CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Senate Bill No. 979Introduced by Senator DoddFebruary 10, 2022 An act to amend Sections 1368.7 and 1797.150 of, and to add Sections 1275.65 and 129690 to, the Health and Safety Code, and to amend Section 10112.95 of the Insurance Code, relating to health emergencies. LEGISLATIVE COUNSEL'S DIGESTSB 979, as introduced, Dodd. Health emergencies.Existing law provides for the licensure and regulation of health facilities, as defined, by the State Department of Public Health. Existing law authorizes the Governor to declare a state of emergency, as specified, and the State Public Health Officer to declare a health emergency under certain circumstances, such as the imminent or proximate threat of the introduction of an infectious or communicable disease.This bill would authorize the State Department of Public Health to waive specified licensing requirements for health facilities during a state of emergency declared by the Governor or a health emergency declared by the State Public Health Officer.When the Governor declares a state of emergency, existing law requires a health care service plan and a health insurer to provide an enrollee or insured who has been displaced or has the immediate potential to be displaced by that emergency access to medically necessary health care services. Existing law requires health care service plans and health insurers operating in a county included in a declaration of emergency to notify the Department of Managed Health Care and the Department of Insurance whether the plan has experienced or expects to experience a disruption to its operation, among other things. Existing provides for health care service plans and health insurers to take specified actions, including relaxing time limits for prior authorization, precertification, or referrals.This bill would expand these provisions to health emergencies declared by the State Public Health Officer and to emergencies that otherwise affect enrollees and insureds or health providers, as determined by the Department of Managed Health Care or the Department of Insurance. The bill would authorize the Department of Managed Health Care to require plans and insurers to take specified actions, such as relaxing or suspending certain time limits. Existing law requires the Emergency Medical Services Authority, which is responsible for the coordination and integration of state activities concerning emergency medical services, to cooperate with the Office of Emergency Services to respond to a medical disaster by mobilizing and coordinating emergency medical services mutual aid resources. This bill would authorize the authority, during a state of emergency declared by the Governor or a health emergency declared by the State Public Health Officer, to approve out-of-state health care personnel to provide services to prepare for, respond to, mitigate the effects of, or recover from the emergency.Existing law requires the Department of Health Care Access and Information to propose building standards for and review design and construction of hospital buildings, among other things.This bill would authorize the department to waive any requirements and regulations with respect to a health facility during a state of emergency proclaimed by the Governor or a health emergency declared by the State Public Health Officer.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 1275.65 is added to the Health and Safety Code, to read:1275.65. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any of the licensing requirements of this chapter and accompanying regulations with respect to any health facility specified in Section 1250. The department may issue a waiver that applies to all facilities statewide, to facilities in an identified geographic area, or to identified facilities or facility types.(b) Notwithstanding subdivision (a), this section does not grant authority to the department to waive licensing requirements governing general acute care hospital nurse-to-patient staffing ratios. However, the department may issue individual facility waivers otherwise authorized by law or waivers authorized by an executive order of the Governor.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.SEC. 2. Section 1368.7 of the Health and Safety Code is amended to read:1368.7. (a) A health care service plan shall provide an enrollee who has been displaced by a state of emergency, or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace enrollees, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affects enrollees or health care providers, as determined by the department, a health care service plan operating in the county or counties included in the declaration shall file with the department a notification describing whether the plan has experienced or expects to experience any disruption to the operation of the plan, explaining how the plan is communicating with potentially impacted enrollees, and summarizing the actions the plan has taken or is in the process of taking to ensure that the health care needs of enrollees are met. This The department may require the plan to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted enrollee to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an enrollee to replace medical equipment or supplies.(5) Allow an enrollee to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the enrollee is out of the area due to displacement.(6) Have a toll-free telephone number that an affected enrollee may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.(d) The director may issue guidance to health care service plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).SEC. 3. Section 1797.150 of the Health and Safety Code is amended to read:1797.150. (a) In cooperation with the Office of Emergency Services, the authority shall respond to any medical disaster by mobilizing and coordinating emergency medical services mutual aid resources to mitigate health problems.(b) During a state of emergency, proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, declared by the State Public Health Officer pursuant to Section 101080, the authority may approve out-of-state health care personnel to provide services to help prepare for, respond to, mitigate the effects of, or recover from the emergency in the same manner as prescribed in Section 179.5 of the Government Code, with respect to licensing and certification. This approval shall remain in effect for the time period specified by the authority, not to exceed the duration of the emergency.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.SEC. 4. Section 129690 is added to the Health and Safety Code, to read:129690. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any requirements of this division and accompanying regulations with respect to any health facility identified in Section 1250.(b) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.SEC. 5. Section 10112.95 of the Insurance Code is amended to read:10112.95. (a) A health insurer shall provide an insured who has been displaced or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace insureds, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affect insureds or health care providers, as determined by the department, a health insurer operating in the county or counties included in the declaration shall file with the department a notification describing whether the insurer has experienced or expects to experience any disruption to the operation of the insurer, explaining how the insurer is communicating with potentially impacted insureds, and summarizing the actions the insurer has taken or is in the process of taking to ensure that the health care needs of insureds are met. This The department may require the insurer to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted insured to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an insured to replace medical equipment or supplies.(5) Allow an insured to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the insured is out of the area due to displacement.(6) Have a toll-free telephone number that an affected insured may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the commissioners authority under any provision of this part.(d) The director may issue guidance to insurers regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Senate Bill No. 979Introduced by Senator DoddFebruary 10, 2022 An act to amend Sections 1368.7 and 1797.150 of, and to add Sections 1275.65 and 129690 to, the Health and Safety Code, and to amend Section 10112.95 of the Insurance Code, relating to health emergencies. LEGISLATIVE COUNSEL'S DIGESTSB 979, as introduced, Dodd. Health emergencies.Existing law provides for the licensure and regulation of health facilities, as defined, by the State Department of Public Health. Existing law authorizes the Governor to declare a state of emergency, as specified, and the State Public Health Officer to declare a health emergency under certain circumstances, such as the imminent or proximate threat of the introduction of an infectious or communicable disease.This bill would authorize the State Department of Public Health to waive specified licensing requirements for health facilities during a state of emergency declared by the Governor or a health emergency declared by the State Public Health Officer.When the Governor declares a state of emergency, existing law requires a health care service plan and a health insurer to provide an enrollee or insured who has been displaced or has the immediate potential to be displaced by that emergency access to medically necessary health care services. Existing law requires health care service plans and health insurers operating in a county included in a declaration of emergency to notify the Department of Managed Health Care and the Department of Insurance whether the plan has experienced or expects to experience a disruption to its operation, among other things. Existing provides for health care service plans and health insurers to take specified actions, including relaxing time limits for prior authorization, precertification, or referrals.This bill would expand these provisions to health emergencies declared by the State Public Health Officer and to emergencies that otherwise affect enrollees and insureds or health providers, as determined by the Department of Managed Health Care or the Department of Insurance. The bill would authorize the Department of Managed Health Care to require plans and insurers to take specified actions, such as relaxing or suspending certain time limits. Existing law requires the Emergency Medical Services Authority, which is responsible for the coordination and integration of state activities concerning emergency medical services, to cooperate with the Office of Emergency Services to respond to a medical disaster by mobilizing and coordinating emergency medical services mutual aid resources. This bill would authorize the authority, during a state of emergency declared by the Governor or a health emergency declared by the State Public Health Officer, to approve out-of-state health care personnel to provide services to prepare for, respond to, mitigate the effects of, or recover from the emergency.Existing law requires the Department of Health Care Access and Information to propose building standards for and review design and construction of hospital buildings, among other things.This bill would authorize the department to waive any requirements and regulations with respect to a health facility during a state of emergency proclaimed by the Governor or a health emergency declared by the State Public Health Officer.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION
Senate Bill
No. 979
Introduced by Senator DoddFebruary 10, 2022
Introduced by Senator Dodd
February 10, 2022
An act to amend Sections 1368.7 and 1797.150 of, and to add Sections 1275.65 and 129690 to, the Health and Safety Code, and to amend Section 10112.95 of the Insurance Code, relating to health emergencies.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
SB 979, as introduced, Dodd. Health emergencies.
Existing law provides for the licensure and regulation of health facilities, as defined, by the State Department of Public Health. Existing law authorizes the Governor to declare a state of emergency, as specified, and the State Public Health Officer to declare a health emergency under certain circumstances, such as the imminent or proximate threat of the introduction of an infectious or communicable disease.This bill would authorize the State Department of Public Health to waive specified licensing requirements for health facilities during a state of emergency declared by the Governor or a health emergency declared by the State Public Health Officer.When the Governor declares a state of emergency, existing law requires a health care service plan and a health insurer to provide an enrollee or insured who has been displaced or has the immediate potential to be displaced by that emergency access to medically necessary health care services. Existing law requires health care service plans and health insurers operating in a county included in a declaration of emergency to notify the Department of Managed Health Care and the Department of Insurance whether the plan has experienced or expects to experience a disruption to its operation, among other things. Existing provides for health care service plans and health insurers to take specified actions, including relaxing time limits for prior authorization, precertification, or referrals.This bill would expand these provisions to health emergencies declared by the State Public Health Officer and to emergencies that otherwise affect enrollees and insureds or health providers, as determined by the Department of Managed Health Care or the Department of Insurance. The bill would authorize the Department of Managed Health Care to require plans and insurers to take specified actions, such as relaxing or suspending certain time limits. Existing law requires the Emergency Medical Services Authority, which is responsible for the coordination and integration of state activities concerning emergency medical services, to cooperate with the Office of Emergency Services to respond to a medical disaster by mobilizing and coordinating emergency medical services mutual aid resources. This bill would authorize the authority, during a state of emergency declared by the Governor or a health emergency declared by the State Public Health Officer, to approve out-of-state health care personnel to provide services to prepare for, respond to, mitigate the effects of, or recover from the emergency.Existing law requires the Department of Health Care Access and Information to propose building standards for and review design and construction of hospital buildings, among other things.This bill would authorize the department to waive any requirements and regulations with respect to a health facility during a state of emergency proclaimed by the Governor or a health emergency declared by the State Public Health Officer.
Existing law provides for the licensure and regulation of health facilities, as defined, by the State Department of Public Health. Existing law authorizes the Governor to declare a state of emergency, as specified, and the State Public Health Officer to declare a health emergency under certain circumstances, such as the imminent or proximate threat of the introduction of an infectious or communicable disease.
This bill would authorize the State Department of Public Health to waive specified licensing requirements for health facilities during a state of emergency declared by the Governor or a health emergency declared by the State Public Health Officer.
When the Governor declares a state of emergency, existing law requires a health care service plan and a health insurer to provide an enrollee or insured who has been displaced or has the immediate potential to be displaced by that emergency access to medically necessary health care services. Existing law requires health care service plans and health insurers operating in a county included in a declaration of emergency to notify the Department of Managed Health Care and the Department of Insurance whether the plan has experienced or expects to experience a disruption to its operation, among other things. Existing provides for health care service plans and health insurers to take specified actions, including relaxing time limits for prior authorization, precertification, or referrals.
This bill would expand these provisions to health emergencies declared by the State Public Health Officer and to emergencies that otherwise affect enrollees and insureds or health providers, as determined by the Department of Managed Health Care or the Department of Insurance. The bill would authorize the Department of Managed Health Care to require plans and insurers to take specified actions, such as relaxing or suspending certain time limits.
Existing law requires the Emergency Medical Services Authority, which is responsible for the coordination and integration of state activities concerning emergency medical services, to cooperate with the Office of Emergency Services to respond to a medical disaster by mobilizing and coordinating emergency medical services mutual aid resources.
This bill would authorize the authority, during a state of emergency declared by the Governor or a health emergency declared by the State Public Health Officer, to approve out-of-state health care personnel to provide services to prepare for, respond to, mitigate the effects of, or recover from the emergency.
Existing law requires the Department of Health Care Access and Information to propose building standards for and review design and construction of hospital buildings, among other things.
This bill would authorize the department to waive any requirements and regulations with respect to a health facility during a state of emergency proclaimed by the Governor or a health emergency declared by the State Public Health Officer.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 1275.65 is added to the Health and Safety Code, to read:1275.65. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any of the licensing requirements of this chapter and accompanying regulations with respect to any health facility specified in Section 1250. The department may issue a waiver that applies to all facilities statewide, to facilities in an identified geographic area, or to identified facilities or facility types.(b) Notwithstanding subdivision (a), this section does not grant authority to the department to waive licensing requirements governing general acute care hospital nurse-to-patient staffing ratios. However, the department may issue individual facility waivers otherwise authorized by law or waivers authorized by an executive order of the Governor.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.SEC. 2. Section 1368.7 of the Health and Safety Code is amended to read:1368.7. (a) A health care service plan shall provide an enrollee who has been displaced by a state of emergency, or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace enrollees, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affects enrollees or health care providers, as determined by the department, a health care service plan operating in the county or counties included in the declaration shall file with the department a notification describing whether the plan has experienced or expects to experience any disruption to the operation of the plan, explaining how the plan is communicating with potentially impacted enrollees, and summarizing the actions the plan has taken or is in the process of taking to ensure that the health care needs of enrollees are met. This The department may require the plan to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted enrollee to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an enrollee to replace medical equipment or supplies.(5) Allow an enrollee to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the enrollee is out of the area due to displacement.(6) Have a toll-free telephone number that an affected enrollee may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.(d) The director may issue guidance to health care service plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).SEC. 3. Section 1797.150 of the Health and Safety Code is amended to read:1797.150. (a) In cooperation with the Office of Emergency Services, the authority shall respond to any medical disaster by mobilizing and coordinating emergency medical services mutual aid resources to mitigate health problems.(b) During a state of emergency, proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, declared by the State Public Health Officer pursuant to Section 101080, the authority may approve out-of-state health care personnel to provide services to help prepare for, respond to, mitigate the effects of, or recover from the emergency in the same manner as prescribed in Section 179.5 of the Government Code, with respect to licensing and certification. This approval shall remain in effect for the time period specified by the authority, not to exceed the duration of the emergency.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.SEC. 4. Section 129690 is added to the Health and Safety Code, to read:129690. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any requirements of this division and accompanying regulations with respect to any health facility identified in Section 1250.(b) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.SEC. 5. Section 10112.95 of the Insurance Code is amended to read:10112.95. (a) A health insurer shall provide an insured who has been displaced or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace insureds, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affect insureds or health care providers, as determined by the department, a health insurer operating in the county or counties included in the declaration shall file with the department a notification describing whether the insurer has experienced or expects to experience any disruption to the operation of the insurer, explaining how the insurer is communicating with potentially impacted insureds, and summarizing the actions the insurer has taken or is in the process of taking to ensure that the health care needs of insureds are met. This The department may require the insurer to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted insured to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an insured to replace medical equipment or supplies.(5) Allow an insured to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the insured is out of the area due to displacement.(6) Have a toll-free telephone number that an affected insured may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the commissioners authority under any provision of this part.(d) The director may issue guidance to insurers regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 1275.65 is added to the Health and Safety Code, to read:1275.65. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any of the licensing requirements of this chapter and accompanying regulations with respect to any health facility specified in Section 1250. The department may issue a waiver that applies to all facilities statewide, to facilities in an identified geographic area, or to identified facilities or facility types.(b) Notwithstanding subdivision (a), this section does not grant authority to the department to waive licensing requirements governing general acute care hospital nurse-to-patient staffing ratios. However, the department may issue individual facility waivers otherwise authorized by law or waivers authorized by an executive order of the Governor.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.
SECTION 1. Section 1275.65 is added to the Health and Safety Code, to read:
### SECTION 1.
1275.65. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any of the licensing requirements of this chapter and accompanying regulations with respect to any health facility specified in Section 1250. The department may issue a waiver that applies to all facilities statewide, to facilities in an identified geographic area, or to identified facilities or facility types.(b) Notwithstanding subdivision (a), this section does not grant authority to the department to waive licensing requirements governing general acute care hospital nurse-to-patient staffing ratios. However, the department may issue individual facility waivers otherwise authorized by law or waivers authorized by an executive order of the Governor.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.
1275.65. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any of the licensing requirements of this chapter and accompanying regulations with respect to any health facility specified in Section 1250. The department may issue a waiver that applies to all facilities statewide, to facilities in an identified geographic area, or to identified facilities or facility types.(b) Notwithstanding subdivision (a), this section does not grant authority to the department to waive licensing requirements governing general acute care hospital nurse-to-patient staffing ratios. However, the department may issue individual facility waivers otherwise authorized by law or waivers authorized by an executive order of the Governor.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.
1275.65. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any of the licensing requirements of this chapter and accompanying regulations with respect to any health facility specified in Section 1250. The department may issue a waiver that applies to all facilities statewide, to facilities in an identified geographic area, or to identified facilities or facility types.(b) Notwithstanding subdivision (a), this section does not grant authority to the department to waive licensing requirements governing general acute care hospital nurse-to-patient staffing ratios. However, the department may issue individual facility waivers otherwise authorized by law or waivers authorized by an executive order of the Governor.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.
1275.65. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any of the licensing requirements of this chapter and accompanying regulations with respect to any health facility specified in Section 1250. The department may issue a waiver that applies to all facilities statewide, to facilities in an identified geographic area, or to identified facilities or facility types.
(b) Notwithstanding subdivision (a), this section does not grant authority to the department to waive licensing requirements governing general acute care hospital nurse-to-patient staffing ratios. However, the department may issue individual facility waivers otherwise authorized by law or waivers authorized by an executive order of the Governor.
(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.
SEC. 2. Section 1368.7 of the Health and Safety Code is amended to read:1368.7. (a) A health care service plan shall provide an enrollee who has been displaced by a state of emergency, or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace enrollees, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affects enrollees or health care providers, as determined by the department, a health care service plan operating in the county or counties included in the declaration shall file with the department a notification describing whether the plan has experienced or expects to experience any disruption to the operation of the plan, explaining how the plan is communicating with potentially impacted enrollees, and summarizing the actions the plan has taken or is in the process of taking to ensure that the health care needs of enrollees are met. This The department may require the plan to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted enrollee to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an enrollee to replace medical equipment or supplies.(5) Allow an enrollee to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the enrollee is out of the area due to displacement.(6) Have a toll-free telephone number that an affected enrollee may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.(d) The director may issue guidance to health care service plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
SEC. 2. Section 1368.7 of the Health and Safety Code is amended to read:
### SEC. 2.
1368.7. (a) A health care service plan shall provide an enrollee who has been displaced by a state of emergency, or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace enrollees, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affects enrollees or health care providers, as determined by the department, a health care service plan operating in the county or counties included in the declaration shall file with the department a notification describing whether the plan has experienced or expects to experience any disruption to the operation of the plan, explaining how the plan is communicating with potentially impacted enrollees, and summarizing the actions the plan has taken or is in the process of taking to ensure that the health care needs of enrollees are met. This The department may require the plan to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted enrollee to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an enrollee to replace medical equipment or supplies.(5) Allow an enrollee to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the enrollee is out of the area due to displacement.(6) Have a toll-free telephone number that an affected enrollee may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.(d) The director may issue guidance to health care service plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
1368.7. (a) A health care service plan shall provide an enrollee who has been displaced by a state of emergency, or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace enrollees, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affects enrollees or health care providers, as determined by the department, a health care service plan operating in the county or counties included in the declaration shall file with the department a notification describing whether the plan has experienced or expects to experience any disruption to the operation of the plan, explaining how the plan is communicating with potentially impacted enrollees, and summarizing the actions the plan has taken or is in the process of taking to ensure that the health care needs of enrollees are met. This The department may require the plan to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted enrollee to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an enrollee to replace medical equipment or supplies.(5) Allow an enrollee to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the enrollee is out of the area due to displacement.(6) Have a toll-free telephone number that an affected enrollee may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.(d) The director may issue guidance to health care service plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
1368.7. (a) A health care service plan shall provide an enrollee who has been displaced by a state of emergency, or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace enrollees, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affects enrollees or health care providers, as determined by the department, a health care service plan operating in the county or counties included in the declaration shall file with the department a notification describing whether the plan has experienced or expects to experience any disruption to the operation of the plan, explaining how the plan is communicating with potentially impacted enrollees, and summarizing the actions the plan has taken or is in the process of taking to ensure that the health care needs of enrollees are met. This The department may require the plan to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted enrollee to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an enrollee to replace medical equipment or supplies.(5) Allow an enrollee to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the enrollee is out of the area due to displacement.(6) Have a toll-free telephone number that an affected enrollee may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.(d) The director may issue guidance to health care service plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
1368.7. (a) A health care service plan shall provide an enrollee who has been displaced by a state of emergency, or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.
(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace enrollees, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affects enrollees or health care providers, as determined by the department, a health care service plan operating in the county or counties included in the declaration shall file with the department a notification describing whether the plan has experienced or expects to experience any disruption to the operation of the plan, explaining how the plan is communicating with potentially impacted enrollees, and summarizing the actions the plan has taken or is in the process of taking to ensure that the health care needs of enrollees are met. This The department may require the plan to take actions, including, but not limited to, the following:
(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.
(2) Extend filing deadlines for claims.
(3) Suspend prescription refill limitations and allow an impacted enrollee to refill his or her their prescriptions at an out-of-network pharmacy.
(4) Authorize an enrollee to replace medical equipment or supplies.
(5) Allow an enrollee to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the enrollee is out of the area due to displacement.
(6) Have a toll-free telephone number that an affected enrollee may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.
(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this chapter.
(d) The director may issue guidance to health care service plans regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
SEC. 3. Section 1797.150 of the Health and Safety Code is amended to read:1797.150. (a) In cooperation with the Office of Emergency Services, the authority shall respond to any medical disaster by mobilizing and coordinating emergency medical services mutual aid resources to mitigate health problems.(b) During a state of emergency, proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, declared by the State Public Health Officer pursuant to Section 101080, the authority may approve out-of-state health care personnel to provide services to help prepare for, respond to, mitigate the effects of, or recover from the emergency in the same manner as prescribed in Section 179.5 of the Government Code, with respect to licensing and certification. This approval shall remain in effect for the time period specified by the authority, not to exceed the duration of the emergency.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.
SEC. 3. Section 1797.150 of the Health and Safety Code is amended to read:
### SEC. 3.
1797.150. (a) In cooperation with the Office of Emergency Services, the authority shall respond to any medical disaster by mobilizing and coordinating emergency medical services mutual aid resources to mitigate health problems.(b) During a state of emergency, proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, declared by the State Public Health Officer pursuant to Section 101080, the authority may approve out-of-state health care personnel to provide services to help prepare for, respond to, mitigate the effects of, or recover from the emergency in the same manner as prescribed in Section 179.5 of the Government Code, with respect to licensing and certification. This approval shall remain in effect for the time period specified by the authority, not to exceed the duration of the emergency.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.
1797.150. (a) In cooperation with the Office of Emergency Services, the authority shall respond to any medical disaster by mobilizing and coordinating emergency medical services mutual aid resources to mitigate health problems.(b) During a state of emergency, proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, declared by the State Public Health Officer pursuant to Section 101080, the authority may approve out-of-state health care personnel to provide services to help prepare for, respond to, mitigate the effects of, or recover from the emergency in the same manner as prescribed in Section 179.5 of the Government Code, with respect to licensing and certification. This approval shall remain in effect for the time period specified by the authority, not to exceed the duration of the emergency.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.
1797.150. (a) In cooperation with the Office of Emergency Services, the authority shall respond to any medical disaster by mobilizing and coordinating emergency medical services mutual aid resources to mitigate health problems.(b) During a state of emergency, proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, declared by the State Public Health Officer pursuant to Section 101080, the authority may approve out-of-state health care personnel to provide services to help prepare for, respond to, mitigate the effects of, or recover from the emergency in the same manner as prescribed in Section 179.5 of the Government Code, with respect to licensing and certification. This approval shall remain in effect for the time period specified by the authority, not to exceed the duration of the emergency.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.
1797.150. (a) In cooperation with the Office of Emergency Services, the authority shall respond to any medical disaster by mobilizing and coordinating emergency medical services mutual aid resources to mitigate health problems.
(b) During a state of emergency, proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, declared by the State Public Health Officer pursuant to Section 101080, the authority may approve out-of-state health care personnel to provide services to help prepare for, respond to, mitigate the effects of, or recover from the emergency in the same manner as prescribed in Section 179.5 of the Government Code, with respect to licensing and certification. This approval shall remain in effect for the time period specified by the authority, not to exceed the duration of the emergency.
(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.
SEC. 4. Section 129690 is added to the Health and Safety Code, to read:129690. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any requirements of this division and accompanying regulations with respect to any health facility identified in Section 1250.(b) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.
SEC. 4. Section 129690 is added to the Health and Safety Code, to read:
### SEC. 4.
129690. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any requirements of this division and accompanying regulations with respect to any health facility identified in Section 1250.(b) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.
129690. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any requirements of this division and accompanying regulations with respect to any health facility identified in Section 1250.(b) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.
129690. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any requirements of this division and accompanying regulations with respect to any health facility identified in Section 1250.(b) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.
129690. (a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, the department may waive any requirements of this division and accompanying regulations with respect to any health facility identified in Section 1250.
(b) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the directors authority under any provision of this division.
SEC. 5. Section 10112.95 of the Insurance Code is amended to read:10112.95. (a) A health insurer shall provide an insured who has been displaced or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace insureds, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affect insureds or health care providers, as determined by the department, a health insurer operating in the county or counties included in the declaration shall file with the department a notification describing whether the insurer has experienced or expects to experience any disruption to the operation of the insurer, explaining how the insurer is communicating with potentially impacted insureds, and summarizing the actions the insurer has taken or is in the process of taking to ensure that the health care needs of insureds are met. This The department may require the insurer to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted insured to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an insured to replace medical equipment or supplies.(5) Allow an insured to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the insured is out of the area due to displacement.(6) Have a toll-free telephone number that an affected insured may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the commissioners authority under any provision of this part.(d) The director may issue guidance to insurers regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
SEC. 5. Section 10112.95 of the Insurance Code is amended to read:
### SEC. 5.
10112.95. (a) A health insurer shall provide an insured who has been displaced or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace insureds, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affect insureds or health care providers, as determined by the department, a health insurer operating in the county or counties included in the declaration shall file with the department a notification describing whether the insurer has experienced or expects to experience any disruption to the operation of the insurer, explaining how the insurer is communicating with potentially impacted insureds, and summarizing the actions the insurer has taken or is in the process of taking to ensure that the health care needs of insureds are met. This The department may require the insurer to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted insured to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an insured to replace medical equipment or supplies.(5) Allow an insured to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the insured is out of the area due to displacement.(6) Have a toll-free telephone number that an affected insured may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the commissioners authority under any provision of this part.(d) The director may issue guidance to insurers regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
10112.95. (a) A health insurer shall provide an insured who has been displaced or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace insureds, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affect insureds or health care providers, as determined by the department, a health insurer operating in the county or counties included in the declaration shall file with the department a notification describing whether the insurer has experienced or expects to experience any disruption to the operation of the insurer, explaining how the insurer is communicating with potentially impacted insureds, and summarizing the actions the insurer has taken or is in the process of taking to ensure that the health care needs of insureds are met. This The department may require the insurer to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted insured to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an insured to replace medical equipment or supplies.(5) Allow an insured to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the insured is out of the area due to displacement.(6) Have a toll-free telephone number that an affected insured may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the commissioners authority under any provision of this part.(d) The director may issue guidance to insurers regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
10112.95. (a) A health insurer shall provide an insured who has been displaced or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace insureds, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affect insureds or health care providers, as determined by the department, a health insurer operating in the county or counties included in the declaration shall file with the department a notification describing whether the insurer has experienced or expects to experience any disruption to the operation of the insurer, explaining how the insurer is communicating with potentially impacted insureds, and summarizing the actions the insurer has taken or is in the process of taking to ensure that the health care needs of insureds are met. This The department may require the insurer to take actions, including, but not limited to, the following:(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.(2) Extend filing deadlines for claims.(3) Suspend prescription refill limitations and allow an impacted insured to refill his or her their prescriptions at an out-of-network pharmacy.(4) Authorize an insured to replace medical equipment or supplies.(5) Allow an insured to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the insured is out of the area due to displacement.(6) Have a toll-free telephone number that an affected insured may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the commissioners authority under any provision of this part.(d) The director may issue guidance to insurers regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).
10112.95. (a) A health insurer shall provide an insured who has been displaced or otherwise affected by a state of emergency, as declared by the Governor pursuant to Section 8625 of the Government Code, or a health emergency, as declared by the State Public Health Officer pursuant to Section 101080, access to medically necessary health care services.
(b) Within 48 hours of a declaration by the Governor of a state of emergency that displaces or has the immediate potential to displace insureds, or a declaration by the State Public Health Officer of a health emergency that displaces, has the immediate potential to displace, or otherwise affect insureds or health care providers, as determined by the department, a health insurer operating in the county or counties included in the declaration shall file with the department a notification describing whether the insurer has experienced or expects to experience any disruption to the operation of the insurer, explaining how the insurer is communicating with potentially impacted insureds, and summarizing the actions the insurer has taken or is in the process of taking to ensure that the health care needs of insureds are met. This The department may require the insurer to take actions, including, but not limited to, the following:
(1) Relax time limits or suspend requirements for prior authorization, precertification, or referrals.
(2) Extend filing deadlines for claims.
(3) Suspend prescription refill limitations and allow an impacted insured to refill his or her their prescriptions at an out-of-network pharmacy.
(4) Authorize an insured to replace medical equipment or supplies.
(5) Allow an insured to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the insured is out of the area due to displacement.
(6) Have a toll-free telephone number that an affected insured may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.
(c) This section shall not be construed to limit the Governors authority under the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), or the commissioners authority under any provision of this part.
(d) The director may issue guidance to insurers regarding compliance with this section. This guidance shall not be subject to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).