CTRC Legislative/Regulatory June 2015 Update

Please Note: CCHP has a pending legislation/regulation webpage located at the following link: http://cchpca.org/state-laws-and-reimbursement-policies


Pending Legislation

State Bill # Status Summary
California AB 57 5/22/15: In Senate. Read first time. Referred to committee on Rules for assignment. States the intent of the Legislature to enact legislation to promote the deployment of communications infrastructure by removing barriers to investment.
California AB 250 5/21/15: In Assembly. Read second time. To consent calendar. This bill would expand the definition of “health care provider” for the purposes of the telehealth provision currently in law, to include a marriage and family therapist intern and trainee.
California AB 648 4/15/15: In Assembly Appropriations. Referred to suspense file. This bill would establish the Virtual Dental Home program to expand the virtual dental home model of community-based delivery of dental care to the residents of CA who are in greatest need, as prescribed. The bill would authorize the administrator of the program to, among other things, encourage development and expansion of the delivery of dental health services in community clinics and school programs, as prescribed.  The bill would appropriate $4,000,000 to the department for the purposes of this program.
California AB 1485 5/13/15: Referred to Appropriations suspense file. This bill would prohibit the Department from requiring a radiologist to be located in California as a condition of Medi-Cal provider enrollment or reimbursement for teleradiology services.
California SB 147 5/23/15: Set hearing for May 28. This bill would require the department to authorize a three year alternative payment methodology pilot project for FQHCs that would be implemented in any county and FQHC willing to participate.
California SB 289 5/23/15: Set hearing for May 28. This bill would require a health care service plan to cover telephonic and electronic patient management services provided by a physician or non-physician health care provider and reimburse those services based on their complexity and time expenditure.



Pending Regulation

Stat Reg. Status Summary
California Title 16 CCR Sections 1820; .5, .7; 1822 3/6/15: Proposed

Comment Deadline: 4/20/15

Title: LPCCS Treatment of Couples and Families

Agency: Board of Behavioral Sciences

This rule would increase the number of hours of supervised experience toward the 3,000 hours required for licensure for a licensed professional clinical counselor, which can be obtained via telehealth from 250 to 375 hours.


Adopted Emergency Rules (with expiration dates)

Stat Reg. Status Summary
California Title 10 CCR

Health Benefit Exchange


5/27/15: Emergency Rule Re-Adoption

Effective Date: 5/11/15


Agency: Health Benefit Exchange

Title: Eligibility and Enrollment Process – Individual Exchange

These regulations established the Health Benefit Exchange’s policies and procedures for eligibility determination and redetermination, enrollment, and termination.  Specific to telehealth, it refers to Section 2290.5 of the Business and Professions Code to define the term telemedicine or telehealth.

California Title 10 CCR Section 2240, .1, .15, .16, .4, .5, .6, .7


2/19/15: Emergency Rule Adoption

Effective: 1/30/15

Expires: 7/30/15

Title: Provider Network Adequacy

Agency: Department of Insurance

Updates the Department’s existing regulation, and addresses concerns regarding inadequate network access, non-network providers in network facilities, and inaccurate provider directories, by implementing the proposed amendments and additions in this regulation.  Section was added to require insurers to submit documents describing the implementation and use of triage, telemedicine and health information technology to provide timely access to care. This allows insurers to demonstrate alternative means of providing adequate access, as appropriate.

California Title 10 CCR Sec. 6428, 6430 2/5/15: Notice of Approval of Emergency Regulatory Action

Effective: 2/5/15

Expires: 2/5/17

Title: 2016 Qualified Health Plan Recertification/New Entrant

Agency: Health Benefit Exchange

Establishes the process and requirements for eligible health issuers in the individual and SHOP exchanges to submit proposed qualified health plans (QHP) for recertification and for new health issuer entrants who are eligible and elect to propose QHPs for the Plan Year 2016. Among the application questions, it asks health issuers strategies they use to implement, or intend to implement, to promote access and care coordination through the use of telemedicine (among other things).