A coda on confirmation…

By the way, Secretary Dale Bonner was confirmed today by the Senate Rules Committee.

But not before several Senators asked a series of tough questions about his oversight over the Department of Managed Health Care. This was part of a wide-ranging hearing that reflected the broad scope of the department, from housing to transportation issues as well.

Senator Padilla asked about the level of fines levied at Blue Cross and other insurers over rescissions, and said he’s “not convinced [they] get to the level of deterrence needed” and that he’s thinks that “all of the players have not gotten the message.” After being asked about how the Department is made aware of consumer complaints, Bonner stated “I don’t think [the Department] is sufficiently pro-active.”

Senator Padilla also asked about the letter by Senate Health Committee Chair Kuehl expressing concern that the timely access regulations adopted are not reflecting the will of the legislature. He ask about the Department’s adoption of new regulation that allow the health plans to set their own standards: “that sounds a little permissive to me.” He made the argument for such clear, enforceable standards. “We know that justice delayed is justice denied. Well, health care delayed is health care denied,” and he pointed out the additional costs and burdens that such delays place on emergency rooms. Padilla also asked about the implementation of language access regulations. Bonner stated that he thought the implementation of language access is “all over the map,” and that “I don’t believe we have enough coherency” with regard to the goal of language access.

Senator Ashburn asked about the appropriateness of Blue Cross’ letter to get doctors to reveal information to the insurer that would get patients retroactively denied. Bonner stated that he didn’t read the infamous letter himself, but that he recognized “the discomfort in anything that interferes in the doctor-patient relationship,” and he thought Blue Cross’ restraction of the letter “confirms that there was a serious problem.” asked more specifically about the actions that Bonner took with regard to the issue, including any conversations with DMHC Director Cindy Ehnes. He said he hadn’t spoken with her directly, but did through staff, and was satisfied that there was a investigation underway. Later, Senator Perata followed up Ashburn’s scolding, saying “you should have seen the letter, and you should have been all over it.”

Senator Perata also agreed about the need for more responsive DMHC. “This isn’t an academic exercise, for those who are in trouble with their HMO, someone who is being horsed around.” Senator Perata also urged higher fines: “you have to put a sharper point on it,” he said, and later, “fines are a real attention getter.” Senator Perata even asked if the DMHC should be in his far-flung Business, Transportation, and Housing Agency. Bonner indicated that it should, given the kind of expertise it regarding business oversight and solvency issues.

Consumers groups like Health Access California and Western Center on Law and Poverty were there, not to oppose Bonner’s confirmation, but to make clear our concerns about how the Department is abdicating their responsibilities to the industry they are supposed to be overseeing.

Senator Cedillo followed up on the language access issue and making sure people have notice of their rights under the law, saying “this is an absurdity. You don’t know you have a right unless someone communiciates it to you. If you don’t know it, it doesn’t exist…. It’s the law. The Escutia law is the law.” Senator Perata suggested that Bonner didn’t want former Senator Escutia coming back to ask questions.

Secretary Bonner was confirmed, but promised to reach out to stakeholders, including consumer groups, to deal with these issues and the other issues presented.

Health Access California promotes quality, affordable health care for all Californians.

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