By: Mario S. Turner

DMHC’s March 2026 Roundtable Signals a Busy Year Ahead

The Department of Managed Health Care (DMHC) held its quarterly roundtable on March 4, 2026, and the message was clear: 2026 will be an active year for health plans. DMHC shared updates on assessments, pending regulations, licensure initiatives, network reporting, and several recently enacted laws. While some items remain in development, the Department’s comments offered a useful look at where regulatory attention is headed.

Assessments, Budget Proposals, and Oversight Priorities

DMHC explained that it does not yet know the 2026-27 health plan assessment rate, though it expects enrollment changes at the federal level may affect the per-enrollee amount. The Department said its annual assessment APL should be issued within the next four to six weeks. DMHC also discussed proposed trailer bill language related to menopause services, including a public education campaign and additional staffing. Beyond those proposals, DMHC raised concerns it has recently seen in-network participation and continuity of care, including reports that some plans may be declining to contract with certain DHCS-provisionally licensed residential treatment centers and concerns about transitions from out-of-network to in-network behavioral health providers without adequate analysis of clinical appropriateness.

Regulatory Activity Continues to Expand

DMHC’s Office of Legal Services reported progress on several regulations. The provider directory regulations under SB 137 have now been approved and will take effect on April 1, 2026. DMHC also announced that formal rulemaking for the SB 17 prescription drug reporting regulations is beginning, with the package submitted to the Office of Administrative Law. In addition, DMHC said it is moving forward with regulations related to health equity and quality standards under AB 133, and it is again seeking stakeholder feedback on proposed revisions to its general licensure regulation, including the exemption process for entities accepting global risk. At the same time, the Department acknowledged continued uncertainty around its proposed Essential Health Benefits benchmark update after CMS paused review of pending state benchmark applications.

Implementation Issues Remain Front and Center

DMHC also addressed implementation of several newer laws. With respect to SB 729, the infertility coverage law, the Department reminded plans that affected products issued, amended, or renewed on or after January 1, 2026 must comply, and that updated EOCs should be submitted with legislative compliance filings due March 19. DMHC noted that it recently amended its prior guidance and may issue FAQs in the coming months. The Department also reiterated that long-acting injectable PrEP drugs may not be denied in favor of oral alternatives on the theory that they are interchangeable. In the licensing space, DMHC said it plans to open eFiling for Pharmacy Benefit Manager (PBM) licensure in July 2026, with a two-step process intended to allow PBMs to obtain conditional licensure by January 1, 2027 while completing the remainder of the application during 2027.

What Plans Should Be Watching For plans, the practical takeaway is that DMHC is advancing several regulatory and legislative initiatives at the same time. Developments involving provider directories, prescription drug reporting, fertility coverage requirements, PBM licensure, combination networks, and prior authorization reporting will likely continue to evolve throughout the year. Plans should remain attentive to DMHC guidance and rulemaking activity as these initiatives move forward.

By: Aaron R. Claxton

On February 27, 2026, the Centers for Medicare and Medicaid Services (“CMS”) issued a moratorium on the enrollment of new durable medical equipment (“DME”) suppliers with Medicare. The moratorium applies to the following seven supplier types:

• Medical supply company
• Medical supply company with orthotics personnel
• Medical supply company with pedorthic personnel
• Medical supply company with prosthetics personnel
• Medical supply company with prosthetics and orthotics  personnel
• Medical supply company with registered pharmacist
• Medical supply company with respiratory therapist

In issuing the moratorium, CMS noted that their determination for the need to implement the moratorium was based on a high risk that fraud, waste, and abuse exists. CMS relied on historical Medicare enrollment and claims data and analyzed key metrics pertaining to enrollment volume and trends for more than eighty types of DME suppliers. Despite a relatively small number of bad actors, DME suppliers continue to be a prime target for allegations of fraud, waste, and abuse.

The moratorium will remain in effect for six months and may be extended thereafter. The CMS notice identifies the following changes that the moratorium does not apply to:

• Changes in practice location (except if the location is changing from a location outside the           moratorium area to a location inside the moratorium area).
•  Changes in provider or supplier information, such as phone number or address.
•  Changes in ownership (except changes in ownership of home health agencies that would require an initial enrollment).

However, the moratorium would apply to suppliers that go through a change of ownership because a supplier that undergoes a nonexempt change in majority ownership within thirty-six months of its initial enrollment must enroll in Medicare as a brand new supplier, despite already operating prior to the moratorium. Additionally, changes of ownership that are the result of asset sales would also be impacted by the moratorium as the new owners would also have to enroll in Medicare as a new DME supplier. Applications submitted to CMS for new enrollment during the moratorium period will be denied and the applications will have to be resubmitted in the future once the moratorium is no longer in place.

The notice indicates that CMS believes the moratorium will not substantially limit Medicare beneficiaries’ access to care because “there is already an adequate nationwide quantity of such suppliers.” However, the number of overall suppliers does not take into account the fact that there may be limited numbers of specific types of suppliers and also fails to consider that there may already be very limited access to Medicare beneficiaries located in certain rural communities.

For existing DME suppliers, this moratorium serves as a barrier to entry to new suppliers that would compete with them for business. DME suppliers currently enrolled in Medicare should note the increased scrutiny that they face for allegations of fraud, waste, and abuse with the current administration. It is as important as ever for DME suppliers to prioritize regulatory and compliance efforts in order to maintain their Medicare enrollment and continue to serve the Medicare beneficiary population.

Aaron Claxton is a California healthcare attorney and partner with Wilke Fleury LLP focused on regulatory compliance for a range of clients providing healthcare services within the state.

By: Trevor L. Stapleton

We recently had a call from an individual, “Person X”, who was asked to pay money to a Companion to help settle the estate of the Companion’s father. Specifically, the money was necessary to pay estate taxes, to allow the release of the decedent’s assets. The Companion provided Person X a copy of a “Will” that seemed to look like a formal and “official” document. It had our firm’s name, logo, and address at the top, recited some “testamentary” sounding language, included the name of an attorney alleged to work at our firm, and had an official-looking “seal” near the signature line. The Companion indicated that several thousand dollars were needed to pay estate taxes, to allow for the release of the several million dollars in assets listed in the “Will.”  Thankfully, Person X was suspicious and, rather than just relying on an internet search to verify that our firm exists, Person X called us and sent us a copy of the “Will” to look at. There were numerous problems with the Companion’s story, and we could immediately see many issues with the document itself. In addition, to claim these assets, there would need to be a probate proceeding. Moreover, all the decedent’s money and property would be available and required to be used to pay any estate taxes, assuming any estate taxes would even be due, which is not necessarily the case due to current exemption amounts. So, a proper analysis required drawing together a number of elements that are not evident to someone without the requisite knowledge or experience in estate planning. Thankfully, Person X was suspicious and contacted us, and we were able to confirm that the story and the document were fake, and this was, unfortunately, a scam to take Person X’s money.

It was clear that the Companion had taken the time to piece together a document to support the tale and ask for money, and by including an actual law firm name, logo, and address, lend it credibility. Research on the internet would verify that yes, we are a law firm in Sacramento, and our services include estate planning, so it could be plausible that the document was authentic. But the internet cannot take the place of the knowledge, experience, and analysis of an estate planning professional.

So, please be careful, trust your instincts, and if something seems off, do not just rely on what you find online. Contact experienced professionals to assist you. A little time or cost now can save you and your family from heartbreak and disaster down the road.

By: Trevor L. Stapleton

Many kinds of accounts and property allow for a beneficiary designation, sometimes called
transfer-on-death (TOD) or payable-on-death (POD) designations, that allow the account to pass
directly to a beneficiary on your death. Do you know if you have made any beneficiary
designations on your accounts? Have you reviewed these lately to be sure they are still consistent
with your wishes? Did you know that TOD, or POD designations, take precedence over your
Will or living trust? Are you aware of what can go wrong if there are issues with your
beneficiary designations?

If you answered “no” to any of these questions, it may be time to review your accounts,
particularly your TOD and POD beneficiary designations, to be sure everything is complete,
accurate, and up to date. An annual review is crucial to ensuring that your accounts and property
go quickly and seamlessly to the right people.

Where to Find TOD, POD, and Beneficiary Designations
Beneficiary, TOD, and POD designations in writing that specify who will receive the asset (e.g.,
accounts, property, death benefits, etc.) after the original owner dies. These designations allow
you to pass assets directly to your beneficiaries and avoid probate. This results in faster
distribution to your family and loved ones and can reduce costs relative to settling your estate.
Some common assets with beneficiary designations include the following:
● retirement accounts—401(k)s, individual retirement accounts, and other
retirement plans;
● investment accounts—Brokerage accounts, stocks, bonds, and mutual funds;
● bank accounts—Checking accounts, savings accounts, and certificates of deposit;
● life insurance policies— Including whole, term, and group; and
● real estate—TOD deeds or survivorship designations on title.
For most, their homes and financial accounts are the primary source of wealth, making it all the
more important that beneficiary designations for these assets reflect your current wishes.

What Can Go Wrong with an Omitted, Incomplete, Inaccurate, or Outdated Beneficiary
Designation?
According to financial advisors, beneficiary form errors are among the most common—and the
costliest—estate planning mistakes that people make. These errors fall into a few main buckets:
● Failure to name a beneficiary. Many people simply forget to complete beneficiary
designation forms or put them off indefinitely. This situation is especially common for
inherited accounts.
● Outdated information. Major life events such as marriage, divorce, the birth of a
child, or the death of a beneficiary generally mean that beneficiary designations need to
be updated.
● Inaccurate or missing information. Mistakes in spelling, addresses, or other
identifying information, or failure to provide complete information, can cause delays,
confusion, or even disputes when processing beneficiary designations.
● Naming a minor as beneficiary. Technically, minors can be named as
beneficiaries, but they cannot legally receive or manage money and property above a
certain value. If they are named as beneficiaries, a court may need to appoint a guardian
to oversee the funds for them until they reach the age of majority (18 years of age in
some states and 21 in others).
● Overlooking complex circumstances. A beneficiary may be unable to manage
their inheritance because of a disability, special needs, poor money habits, mental health
issues, or substance use disorder.
● Not naming contingent beneficiaries. If the primary beneficiary dies before the
account holder or cannot be located, and no contingent (backup) beneficiary has been
named, it will be treated as if no beneficiary had been named.
● Lost or invalid forms. Unfortunately, financial institutions sometimes misplace
beneficiary designation forms or fail to process them correctly. Also, if a financial
institution or employer changes the plan’s service provider or administrator, the original
beneficiary designation may no longer apply, meaning that a new beneficiary
designation form needs to be completed under the new provider.

In addition to the unintended distribution of accounts, property, or death benefits and related
disputes, an invalid, missing, or outdated beneficiary designation can result in the assets
requiring probate administration, resulting in payout delays and increased costs:

Robert had a brokerage account but never designated a beneficiary. When he died, the
account became part of his probate estate, resulting in a lengthy and expensive legal
process that delayed the distribution of his money. Moreover, the costs of the probate
reduced the final amount that went to his heirs, and even though Robert may have told
family that he wanted the brokerage account to pass to a specific beneficiary, through the
probate proceeding, the account was divided among several beneficiaries.

Calendar Your Estate Plan Review
You should be reviewing your estate plan at least every few years or after any significant life
event. But even if you have not formalized your estate plan (what?!?!), you should, at a
minimum, review your account beneficiary designations and ask:
● Are these beneficiaries still the people you want to receive your accounts?
● Are the beneficiaries still living?
● Are they capable of managing the inheritance? Should they receive an outright
distribution, or are safeguards needed?
● Is there more than one beneficiary named, and if so, how hard is it to divide the
account or property, and what is the potential for conflict between/among the
beneficiaries?
● Do the beneficiaries know that they are named? Do they know how to proceed
after your passing?

As part of your review process, it is important that you have accurate information. Get the
current confirmation directly from the financial institutions of what they have on record. Do not
just rely on memory or copies of forms you originally filled out.

Even if everything looks good after a review, you may benefit from reviewing your plan with
your attorney or financial advisor. They have seen it all and may be able to suggest options or
alternatives that are better suited to your needs.

We are pleased to congratulate Jason Eldred on his promotion to senior counsel at Wilke Fleury LLP. Jason’s work in service of clients is outstanding. His thoughtfulness and hard work contribute so much to what makes our firm truly special. Jason’s clients include construction companies, real estate companies, and medical professionals. Jason’s practice focuses on business and healthcare litigation, employment counseling and litigation, and bankruptcy. Senior Counsel at Wilke Fleury have a minimum of six years experience delivering high-quality legal services, collaborating with partners on development and management of cases, and actively mentoring junior lawyers. Congratulations Jason!

Myth 1: I have a will, so I do not need anything else.

Fact: A will is one part of the estate planning puzzle. But it is only one part and by itself is generally insufficient to meet the comprehensive needs of a business owner. A will does not address what happens to your business if you become incapacitated (unable to handle your own affairs). A will does not avoid probate, leaving your loved ones to have to navigate the probate process after your death to transfer your business ownership interest. For everyone—but especially business owners—a comprehensive estate plan can help avoid delays, frozen assets, and legal battles. Relying on a will alone can leave your business vulnerable to disruption and potentially a significant loss of value.

Myth 2: My family will automatically take over the business if something happens to me.

Fact: Neither business ownership nor management automatically transfers to another person if you become incapacitated or pass away, unless you have taken formal steps and documented a legally binding transition process.

If you become incapacitated, your family cannot simply step in to run the business on your behalf. Without the proper estate planning tools in place, they may need to seek a court-appointed conservator, which can be time-consuming and costly, just to handle essential tasks for day-to-day management of your business, such as signing contracts, accessing business bank accounts, or approving payroll.

If you pass away without addressing the operation and transition of your business in your estate plan, the problems only multiply. Before your business interests can be transferred, there will likely have to be a probate proceeding —a public and often lengthy court process. Even worse, if you have done no estate planning, the court could determine who inherits your business interests according to state law, which may not be the person(s) you would have chosen. A relative with no interest or experience in running the business could end up in charge, or ownership could be split among multiple heirs, leading to disputes and instability.

A well-structured estate plan ensures that the right people are in control, operations continue smoothly, and your life’s work retains its value and purpose.

Myth 3: My business is small, so I do not need to worry about estate planning.

Fact: Even small businesses can face serious consequences without proper estate planning and may actually be more vulnerable than larger businesses because they often rely so heavily on the owner’s day-to-day involvement. If something happens to you and no one is legally authorized to act in your place, your business could lose access to contracts or bank accounts, miss payroll or tax deadlines, or even be forced to shut down. An estate plan ensures that someone you trust can step in immediately to make decisions, pay bills, and keep operations running, regardless of business size.

Wilke Fleury LLP is pleased to announce that Neal Lutterman is the firm’s Managing Partner beginning January 1, 2026.  Neal succeeds Steve Williamson, who held the role of Managing Partner from 2020 through 2025.  Steve Williamson led the firm through several years of significant change, and the firm is immeasurably grateful for Steve and his leadership.

Neal joined Wilke Fleury in 2015 and has been a Partner since 2017.  Neal is an incredibly valuable member of the firm’s partnership and litigation teams.  He has a demonstrated history of leadership on the firm’s Management Committee for 4+ years. Neal’s practice focuses on litigated matters in the healthcare arena. For over 25 years, Neal has defended physicians, healthcare systems, hospitals, medical groups, and allied healthcare providers in professional and general liability matters.  Neal regularly represents physicians and other healthcare clients in administrative proceedings relating to professional licensing and disciplinary matters.  Neal also works closely with the firm’s corporate healthcare clients representing health plans, Medicare Advantage Plans, Risk Bearing Organizations (RBOs), and other entities in reimbursement and contract disputes.

Neal will work closely with the firm’s Management Committee to advance the firm’s focus on client development, strategic growth, and attorney excellence in the years to come. Neal Lutterman is excited about the firm’s future, committed to the “next generation” of talented Sacramento lawyers, and continues to establish Wilke Fleury as the preeminent law firm in Sacramento.