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Section 1366.1 Of Article 4. Solicitation And Enrollment From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 4.
1366.1
. (a) The department shall adopt regulations on or before
July 1, 2003, that establish an extended geographic accessibility
standard for access to health care providers served by a health care
service plan in counties with a population of 500,000 or less, and
that, as of January 1, 2002, have two or fewer health care service
plans providing coverage to the entire county in the commercial
market.
(b) This section shall not apply to specialized health care service plans or health care service plan contracts that provide benefits to enrollees through any of the following:
(1) Preferred provider contracting arrangements.
(2) The Medi-Cal program.
(3) The Healthy Families program.
(c) (1) At least 30 days before a health care service plan files for modification of its license with the department in order to withdraw from a county with a population of 500,000 or less, or a portion of that county, the health care service plan shall hold a public meeting in the county or portion of the county from which it intends to withdraw, and shall do all of the following:
(A) Provide notice announcing the public meeting at least 30 days prior to the public meeting to all affected enrollees, health care providers, advocates, public officials, and other interested parties.
(B) Provide notice announcing the public meeting at least 30 days prior to the public meeting in a newspaper of general circulation within the affected county or portion of the affected county.
(C) At the public meeting, allow testimony, which may be limited to a certain length of time by the health care service plan, of all interested parties.
(D) Send a summary of the comments received at the public meeting to the department.
(E) Send a summary of the comments received at the public meeting to the Centers for Medicare and Medicaid Services if the modification would affect Medicare beneficiaries.
(F) File with the department for review, no less than 30 days prior to the date of mailing or publication, the notices required under subparagraphs (A) and (B).
(2) A representative of the department shall attend the public meeting.
(b) This section shall not apply to specialized health care service plans or health care service plan contracts that provide benefits to enrollees through any of the following:
(1) Preferred provider contracting arrangements.
(2) The Medi-Cal program.
(3) The Healthy Families program.
(c) (1) At least 30 days before a health care service plan files for modification of its license with the department in order to withdraw from a county with a population of 500,000 or less, or a portion of that county, the health care service plan shall hold a public meeting in the county or portion of the county from which it intends to withdraw, and shall do all of the following:
(A) Provide notice announcing the public meeting at least 30 days prior to the public meeting to all affected enrollees, health care providers, advocates, public officials, and other interested parties.
(B) Provide notice announcing the public meeting at least 30 days prior to the public meeting in a newspaper of general circulation within the affected county or portion of the affected county.
(C) At the public meeting, allow testimony, which may be limited to a certain length of time by the health care service plan, of all interested parties.
(D) Send a summary of the comments received at the public meeting to the department.
(E) Send a summary of the comments received at the public meeting to the Centers for Medicare and Medicaid Services if the modification would affect Medicare beneficiaries.
(F) File with the department for review, no less than 30 days prior to the date of mailing or publication, the notices required under subparagraphs (A) and (B).
(2) A representative of the department shall attend the public meeting.
