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Volume X, Number 216

July 31, 2020

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California Health Plans Take Note: California Department of Managed Health Care issues All Plan Letter on Social Distancing and COVID-19

On Thursday, March 12, 2020, the California Department of Managed Health Care (the “Department”) released a guidance letter (the “Letter”) to all health care service plans regarding the coronavirus (COVID-19) pandemic. The Letter encourages plans to take certain steps to promote social distancing to decrease in-person visits during the delivery of health care services.  The Letter encourages plans to continue following these social distancing measures for the duration of the state of emergency proclaimed by Governor Newsom on March 4th.

Coronavirus; social distancing

First, the Department encourages plans to expand the use of telehealth by (i) expediting or relaxing any pre-authorization/pre-certification requirements for contracted providers, so that providers are able to more quickly offer services via telehealth; and (ii) waiving any telehealth cost-sharing above that which would be applicable if the provider had delivered in-person care.

Second, the Department encourages plans to decrease the need for in-person pharmacy visits, if appropriate for the enrollee, by (i) allowing enrollees to receive at least a 90-day supply of maintenance drugs; (ii) suspending prescription drug refill limitations; and (iii) waiving delivery charges for home delivery of prescription medications. Maintenance drugs are defined as those outpatient prescription drugs that are prescribed for the enrollee on a continual basis to treat a chronic condition.

We will continue to provide updates regarding the Department’s position and guidance.

Copyright © 2020, Sheppard Mullin Richter & Hampton LLP.National Law Review, Volume X, Number 79

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About this Author

Kenneth Yood Healthcare Attorney SheppardMullin
Partner

Ken is a partner in the Corporate practice group in the firm's Los Angeles office. Chambers USAranks him highly for Healthcare, where he was commended for his "broad-based ability in the regulatory area." Clients appreciate that "his explanations are clear, and he understands the business side of things," notes Chambers 2016.

Areas of Practice

Ken represents a wide range of healthcare providers and healthcare companies, including specialty and general acute hospitals (including local district, nonprofit and...

310-228-3708
John Tilton Corporate Attorney
Associate

John M. Tilton is an associate in the Corporate Practice group in the firm's Century City office.

Education

  • J.D., University of California, Los Angeles, 2018

  • B.A., Hillsdale College, 2014

Admissions

  • California

424-288-5317
Dhara B. Waghela Associate Corporate Healthcare
Associate

Dhara Waghela is an associate in the Corporate Practice Group in the firm's Century City office and is a member of the firm’s Healthcare team.

424-288-5331