog before, after going back-and-forth with specific standards, the DMHC decided a few months ago to simply let the HMOs determine their own standards. As the article indicates, Health Access California and Western Center for Law and Poverty were prepared to go to court, since it’s just unacceptable for the DMHC to abdicate their role to insurers, and the regulations simply did not implement the intent of the legislature.
But that was avoided, since the Office of Administrative Law rejected the regulations on a technical process issue. The Bee has a statement by the DMHC:
“With the disapproval of the timely access regulations, we will take the
opportunity to re-examine the concerns of all stakeholders and determine the
best approach going forward.”
It would be inappropriate for the DMHC to respond to just the procedural issues and resubmit the same, flawed regulations. We truly hope the Department, in the short winodw of time before they need to resubmit in the next few months, commits to a process that results in clear standards of timely access, standards that consumers can understand and demand the next time they are told they can’t see a specialist for two months.
Until such a process is set, the next step is a special oversight hearing by the Senate Health Committee, chaired by Sen. Sheila Kuehl, set for later this month.