AB 2470 Summary

• Extends the 24-month limit on health plan rescissions to all health care service plan contracts and health insurance policies, prohibiting rescissions after 24 months for any reason except fraud or intentional material misrepresentation.

• Requires health plans and insurers to provide written notice via certified mail at least 30 days before rescinding coverage, and allows coverage to continue pending appeal of rescission decisions.

• Reduces decision timeframes for medical necessity determinations to 72 hours (or the shorter federal timeframe) when an enrollee faces imminent and serious health threats, and consolidates cancellation and nonrenewal appeal rights between health care service plans and health insurers.

• Establishes new appeal rights for health insurance policyholders similar to those for health care service plan enrollees, requiring continued coverage during the appeal process.

• Repeals three existing Health and Safety Code sections and authorizes the Department of Managed Health Care Director and Insurance Commissioner to issue compliance guidance through December 31, 2013.