BOM Toolkit

Medicare’s Annual Enrollment Period begins October 15. Blue Shield of California has announced its 2027 Medicare portfolio, including Medicare Advantage products that use tailored provider networks. The announcement does not identify practice-level network changes, so physicians should not assume that 2026 participation or directory information automatically carries forward. Before patients begin comparing plans, verify each 2027 product, service area, referral requirement and directory listing through your contract and the payer’s provider channels. Flag discrepancies promptly and give front-office staff a consistent response for patients asking whether the practice will remain in network.

Review the plan announcement

New laws address clinical judgment, patient privacy and biased outcomes from clinical decision-support tools.

When a clinical decision-support tool informs care, physicians need the authority to question its recommendations—and practices need a clear process for addressing problems.

Governor Gavin Newsom signed AB 1979 and SB 503 on September 30, adding protections governing technology in health care. With implementation expected January 1, 2027, Los Angeles practices should use the coming months to review their tools, oversight and vendor agreements.

AB 1979 requires physician offices, group practices, clinics and health facilities to take reasonable steps to preserve licensed professionals’ independent judgment when clinical decision-support tools inform care. It prohibits covered practices and facilities from using or deploying AI to independently perform clinical functions reserved for licensed professionals or to direct unlicensed personnel to perform those functions.

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A new California law gives practices a minimum window to fix eligible claims after a denial or overpayment notice.

A correctable claim defect should prompt a billing-team review before it becomes a write-off.

SB 1049, signed and chaptered September 30 as Chapter 1001, Statutes of 2026, takes effect January 1, 2027.

The law gives claimants at least 90 calendar days from a covered plan or insurer’s most recent action to submit a corrected claim when a denial, partial denial or overpayment notice is based wholly or partly on a defect that a corrected claim can remedy.

A corrected claim submitted under this protection cannot be denied because another filing deadline has expired. Disputes involving those corrected claims must be eligible for submission to the payer’s dispute-resolution process.

What your practice can do now

Purpose: Keep correctable claims moving, preserve dispute rights and prevent avoidable write-offs.

SB 1049 update — effective January 1, 2027: For covered plans and insurers, a denial, partial denial or overpayment notice based wholly or partly on a correctable claim defect triggers a minimum 90-calendar-day correction window from the payer’s most recent action. A corrected claim submitted within that protection cannot be denied because another filing deadline expired. Related disputes remain eligible for the payer’s dispute-resolution process. This is not a blanket extension of appeal deadlines or a guarantee of payment.

1. Capture the notice and assign ownership

• Record the payer, plan/product, claim number, dates of service and disputed amount.

• Save the complete denial, partial-denial or overpayment notice, including reason codes.

• Record the date of the payer’s action and the date received separately.