CA AB1429

Requires a health care service plan identified in the Department of Managed Health Care's Enforcement Matter Number 22-496 (related to a 2023 settlement agreement) to fully reimburse enrollees for out-of-pocket behavioral health care costs incurred from non-plan providers, facilities, or pharmacies since May 1, 2022

Reimbursement must be paid within 60 calendar days of an enrollee submitting receipts, documentation from a licensed provider, and a statement affirming care could not be obtained timely through the plan

Failure to provide required reimbursement results in payment of the original amount plus 10% annual interest to the enrollee, plus a $5,000 fine per incident

The plan must submit monthly reports to the Department of Managed Health Care including number of reimbursement requests received, total amounts reimbursed, average processing time, and denied requests with reasons

Reimbursement requirements remain in effect until the department certifies the plan has completed its corrective action work plan from the 2023 settlement agreement, at which point the provisions are repealed