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California DMHC Licensure Regulation

Event Date:5/20/2019

Event Overview

Monday, May 20, 2019
1:00 PM CDT – 2:00 PM CDT (60 minutes)

This event is hosted on our ReadyTalk platform

 

California's Department of Managed Health Care (DMHC) introduced new regulations to ensure that current provider compensation models are financially sound.  The regulations go into effect July 1, 2019.

This discussion is designed specifically for Alliance members doing business in California.  Other Alliance members may be interested because their state is considering similar requirements or members may simply want to be aware of developments.

Impacted arrangement include:

  • Capitation
  • Risk Pools - sharing in surpluses or loss
  • Per diem (unclear)
  • DRG (unclear)

Excluded arrangements

  • Medicare ACOs (unclear)
  • Contracts with insurers regulated by CIO (unclear)

The Sheppard Mullin team have been monitoring the regulations.  They will share their understanding of the requirements and actions plans you should be taking.  Alliance members will have opportunity to ask questions and seek clarification as well as share their action steps.

 

Audience

Executives in health plans doing business in California, including CEOs, CFOs, provider contracting/network managers, and chief legal counsel.


Ask your peers a question or share a resource anytime through the Alliance discussion forum

You can visit the discussion forum and post a question anytime. It's only available to Alliance members, so you question is private and secure. When submitting a question, you can select which topics your question is related to, such as "risk adjustment" or "coding". Individuals who have indicated in their Alliance profile they are interested in those topics and are opted in to discussion forum emails will receive your question. You can also add an attachment to your question or reply, making this tool another great resource for sharing best practices with your peers.

 


 

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Register now for these upcoming events

View the presentation materials from these recent events

 

Documents
  • 5/20/2019
  • Presentation: Knox-Keene Licensure & the Assumption of Global Risk
  • Sheppard Mullin presents on the Knox-Keene License and the assumption of global risk and DMHC's new approach. Although designed specifically for Alliance members doing business in California, other Alliance members may be interested because their state is considering similar requirements or members may simply want to be aware of developments.
  • 5/20/2019
  • Recording: California DMHC Licensure Regulation
  • Sheppard Mullin presents on the Knox-Keene License and the assumption of global risk and DMHC's new approach. Although designed specifically for Alliance members doing business in California, other Alliance members may be interested because their state is considering similar requirements or members may simply want to be aware of developments.
Attendees

Below is a list of all delegates registered to date for this event

  • Danielle Bailey
  • ALLIANCE MEMBER
  • Manager, Commercial Compliance at Sharp Health Plan
  • Ngoc Bui-Tong
  • ALLIANCE MEMBER
  • Director of Health Care Economics at Santa Clara Family Health Plan
  • Dave Gioia
  • ALLIANCE MEMBER
  • Senior Attorney, Legal at Western Health Advantage
  • Vaish Katarey
  • ALLIANCE MEMBER
  • Commercial Compliance Project Coordinator at Sharp Health Plan
  • Leslie Pels-Beck
  • ALLIANCE MEMBER
  • Chief Operations Officer at Sharp Health Plan
  • Daniel Quan
  • ALLIANCE MEMBER
  • Compliance Officer at Chinese Community Health Plan
  • Jean Rao
  • ALLIANCE MEMBER
  • Pharmacy Manager at Chinese Community Health Plan
  • Annie Shieh
  • ALLIANCE MEMBER
  • Senior Compliance Counsel at Central Health Plan of California
  • Erica Stanley
  • ALLIANCE MEMBER
  • Compliance Lead- Delegation/Oversight at Sharp Health Plan
  • Jordan Yamashita
  • ALLIANCE MEMBER
  • Director of Compliance at Santa Clara Family Health Plan
Speakers