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DMHC issues All Plan Letter to health plans implementing CMA-sponsored telehealth legislation

January 25, 2022


The California Department of Managed Health Care (DMHC) issued an All Plan Letter (APL) to its regulated health plans, implementing a California Medical Association (CMA)-sponsored telehealth law (AB 457) that took effect on January 1, 2022. The APL clarifies plans’ responsibilities under the statute.

AB 457 made major changes to California telehealth law:

  • Requires health plans that contract with third-party corporate telehealth companies to offer their patients appointments with local community physicians, prior to referring them to a third-party corporate telehealth provider.
  •  If a patient chooses to be treated by a third-party corporate telehealth provider, requires the provider to forward patient records from the visit to the patient’s primary care physician, unless the patient objects.
  • Requires all commercial health plan contracts to pay telehealth services at parity to in-person. Previously there was a rolling implementation date, as existing law only applied to contracts issued or renewed after January 1, 2021.

This important legislation is intended to stop the health plan practice of steering patients to corporate telehealth entities. CMA is concerned that plans use these third-party corporate telehealth companies to sidestep their contracted physician networks, weakening the physician-patient relationship.

Also see: CMA publishes telehealth policy update

 

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