All Plan Letters

2025

APL 25-012 – Closure of Rite Aid Pharmacies (6/9/2025)

APL 25-011 – Health Plan Coverage of HIV Preexposure Prophylaxis (PrEP) (5/23/2025)

APL 25-010 – Sections 1357.503 and 1357.505 MEWA Registration and Annual Compliance Requirements (5/20/2025)

• DMHC 10-283 MEWA Registration Form

APL 25-009 – 2025 Health Plan Annual Assessments (4/15/2025)

APL 25-008 – Provider Directory Annual Filing Requirements (4/8/2025)

• Checklist For Health Care Service Plan Section 1367.27 Annual Filing (Provider Directories)
• MODEL Section 1367.27 Exhibit E-1

APL 25-007 – Assembly Bill 3275 Guidance (Claim Reimbursement) (4/1/2025)

APL 25-006 – Health Plan Coverage of Mobile Crisis Services (3/21/2025)

APL 25-005 – Southern California Fires and Flexibilities to Impacted Providers (3/19/2025)

APL 25-004 – AB 118: Part 1 – Compliance with Large Group Standardized Evidence of Coverage/Disclosure Form (3/10/2025)

• Attachment 1: Exclusions and Limitations
• Attachment 2: Members' Rights and Responsibilities
• Attachment 3: Definitions

APL 25-003 - Large Group Renewal Notice Requirements (2/5/2025)

APL 25-002 - Plan Year 2026 QHP, QDP, and Off-Exchange Filing Requirements (1/28/2025)

APL 25-001 - Southern California Fires and Enrollees’ Continued Access to Health Care Services (1/9/2025)

2024

APL 24-023 – Newly Enacted Statutes Impacting Health Plans (2024 Legislative Session) (12/20/2024)

APL 24-022 – Children and Youth Behavioral Health Initiatives, Certified Wellness Coaches (12/13/2024)

APL 24-021 – Notice of Amendments to Rules 1300.67.2.1, 1300.67.2 and Incorporated Documents – Network Adequacy Standards and Methodology for RY 2025 (12/12/2024)

• • Amendments to 28 CCR § 1300.67.2
  • New and amended documents incorporated by reference in 28 CCR § 1300.67.2:
    • Counseling Non-Physician Mental Health Ratio Standards and Methodology
      • • Attached: Schedules A - A6
    • Mental Health Geographic Access Standards and Methodology
      • • Attached: Schedule B
    • Counseling Non-Physician Mental Health Professionals Accepting New Patients Standards and Methodology
      • • Attached: Schedule C
    • Specialist Physician Ratio Standards and Methodology
      • • Attached: Schedules D - D6
        • RY 2025 Combined County Modifier - Thresholds for Eligibility
    • Specialist Physician Geographic Access Standards and Methodology
      • • Attached: Schedule E
    • Primary Care Physician Accepting New Patients Standards and Methodology
      • • Attached: Schedule F
    • Required Network Provider Types
    • Adjacent Counties and Exceptions for RY 2025 Standards and Methodology
  • Amendments to 28 CCR § 1300.67.2.1
  • Frequently Asked Questions (FAQ)
  • Specialist Physician Standards – Summary Tables for RY 2025
  • Mental Health Standards - Summary Tables for RY 2025

APL 24-020 – RY 2026/MY 2025 Provider Appointment Availability Survey Manual and Report Form Amendments (11/13/2024)

• APL 24-020 Notice of Errata (1/24/2025)
• PAAS Manual – Notice of Changes for RY 2026/MY 2025:
  • PAAS Manual for RY 2026/MY 2025 – Track Changes
  • PAAS Manual for RY 2026/MY 2025 – Clean
• Timely Access Submission Instruction Manual – Notice of Changes for RY 2026/MY 2025:
  • Timely Access Submission Instruction Manual for RY 2026/MY 2025 – Track Changes
  • Timely Access Submission Instruction Manual for RY 2026/MY 2025 – Clean
• PAAS Report Forms – Notice of Changes for RY 2026/MY 2025 (See Notice of Errata (1/24/2025))

APL 24-019 - Amendments to Rule 1300.67.2.2 and the Incorporated Annual Network Submission IM and Report Forms for RY 2025 (10/30/2024)

• Amendments to Rule 1300.67.2.2 – With edits
• Annual Network Submission Instruction Manual – Notice of Changes for RY 2025 – With edits
• Annual Network Submission Instruction Manual – Notice of Changes for RY 2025 – Clean
• Annual Network Report Forms - Notice of Changes for RY 2025 - With edits:
  • • Network Service Area and Enrollment Report Form (Form No. 40-265)
    • PCP and PCP Non-Physician Medical Practitioner Report Form (Form No. 40-266)
    • Specialist and Specialist Non-Physician Medical Practitioner Report Form (Form No. 40-267)
    • Mental Health Professional and Mental Health Facility Report Form (Form No. 40-268)
    • Other Outpatient Provider Report Form (Form No. 40-269)
    • Hospital and Clinic Report Form (Form No. 40-270)
    • Telehealth Report Form (Form No. 40-271)
    • Timely Access and Network Adequacy Grievance Report Form (Form No. 40-272)
    • Out-of-Network Payment Report Form (Form No. 40-273)
    • Third-Party Corporate Telehealth Provider Report Form (Form No. 40-274)
    • Non-Network Arrangements Report Form (Form No. 40-287)
• Frequently Asked Questions for Regulatory Amendments Impacting the RY 2025 Annual Network Report Submission

APL 24-018 –  Compliance with Senate Bill 923 (8/15/2024)

APL 24-017 – RY 2025/MY 2024 Provider Appointment Availability Survey NPMH Provider Follow-Up Appointment Rate of Compliance (7/31/2024)

• Amendments to Rule 1300.67.2.2

APL 24-016 – Request for Health Plan Contact Information (7/25/2024)

APL 24-015 – High Deductible Health Plan Products and Coverage of COVID-19 Testing (7/22/2024)

APL 24-014 – Guidance Regarding Dental Rate Review Reporting Requirements (7/8/2024)

• Dental Rate Review Guidance (7/1/2024)
• Dental Rate Review Workbook (7/1/2024)

APL 24-013 – Health Equity and Quality Program Policies and Requirements (6/28/2024)

• MY 2023 HEQMS Reporting Table (6/28/2024)
• MY 2024 HEQMS Reporting Table (6/28/2024)
• Health Equity and Quality Program Submission Instructions (Revised 10/24/2024)
• Health Equity and Quality FAQs (6/28/2024)

APL 24-012 – Single Point of Contact for Hospitals to Request Authorization for Poststabilization Care (6/25/2024)

APL 24-011 – Request for Health Plan Information and Addendum Revisions (6/17/2024)

• RHPI Revised (6/17/2024)
• RHPI Addendum SB 855 (6/17/2024)

APL 24-010 – Coverage of Ground Ambulance Services Provided by a Noncontracted Provider (6/13/2024)

APL 24-009 – Change Healthcare Cyberattack Response Filing (5/6/2024)

APL 24-008 – 2024 Health Plan Annual Assessments (4/15/2024)

APL 24-007 – Implementation of Senate Bill 855 Regulation, Mental Health and Substance Use Disorder Coverage (4/3/2024)

APL 24-006 – Provider Directory Annual Filing Requirements (3/20/2024)

• MODEL Section 1367.27 Exhibit E-1 (3/20/2024)

APL 24-005 – Change Healthcare Cyberattack (3/11/2024)

APL 24-004 – Coverage of Over-the Counter FDA Approved Contraceptives (2/22/2024)

APL 24-003 – Plan Year 2025 QHP, QDP, and Off-Exchange Filing Requirements (1/29/2024)

APL 24-002 – Large Group Renewal Notice Requirements (1/22/2024)

APL 24-001 – Amendment to Rule 1300.71.31 regarding calculation of the “Average Contracted Rate” for AB 72 (2016) purposes (1/12/2023)

2023

APL 23-029 – Health Equity and Quality Measure Set Benchmark – REVISED (5/13/2024)

• Health Equity and Quality FAQs (9.29.2023) – REVISED (5/13/2024)

APL 23-029 – Health Equity and Quality Measure Set Benchmark (12/27/2023)

APL 23-028 (OPM) – RY 2025/MY 2024 Provider Appointment Availability Survey Manual and Report Form Amendments (12/22/2023)

• APL 23-028 Notice of Errata (2/13/2024)

Rule 1300.67.2.2 – Notice of Changes:

• Amendments to Rule 1300.67.2.2 – Track Changes

PAAS Manual – Notice of Changes for RY 2025/MY 2024:

• PAAS Manual for Reporting Year (RY) 2025/Measurement Year (MY) 2024 – Track Changes
• PAAS Manual for Reporting Year (RY) 2025/Measurement Year (MY) 2024 – Clean

Timely Access Submission Instruction Manual – Notice of Changes for RY 2025/MY 2024:

• Timely Access Submission Instruction Manual for Reporting Year (RY) 2025/Measurement Year (MY) 2024 – Track Changes
• Timely Access Submission Instruction Manual for Reporting Year (RY) 2025/Measurement Year (MY) 2024 – Clean

PAAS Report Forms – Notice of Summary of Changes for RY 2025/MY 2024:

• Primary Care Providers Contact List Report Form (Form No. 40-254) – Summary of Changes
• Non-Physician Mental Health Care Providers Contact List Report Form (Form No. 40-255) – Summary of Changes
• Specialist Physicians Contact List Report Form (Form No. 40-256) – Summary of Changes
• Psychiatrists Contact List Report Form (Form No. 40-257) – Summary of Changes
• Ancillary Service Providers Contact List Report Form (Form No. 40-258) – Summary of Changes
• Primary Care Providers Raw Data Report Form (Form No. 40-259) – Summary of Changes
• Non-Physician Mental Health Care Providers Raw Data Report Form (Form No. 40-260) – Summary of Changes
• Specialist Physicians Raw Data Report Form (Form No. 40-261) – Summary of Changes
• Psychiatrists Raw Data Report Form (Form No. 40-262) – Summary of Changes
• Ancillary Service Providers Raw Data Report Form (Form No. 40-263) – Summary of Changes
• Results Report Form (Form No. 40-264) – Summary of Changes

APL 23-027 – Hospitalization Surge in Fresno County (12/21/2023)

APL 23-026 – Compliance with Health and Safety Code Section 1374.722 and the Children and Youth Behavioral Health Initiative (12/20/2023)

APL 23-025 – Newly Enacted Statutes Impacting Health Plans (2023 Legislative Session) - REVISED (2/7/2024)

APL 23-025 – Newly Enacted Statutes Impacting Health Plans (2023 Legislative Session) (12/20/2023)

APL 23-024 Request for Health Plan Information Addendum – Additional Questions Section Added (12/19/2023)

• Request for Health Plan Information (RHPI) Addendum Form

APL 23-023 – Network Adequacy Requirements and Mental Health Standards and Methodology for RY 2024 (12/14/23)

• APL 23-023 Notice of Errata (01/12/2024)
  • Amendments to 28 CCR 1300.67.2
  • Documents incorporated by reference in 28 CCR § 1300.67.2:
    • Geographic Access Measurement Methodology
    • Counseling Non-Physician Mental Health Ratio Standards and Methodology
      • Attached: Schedules A - A6
    • Mental Health Geographic Access Standards and Methodology
      • Attached: Schedule B
    • Counseling Non-Physician Mental Health Professionals Accepting New Patients Standards and Methodology
      • Attached: Schedule C
  • Amendments to 28 CCR § 1300.51(d), Item H
  • Frequently Asked Questions (FAQ)
  • Mental Health Standards – Summary Tables for RY 2024

APL 23-022 – Compliance with Senate Bill 1419 (2022) – Health Information (12/13/23)

APL 23-021 – Payment of COVID Claims for COVID-19 Tests Delivered between March 4, 2020 and December 31, 2021 (11/14/2023)

APL 23-020 – Amendments to Rule 1300.67.2.2 and the Incorporated Annual Network Submission Instruction Manual and Annual Network Report Forms for Reporting Year 2024 (10/26/2023)

• APL 23-020 Notice of Errata (02/13/2024)

• Amendments 1300.67.2.2
• Annual Network Submission Instruction Manual for Reporting Year (RY) 2024 (Clean)
• Annual Network Submission Instruction Manual for Reporting Year (RY) 2024 (Track Changes)
• Hospital And Clinic Report Form (Form. No. 40-270) – Summary of Changes
• Mental Health Professional and Mental Health Facility Report Form (Form. No. 40-268) – Summary of Changes
• Network Service Area and Enrollment Report Form (Form. No. 40-265) – Summary of Changes
• Other Outpatient Provider Report Form (Form. No. 40-269) – Summary of Changes
• Out-Of-Network Payment Report Form (Form. No. 40-273) – Summary of Changes
• PCP and PCP Non-Physician Medical Practitioner Report Form (Form. No. 40-266) – Summary of Changes
• Specialist and Specialist Non-Physician Medical Practitioner Report Form (Form. No. 40-267) – Summary of Changes
• Telehealth Report Form (Form. No. 40-271) – Summary of Changes
• Third-Party Corporate Telehealth Report Form (Form. No. 40-274) – Summary of Changes
• Timely Access and Network Adequacy Grievance Report Form (Form. No. 40-272) – Summary of Changes

APL 23-019 - Health Plan Expansion for Medicare Medi-Cal Plans (9/21/2023)

• Cal MediConnect Transition to Medicare Medi-Cal Plans Checklist
• New Medicare Medi-Cal Plans Product and Benefit Expansion Filings Checklist

APL 23-018 - RY 2024/MY 2023 PAAS NPMH Provider Follow-Up Appointment Initial Performance Target for Corrective Action (8/17/2023)

• APL 23-018 Notice of Errata (10/4/2023)

APL 23-017 - Impact of the end of federal Public Health Emergency on health plan coverage of COVID-19 tests, immunizations, and therapeutics (7/21/2023)

APL 23-016 – Implementation of SB 1338 (2022) - Community Assistance, Recovery, and Empowerment (CARE) (6/29/2023)

APL 23-015 - Supplemental Provider Directory Annual Filing Requirements (2023) (5/16/2023)

APL 23-014 - Health Care Service Plans Are Mandatory Signatories to the CalHHS Data Exchange Framework - REVISED (5/19/2023)

APL 23-014 - Health Care Service Plans Are Mandatory Signatories to the CalHHS Data Exchange Framework (4/24/2023)

APL 23-013 – Large Group Coverage of Association Health Plans: Extension of Phase Out and Guidance (4/20/2023)

APL 23-012 - 2023 Health Plan Annual Assessments (4/17/2023)

APL 23-011 – Annual Segregation Fund Report Requirements (4/10/2023)

• Exhibit FF-6 AB 2205 Annual Segregation Fund Report (3/7/2023)

APL 23-010 – Coverage of Misoprostol-Only Abortion Care (4/10/2023)

APL 23-009 – Health Plan Coverage of Preventive Services (3/30/2023)

APL 23-008 – Health Plan Requirements to Timely Pay Claims (3/24/2023)

APL 23-007 – Provider Directory Annual Filing Requirements (3/23/2023)

• MODEL Section 1367.27 Exhibit E-1 (2023)

APL 23-006 – Independent Medical Review (IMR) Application/Complaint Form (DMHC 20-224) (2/24/2023)

APL 23-005 – Network Service Area Confirmation Process (2/13/2023)

APL 23-004 – Plan Year 2024 QHP, QDP, and Off-Exchange Filing Requirements (2/6/2023)

APL 23-003 – AB 1982 Telehealth: Dental Care (1/24/2023)

APL 23-002 - Senate Bill 979 – Health Emergencies Guidance (1/12/2023)

APL 23-001 - Large Group Renewal Notice Requirements (1/5/2023)

2022

APL 22-032 – Compliance with Senate Bill 1473 (2022) (12/27/2022)

APL 22-031 - Newly Enacted Statutes Impacting Health Plans – 2022 Legislative Session (12/22/2022)

APL 22-030 – Requirement for Plans to “Arrange for” Covered Services (12/22/2022)

APL 22-029 – RY 2024 MY 2023 Provider Appointment Availability Survey Manual and Report Form Amendments (12/21/2022)

• RY 2024 MY 2023 PAAS Manual
• RY 2024 MY 2023 PAAS Report Form Instructions

APL 22-028 – Health Equity and Quality Measure Set and Reporting Process (12/21/2022)

• Health Equity and Quality FAQs (9/29/2023)

APL 22-027 – Timely Access to Emergent and Urgent Services When an Enrollee is Outside of California (11/7/2022)

APL 22-026 - Implementation of TA Regulation Amendments (11/4/2022)

APL 22-025 – Health Plan Requirements to File Annual Antifraud Report (11/1/2022)

APL 22-024 – New and Amended Annual Network Report Forms for Reporting Year 2023, Resulting from SB 221 and AB 457 (10/27/2022)

• Mental Health Professional and Mental Health Facility Report Form (Form No. 40-268) Instructions
• Mental Health Professional and Mental Health Facility Report Form (Form No. 40-268) Instructions (With Track Changes)
• Telehealth Report Form (Form No. 40-271) Instructions
• Telehealth Report Form (Form No. 40-271) Instructions (With Track Changes)
• Third-Party Corporate Telehealth Provider Report Form Instructions

APL 22-023 – Summary of Dental Benefits and Coverage Disclosure Matrix (10/27/2022)

APL 22-022 – AB 72 Non-Emergency Transportation (10/26/2022)

APL 22-021 – Quarterly Grievance Reports - REVISED (11/8/2022)

APL 22-021 – Quarterly Grievance Reports (10/11/2022)

APL 22-020 – HC Notice of Rate Changes for Independent Medical Reviews (10/10/2022)

APL 22-019 – Health Plan Coverage of Monkeypox Testing, Vaccinations, and Therapeutics (10/6/2022)

APL 22-018 – Fiscal Year 2022-23 Health Plan Annual Assessments (7/11/2022)

APL 22-017 – Coverage of COVID-19 Therapeutics (6/14/2022)

APL 22-016 – National Infant Formula Shortage (6/10/2022)

APL 22-015 – Financial Reporting Regulation (5/31/2022)

APL 22-014 – Senate Bill 510 COVID-19 Testing and Vaccination Coverage Guidance (4/25/2022)

APL 22-013 – Compliance with Senate Bill 368 - Revised (10/10/2022)

APL 22-012 – Section 1357.503 Compliance and MEWA Registration (3/24/2022)

• DMHC 10-283 MEWA Registration Form (5/20/2025)

APL 22-011 – No Surprises Act (NSA) Guidance 3/21/2022

APL 22-010 – Guidance Regarding AB 1184 - Confidentiality of Medical Information (3/17/2022)

APL 22-009 – Provider Directory Annual Filing Requirements (3/16/2022)

• Model Section 1367.27 Exhibit E-1

APL 22-008 – 2022 Annual Assessments (3/9/2022)

APL 22-007 – DPN Monitoring and Annual Reporting Changes (3/4/2022)

APL 22-006 – Plan Year 2023 QHP and QDP Filing Requirements (2/1/2022)

APL 22-005 – Federal Requirement to Cover At-Home COVID-19 Tests Purchased Over-the-Counter (1/25/2022)

APL 22-004 – Assembly Bill 347 Step Therapy Exception Coverage Guidance (1/21/2022)

APL 22-003 – Assembly Bill 457 Protection of Patient Choice in Telehealth Provider Act (1/21/2022)

APL 22-002 – Hospital Block Transfer Filings for PPO Enrollees (1/19/2022)

APL 22-001 – Large Group Renewal Notice Requirements (1/4/2022)

2021

APL 21-025 – Newly Enacted Statutes Impacting Health Plans (12/20/2021)

APL 21-024 – Risk-Bearing Arrangement Disclosures (11/17/2021)

APL 21-023 – Flu Vaccines; Preparation for COVID-19 Vaccines (11/1/2021)

APL 21-022 – Continued Applicability of COVID-19 Requirements (10/26/2021)

APL 21-021 – Transfer of Hospitalized Enrollees per Regulation Section 1300.67.02 (8/17/2021)

APL 21-020 – Continued Coverage of COVID-19 Diagnostic Testing (7/26/2021)

APL 21-019 – Guidance Regarding Assembly Bill (AB) 2118 Reporting Requirements (7/13/2021)

• AB 2118 Guidance
• Individual Annual Aggregate Rate Workbook
• Small Group Annual Aggregate Rate Workbook

APL 21-018 – Preventive Coverage for HIV Preexposure Prophylaxis (7/6/2021)

APL 21-017 – Large Group Renewal Notice Requirements (7/6/2021)

APL 21-016 – Continued Coverage of COVID-19 Diagnostic Testing (6/7/2021)

APL 21-015 – Block Transfer Portal Updates (6/7/2021)

APL 21-014 – COVID-19 Vaccinations for Homebound Enrollees (5/3/2021)

APL 21-013 – 2021 Annual Assessments (4/1/2021)

APL 21-012 – COVID-19 Vaccine Prioritization (3/12/2021)

• Follow-up Email to Plans Regarding APL 21-012 (3/24/2021)

APL 21-011 – New Federal Guidance Regarding COVID-19 Testing (3/10/2021)

APL 21-010 – Provider Directory Annual Filing Requirements (3/4/2021)

• MODEL Section 1367.27 Annual Filing Exhibit E-1

APL 21-009 – Dental Plan Reporting Regarding Network Stability - REVISED (2/16/2021)

• Dental Reporting Template for Dental Network Stability - REVISED
• Dental Practice Sale or Closure Report Template

APL 21-008 – Special Enrollment Period; Coverage Effective Dates (1/28/2021)

APL 21-007 – Dental Plan Reporting Regarding PPE and Related Support to Providers (1/26/2021)

APL 21-006 – Dental Plan Reporting Regarding Network Stability (1/26/2021) SUPERSEDED BY APL 21-009

APL 21-005 – Plan Year 2022 QHP and QDP Filing Requirements (1/15/2021)

APL 21-004 – Transfer of Unstable or Destabilized Enrollees (1/6/2021)

APL 21-003 – Transfer of Enrollees Per State Public Health Officer Order (1/6/2021)

APL 21-002 – Implementation of SB 855, MH/SUD Coverage (1/5/2021)

APL 21-001 – Model Notices; Compliance with SB 260 (1/5/2021)

2020

APL 20-043 – Health Plan Reporting Regarding PPE and Related Support to Providers (12/16/2020)

• Exhibit E-1 Health Plan Support Regarding COVID-19 Supplies
• Exhibit E-1 Form II.A.
• Exhibit E-1 Form II.B.

APL 20-042 - Removal of Administrative Burdens on Hospitals (12/16/2020)

APL 20-041 - Newly Enacted Statutes Impacting Health Plans (12/15/2020)

APL 20-040 - Network Stability - REVISED (1/28/2021)

APL 20-040 - Network Stability (12/14/2020)

• Template APL Priority Practice Report
• Template APL Sale or Closure Report

APL 20-039 - COVID-19 Vaccine Coverage (12/11/2020)

APL 20-038 - General Licensure Regulation 3rd Phase-In Period (12/3/2020)

APL 20-037 - Vaccinations; Coverage and Flexibility (10/14/2020)

APL 20-036 - Large Group Renewal Notice Requirements (10/9/2020)

APL 20-035 - Medi-Cal Pharmacy Benefit Carve Out - Medi-Cal Rx (10/6/2020)

APL 20-034 - Updated COVID-19 Screening and Testing (9/23/2020)

APL 20-033 - Implementation of Emergency Regulation Regarding COVID-19 Diagnostic Testing (9/18/2020)

APL 20-032 - Continuation of DMHC's All Plan Letters Regarding Telehealth (9/4/2020)

APL 20-031 - Association Health Plans Extension of Phase-Out Period (8/21/2020)

APL 20-030 - State of Emergency due to Extreme Weather and Wildfires (8/19/2020)

APL 20-029 - Extension of Special Enrollment Period to August 31, 2020 (7/31/2020)

APL 20-028 - Emergency Regulation Regarding COVID-19 Diagnostic Testing (7/23/2020)

APL 20-027 - Guidance Regarding Assembly Bill (AB) 731 (7/13/2020)

• AB 731 Large Group Guidance (7/13/2020)
• Individual and Small Group Guidance (7/13/2020)
• AB 731 LG Methodology Workbook (7/13/2020)
• Individual and Small Group Workbook (7/13/2020)

APL 20-026 - Preventive Health Services Coverage for HIV Preexposure Prophylaxis (PrEP) (7/8/2020)

APL 20-025 - Guidance Regarding New or Innovative Benefits (7/1/2020)

APL 20-024 - AB 315 Reporting Requirements (6/26/2020)

• AB 315 Pilot Project Template (6/26/2020)

APL 20-023 - Extension of Special Enrollment Period in APL 20-010 (6/23/2020)

APL 20-022 - Compliance with California nondiscrimination requirements (6/15/2020)

APL 20-021 - Governor's State of Emergency in Los Angeles County (6/1/2020)

APL 20-020 - Network Adequacy and Unnecessary Burdens on Providers (5/20/2020)

APL 20-019 - Association Health Plans Extension of "Phase-Out" Period (5/5/2020)

APL 20-018 - Modification of Timely Access PAAS Timeframes (4/29/2020)

APL 20-017 - General Licensure Regulation (4/16/2020)

APL 20-016 - Assistance to Seniors (4/15/2020)

APL 20-015 - COVID-19 Temporary Extension of Plan Deadlines (4/13/2020)

APL 20-014 - Mitigating Negative Health Outcomes due to COVID-19 (4/7/2020)

APL 20-013 - Telehealth Services (4/7/2020)

APL 20-012 - Health Plan Actions to Reach Vulnerable Populations (3/27/2020)

APL 20-011 - 2020 Annual Assessment Letter (3/26/2020)

APL 20-010 - Special Enrollment Period and Coverage Effective Dates (3/21/2020)

APL 20-009 - Reimbursement for Telehealth Services (3/18/2020)

APL 20-008 - Provision of Health Care Services During Self Isolation Orders (3/18/2020)

APL 20-007 - “Social Distancing” Measures in Response to COVID-19 (3/12/2020)

APL 20-006 - COVID-19 Screening and Testing (3/5/2020)

APL 20-005 - Plan Year 2021 QHP and QDP Filing Requirements (2/7/2020)

APL 20-004 - Federal SBC Template Filing (2/7/2020)

APL 20-003 - Provider Directory Annual Filings 2020 (1/24/2020)

APL 20-002 - Enrollment Data Reporting (1/21/2020)

• MEWA and Exchange Enrollment Instructions and Forms (1/16/2020)

APL 20-001 - Newly Enacted Statutes Impacting Health Plans (1/15/2020)

2019

APL 19-024 - Association Health Plans (12/9/2019)

APL 19-023 - Standard Prescription Drug Formulary Template (12/4/2019)

APL 19-022 - Governor's Proclamation of a Statewide State of Emergency (10/28/2019)

APL 19-021 - Governor's Proclamation of a State of Emergency (10/25/2019)

APL 19-020 - Guidance for Sec. 1365 Cancellation Regulations (10/21/2019)

APL 19-019 - Requirements Pursuant to SB 546 (Leno, 2015): Large Group Renewal Notice Requirements (10/14/2019)

APL 19-018 - Governor's Proclamation of a State of Emergency Due to Fires in Los Angeles and Riverside Counties (10/14/2019)

APL 19-017 - Requirements Pursuant to AB 315 Pharmacy Benefit Management (10/11/2019)

• DMHC 10-242 PBM Registration Form

APL 19-016 - Amendment to the Risk Bearing Organization Regulations (9/6/2019)

APL 19-015 - Governor's Declarations of Emergency in Kern and San Bernardino Counties - Ridgecrest Earthquakes (7/8/2019)

APL 19-014 - Guidance Regarding General Licensure Regulation (6/14/2019)

• DMHC 10-239 (Rev: 7/19) - Request for Expedited Exemption Form
• DMHC 10-238 (Rev: 7/19) - Request for Confidentiality Form

APL 19-013 - Block Transfer Enrollee Transfer Notices (6/13/2019)

APL 19-012 - AB 72 Policy and Procedures (6/4/2019)

APL 19-011 - QIF Plan Regulatory Requirements (5/9/2019)

APL 19-010 - Introduction of a New Independent Review Organization (4/3/2019)

APL 19-009 - 2019 Annual Assessment (3/29/2019)

APL 19-008 - Timely Access Compliance Reports MY 2019 (3/8/2019)

APL 19-007 - Governor's Declarations of Emergency (2/28/2019)

APL 19-006 - Clinical Quality Improvement (2/15/2019)

APL 19-005 - Plan Year 2020 QHP and QDP Filing Requirements - REVISED (3/22/2019)

APL 19-005 - Plan Year 2020 QHP and QDP Filing Requirements (1/24/2019)

APL 19-004 - Telehealth and Teledentistry Sample Questions (1/23/2019)

APL 19-003 - SB 137 Guidance Regarding Provider Directory Annual Filings (1/14/2019)

APL 19-002 - Newly Enacted Statutes Impacting Health Plans (1/11/2019)

APL 19-001 - Health Plan Profile Webinars - REVISED (1/25/2019)

APL 19-001 - Health Plan Profile Webinars (1/11/2019)

2018

APL 18-020 - Electrical Shutdown Preparation - Friday November 30th (11/29/2018)

APL 18-019 - State of Emergency due to Fires (Butte, LA, Ventura) (11/9/2018)

APL 18-018 - 2019 SB 137 Annual Implementation (11/1/2018)

APL 18-017 - SB 546 Implementation (10/5/2018)

APL 18-016 - Communication between the Help Center and Health Plans (9/12/2018)

APL 18-015 - Requirements for Medi-Cal Health Home program (8/23/2018)

APL 18-014 - States of Emergency Due To Wild Fires (8/15/2018)

APL 18-013 - Independent Medical Review (IMR)/Complaint Form (8/1/2018)

APL 18-012 - State of Emergency Due to Fires in Riverside and Shasta Counties (7/27/2018)

APL 18-011 - SB 17 Prescription Drug Cost Requirements (7/27/2018)

APL 18-010 - Update on Plan Compliance with MHPAEA Rules (7/6/2018)

APL 18-009 - Responding to Help Center RHPIs (5/3/2018)

APL 18-008 - AB 72 Delegated Entity Report (3/23/2018)

APL 18-007 - Confidentiality of Information Submitted to Office of Plan Licensing (2/20/2018)

APL 18-006 - 2018 Annual Assessment (2/16/2018)

APL 18-005 - Administrative Services Agreement (ASA) Checklist (1/30/2018)

APL 18-004 - Unified Billing (1/26/2018)

APL 18-003 - Plan Year 2019 QHP/QDP Filing Requirements (1/19/2018)

APL 18-002 - Timely Access Compliance Reports MY 2018 (1/19/2018)

APL 18-001 - Newly Enacted Statutes Impacting Health Plan License Filings (1/5/2018)

2017

APL 17-017 - Standard for Determining Emergency (12/19/2017)

APL 17-016 - State of Emergency Due to Fires in Ventura & LA Counties (12/7/2017)

APL 17-015 - SB 137 Guidance Regarding Provider Directory Annual Filings (11/1/2017 and 1/18/2018)

APL 17-014 - SB 546 Implementation – Large Group Renewal Notice Requirements (10/30/2017)

APL 17-013 - State of Emergency Due to Northern CA Fires (10/9/2017 & 10/10/2017)

APL 17-012 - Compliance With SB 908’s Requirements (9/22/2017)

APL 17-011 - Guidance Regarding AB 72 and Notice to Enrollees (7/12/2017)

APL 17-010 - QHP Guidance Regarding Silver & Dual Rates (7/10/2017 & 7/13/2017 & 7/21/2017)

APL 17-009 - Guidance Regarding AB 72 and Notice to Enrollees (7/3/2017)

APL 17-008 - Filing EHB Worksheets (5/9/2017)

APL 17-007 - Timely Access Compliance Reports Measurement Years 2016 & 2017 (4/7/2017)

APL 17-006 - Newly Enacted Statutes and Regulations (3/2/2017)

APL 17-005 - 2018 DMHC Checklist and Attachment for QDPs (2/23/2017)

APL 17-004 - 2018 DMHC Checklist and Worksheet for QHPs (2/23/2017 & 6/20/2017)

APL 17-003 - Oroville Dam State of Emergency and Evacuations (2/13/2017)

APL 17-002 - Timely Access Compliance Reports – MY 2016 & MY 2017 (2/13/2017)

APL17-001 - Federal Summary of Benefits and Coverage Template Filing (2/7/2017)

2016

Uniform Provider Directory Standards HSC Section 1367.27(k) (12/30/2016)

SB 137 Annual Reporting (11/1/2016)

Exhibit W-13 Health Plan Provider Dispute Contacts (10/25/2016)

Exemption Order Concerning Dental Plans Mirror Requirement (10/18/2016)

SB 546 - Large Group Renewal Notices for 2017 (10/7/2016)

SB 546 Director's Letter No 8-K Revised (9/2/2016 & 9/7/2016)

Section 1367.27 EAP Compliance (8/18/2016 and 10/4/2016)

AB 248 Large Group Market Minimum Value (5/2/2016)

DMHC Provider Directory Filing and FAQs (4/15/2016)

SBX2 MCO Tax Proposal - Data Regarding CDI Affiliates (4/5/2016)

DMHC Provider Directory Checklist and Worksheet (3/16/2016)

New Independent Medical Review Application - Complaint Form Translations (2/5/2016)

2015

AB 684 Workload Data Call (12/21/2015)

New Independent Medical Review Application - Complaint Form (12/10/2015)

AB 1305 Compliance (11/16/2015)

Exemption Order Concerning Dental Plans Mirror Requirement (10/20/2015)

Rule 1300.65 Compliance (9/18/2015)

Final Implementation of MHPAEA Compliance (7/17/2015 & 8/7/2015)

2016 SBD Bronze Design & Prescription Drug End Notes (6/9/2015)

Individual and Small Group Rates (5/7/2015 and 5/29/2015)

Health and Safety Code Section 1365.5 Compliance (2/5/2015)