Year: 2022

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.

Affordable Care Act, Covered California

California Health Committee Chairs Introduce Bills to Increase Affordability in CoveredCA

New state legislation introduced today would fill key affordability gaps in Covered California, potentially lowering cost-sharing and eliminating deductibles for over a million Californians getting coverage through the state marketplace.

AB 1878 by Assemblymember Dr. Jim Wood, and SB 944 by Senator Dr. Richard Pan, both sponsored by Health Access California, the statewide health care consumer advocacy coalition, would remove financial barriers to care for hundreds of thousands of patients, and encourage even more Californians to sign up for coverage.

Medi-Cal

JOINT STATEMENT: Consumer Advocates Respond to Kaiser Medi-Cal Contract Announcement

Two leading health and consumer advocate organizations have released the following statement in response to the recently announced Medi-Cal contract between the Department of Health Care Services (DHCS) and Kaiser Permanente.

 “Health and consumer advocates have been strong supporters of the state’s proposal to recontract with all the managed care plans in our Medi-Cal program. It’s been decades since this re-contracting process has been done, and we have urged the state to hold all plans to higher standards for quality and equity for the over 14 million Californians who depend on Medi-Cal for their care.  These standards should include Kaiser, which has avoided a statewide contract to date, and push them to do more in Medi-Cal.”

Affordability, Budget, Legislation, Medi-Cal, Prescription Drugs

Key Health Investments to be Heard in CA Budget Committees Starting This Week

Big health reforms, from major expansions of access and affordability to efforts to control costs and improve quality and equity, will be heard in the California Legislature starting tomorrow, as hearings begin on the Governor Gavin Newsom ‘s $286.4 billion state budget for 2022-23. The hearings will discuss historic steps to close coverage gaps and bring California to near-universal health coverage. These hearings will debate what is in the current budget proposal, but also areas where the state can improve, or take additional steps to strengthen our health care system. 

Affordability, Consumer Protection, Medi-Cal, Surprise Bills

HEALTH ACCESS: Updated Health Access Report Points to Success for New National Law Against Surprise Medical Bills Now in Effect

On the week that new federal rules go into effect to prevent patients from getting surprise medical bills, consumer advocacy group Health Access California releases an updated report on the California experience of a similar state law. The report shows the laws success in protecting patients from unexpected out-of-network bills as well as inflated premiums from provider overcharging with no indication of negative impacts on network size or patient access to care.