Below is a list of proposed IT Projects that are currently in the PAL review and approval process with the California Department of Technology (CDT). For purposes of this list “PAL Stage” refers to the last document officially submitted to CDT.
Projects are removed from this list when they exit the PAL process because: 1) the Agency/state entity receives CDT’s approval to begin project implementation; 2) CDT approves a Project Delegation Request; 3) the Agency/state entity withdraws the project; or 4) the CDT denies the project approval.
The Department of Managed Health Care (DMHC) seeks to implement an Electronic Filing and Analysis of Claims Settlement data solution enabling the Office of Financial Review (OFR) to improve program efficiencies for electronic filing of all documents by health plans and their delegated entities. The resultant solution will allow OFR to review claims payment timeliness data in a faster manner, identify and categorize claims payment timeliness issues more efficiently, and analyze the claims payment timeliness trends to determine the appropriate action. While the scope of this proposal is focused on the implementation of a complete solution for the Electronic Filing and Analysis of Claims Settlement Data, DMHC proposes to first implement an interim solution (a Maintenance and Operations – M&O – effort that is not within the scope of this project proposal) to meet the statutory requirements of AB 3275. Effective January 1, 2026, this bill has the following statutory requirements: • Health plans and capitated providers, including Medi-Cal and specialized plans, are required to reimburse complete claims within 30 calendar days (instead of the current limit of 45 working days) • Health plans and capitated providers are required to contest or deny claims in writing within 30 calendar days. • Health plans and capitated providers are required to file quarterly and annual reports in compliance with the updated requirements of the new law.
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20250505 Release-15