California AB2327 mandates that Medi-Cal managed care plans ensure actuarially sound rates for subcontractors.

California AB2327 adds provisions to the Welfare and Institutions Code, requiring Medi-Cal managed care plans to pay subcontractors in an actuarially sound manner. This means rates must be certified and ensure plans have necessary resources for service delivery, stability, and fiscal solvency. Subcontractors can request a rate review if certain conditions are met, such as a loss in Medi-Cal membership or a high medical loss ratio. The Department of Health Care Services must order rate revisions if deemed unsound, ensuring fair competition and preventing cross-subsidization.

California AB2327 mandates that Medi-Cal managed care plans ensure actuarially sound rates for subcontractors.

California AB2327 adds provisions to the Welfare and Institutions Code, requiring Medi-Cal managed care plans to pay subcontractors in an actuarially sound manner. This means rates must be certified and ensure plans have necessary resources for service delivery, stability, and fiscal solvency. Subcontractors can request a rate review if certain conditions are met, such as a loss in Medi-Cal membership or a high medical loss ratio. The Department of Health Care Services must order rate revisions if deemed unsound, ensuring fair competition and preventing cross-subsidization.