After six years of discussion, California is on the brink of becoming the first state in the country to set rules as to how many hours a health plan member must wait before seeing their doctor.
Under the proposed rules, any patient needing an "urgent" appointment for a service not requiring prior authorization must be seen within 48 hours; if the appointment does require prior authorization, the patient must be seen within 96 hours.
Meanwhile, non-urgent visits for primary care must take place within 10 business days of the appointment request. Non-urgent specialist requests would be required to take place within 15 business days.
And here's an even tougher standard to meet: The new rules would require that patients be allowed to speak with a doctor on the phone--or at least receive a call back from a health professional--within 10 minutes, regardless of what time of day or night they call.
If passed, the regulations will apply to about 39 plans, covering about 17 million lives.
To learn more about California's plans:
- read this Health Leaders Media piece