Anthem and Oscar plans have decided to expand their covered area’s starting 2021. However, doing so will also increase the cost of plans. Anthem is doing a 6% increase and Oscar is increasing slightly more with 7.6%. Some other plans like Blue Shield are experiencing a 2.4% decrease; along with LA Care also decreasing by 4.6%
The Covid-19 pandemic has impacted less than projected in California. While insurances did see an impact from Covid-19 testing, there was a greater impact due to telehealth needs and services. So, for the second consecutive year, the Golden State is below the projected policy rate increase. These historically low changes are in part due to the effort to expand on the Affordable Care Act for everyone to obtain necessary coverage.
California’s Governor, Gavin Newsom, signed a bill into law on October 14th 2019 (but will not take into effect until 2021) about telehealth’s private payer parity bill which will require current contracts to amend themselves or renew to allow services between a healthcare plan and provider – stating that the provider who delivers services through telehealth be reimbursed on the same basis the provider would have been for an in-person visitation. Under this new law, the healthcare plan and the provider cannot negotiate reimbursement; nor can the healthcare plan require a patient to use telehealth if the provider has deemed it not appropriate.
Another bill that has passed into effect concerns Medi-Cal. These plans will be required to provide the DHCS (Department of Health Care Services) additional information when requesting alternative services. Telehealth is specified as an alternative.