An Opportunity to Get Better Timely Access to Care Regulations in California

[courtesy of California Progress Report]

And a Lesson in Civics on the process of rulemaking

By Hanh Kim Quach
Health Care Policy Coordinator
Health Access California

While we glow (and gloat) about how the Department of Managed Health Care's regulations on timely access to care were returned to them earlier this week -- without approval -- by the Office of Administrative Law, we also want to take the opportunity to talk about the obscure process in state government called rulemaking.

I'll strongly note here that the OAL's refusal to finalize DMHC's proposed Timely Access regulations had nothing to do with how miserable the regulations actually were. Office of Administration Law merely dinged DMHC because they did not follow the proper waiting periods and rules -- (hey, we'll take our wins where we can get them). This is an important point as we embark on a second year of rulemaking for Timely Access to Health Care standards.

First, I want to point everyone to the Office of Administrative Law's handy dandy lay person's guide on How to Participate in the rulemaking process.

Secondly, some context. Here's how the Timely Access regulations came to be:

January 1, 2003: AB 2179 (Cohn) takes effect, requiring the state to adopt regulations to ensure that enrollees have "timely access to needed health care services.'' (Timely access means reasonable waiting times for appointments with physicians, quick and timely care when a patient is sick or needs services, etc. )

January 1, 2004: The date by which DMHC was supposed to have adopted regulations.

July 9, 2004: DMHC begins writing regulations, but withdraws them in April 2005 because of feared "unintended consequences" and restarts discussions with various parties, including insurers, providers and consumers on how to craft the rules.

January 11, 2007: DMHC reopens the rulemaking process with Office of Administrative Law on this date; the department has 365 days from this date to complete the regulations.