AB 2601, as introduced, Morrell. California Health Benefit Exchange: appeals.
Existing law created the California Health Benefit Exchange (Exchange) as an independent public entity in the state government, not affiliated with an agency or department. The Exchange is governed by an executive board consisting of 5 members. Existing law requires the board to establish an appeal process for prospective and current enrollees of the Exchange that complies with all requirements of the federal Patient Protection and Affordable Care Act concerning the role of a state Exchange in facilitating federal appeals of Exchange-related determinations.
This bill would make technical, nonsubstantive changes to these provisions.
Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 100506 of the Government Code is
2amended to read:
(a) The board shall establish an appeals process for
2prospective and current enrollees of the Exchange that complies
3with all requirements of the federal act concerning the role of a
4state Exchange in facilitating federal appeals of Exchange-related
5determinations.begin delete In no event shall theend deletebegin insert Theend insert scope of those appeals
6begin insert shall notend insert be construed to be broader than the requirements of the
7federal actbegin insert in any eventend insert. Once the federal regulations concerning
8appeals have been
issued in final form by the United States
9Secretary of Health and Human Services, the board may establish
10additional requirements related to appeals, provided that the board
11determines, prior to adoption, that any additional requirement
12results in no cost to the General Fund and no increase in the charge
13imposed under subdivision (n) of Section 100503.
14(b) The board shall not be required to provide an appeal if the
15subject of the appeal is within the jurisdiction of the Department
16of Managed Health Care pursuant to the Knox-Keene Health Care
17Service Plan Act of 1975 (Chapter 2.2 (commencing with Section
181340) of Division 2 of the Health and Safety Code) and its
19implementing regulations, or within the jurisdiction of the
20Department of Insurance pursuant to the Insurance Code and its
21implementing regulations.
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