Category: Timely Access

Access, Affordability, Budget, Care4AllCA, Cost Containment, Covered California, DMHC, Equity, Expanding Coverage, Health Reform, Health4All, Insurers, LGBT, Medi-Cal, Prescription Drugs, Quality, Timely Access, Undocumented, Uninsured

Major Health Care Consumer Wins this #CALeg and #CABudget Session

With the Governor’s final actions on bills last week, health consumer advocates applauded a major year in health reform, where California continued its leadership on health care access, affordability, and equity. Californians will see both short and long-term benefits from the bills and budget items adopted by Governor Newsom and the state legislature this year […]

Access, Affordability, Cost Containment, Legislation, Mergers, Timely Access

Major CA Bills to Increase Accountability in Our Health Care System Up In Committee This Week

California legislative committees are set to hear two health care bills this week that would increase accountability for health care consumers while preserving their access to care and preventing inflated health prices. SB 858 by Senator Scott Wiener, which will be heard today (Tuesday) in Senate Judiciary Committee, updates penalty amounts that the state can levy on health plans that don’t meet consumer protection standards. AB 2080 by Assemblymember Wood, which will be heard today (Tuesday) in Assembly Health Committee and on Thursday in Assembly Judiciary Committee, would provide needed oversight on for-profit hospital mergers to ensure they are in the best interest of the California public.  

DMHC, Timely Access

Consumer Advocate Reaction to $55M Fine on LA Care Health Plan

Today, the California Department of Managed Health Care (DMHC)  and the Department of Health Care Services (DHCS) fined the L.A. Care health plan $55 million dollars for tens of thousands of violations that resulted in delayed or denied care. Going back several years, L.A. Care systematically failed to handle grievances timely, by not giving consumers authorization for timely care, and by failing to ensure that LA County Department of Health Services provided timely access to care, especially specialty care.

Access, Affordability, COVID-19, Timely Access

New CA Bill Helps Connect Unemployed Californians to Health Coverage

The COVID-19 pandemic has led to unprecedented job loss and drops in income, and with that a loss in job-based health care coverage. Since the implementation of the Affordable Care Act (ACA), most Californians without employer coverage can enroll in health insurance through Medi-Cal or Covered California, both which provide help in paying for coverage depending on income. Despite significant job loss as a result of the pandemic, both Medi-Cal and Covered California have experienced lower-than-expected enrollment, particularly among communities of color. Keeping Californians covered requires proactive efforts to ensure that they are aware of their options.

Timely Access

Report: CA Health Plans Still Struggle to Meet Timely Access Standards

CARE DELAYED IS CARE DENIED A new report by California’s Department of Managed Health Care (DMHC) released today is the first of its kind to provide data on timely access to care separating out commercial, individual/family, and Medi-Cal health plans. Health Access sponsored 2014’s SB 964 (Hernandez) that requires this annual report. The report found industry-wide difficulty providing timely […]

Research, Timely Access

California Health Plans Flunk Timely Access Report

A new report by the Department of Managed Health Care (DMHC) found industry-wide problems providing timely access to care, or even accurately reporting the size and availability of their provider networks. Almost all—36 of 40—of the health plans monitored by the DMHC have been referred to the Department’s enforcement unit for potential fines or corrective […]