Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law authorizes the Director of the Department of Managed Health Care to authorize a pilot program in southern California under which approved providers may undertake risk-bearing arrangements with a voluntary employees’ beneficiary association with enrollment of more than 100,000 lives, as specified, beginning no earlier than January 1, 2022, to December 31, 2027, inclusive, if certain criteria are met. Existing law requires the association and each participating health care provider to report to the department information regarding cost savings and clinical patient outcomes compared to a fee-for-service payment model. Existing law requires the department to report those findings to the Legislature after the termination of the pilot program and before January 1, 2027. Existing law repeals these provisions on January 1, 2030.

This bill would extend that repeal date to January 1, 2033. The bill would authorize the pilot program to be throughout California and would extend the end date of the pilot program to December 31, 2032. The bill would instead require the department to submit an interim report of the findings to the Legislature before December 31, 2029.