Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and.
Most health plans participating in either Medicaid/CHIP managed care programs (42 CFR 440.395) or Group Health Insurance markets (45 CFR 146.136) are required by the Centers.
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On January 5, 2021, the California Department of Managed Health Care (DMHC) issued an All Plan Letter regarding the newly passed California Senate Bill 855 (Wiener, Stats. 2020, ch. 151 § 2) (SB 855).
1 SB 855 became effective on January 1, 2021. It amends the California Health and Safety Code and Insurance Code to expand state coverage requirements for mental health and substance use disorder services, and it requires health plans and insurers to adopt a standardized definition of “medical necessity” for those treatments.
2
The All Plan Letter provides an overview of SB 855, identifies clinical criteria and guidelines that health plans