Managed care
Calif. rules on MD visits through HMOs still stalled
Six years ago, California passed a new law requiring that HMO patients get timely appointments with their doctors. State regulators thought they had licked the problem--but they were a bit too... Read more...
PacifiCare faces $1.33B fine
Man, California regulators are tough. Over the past year, I wouldn't be surprised if there had been more fines imposed by the state's Department of Managed Health Care (DMHC) then by state health... Read more...
The policy cancellations standoff--who wins?
Increasingly, it's looking like some major California health plans are settling in for a war with the state over cancellations of individual policies. Despite facing angry regulators--including the... Read more...
CA seeks $12.6 million fine for Blue Shield
The state of California's insurance chief is seeking a $12.6 million fine against Blue Shield of California, accusing it of 1,262 claims-handling law violations and regs and more than 200 improper... Read more...
ALSO NOTED: CMS "secret shoppers" attend Medicare health plan pitches; CA health plans adding interpreters; and much more...
> CMS "secret shoppers" have begun attending insurance agents' sales pitches for Medicare managed care plans to see how they work. Read more...
HealthNet fined $1M for non-disclosure of cancellation bonuses
Following disclosures forced by a lawsuit, HealthNet has been fined $1 million by the state's Department of Managed Health Care (DMHC) for failing to admit that it did indeed have plans in place... Read more...
CA bars Blue Cross of CA from demanding fee confidentiality
Capping a year of disputes between the health plan and its providers, the state of California has ruled that Blue Cross of California may not force physicians, hospitals and labs to sign a... Read more...
Hot topics at the MGMA
This coming Monday and Tuesday (10/29 and 10/30), I'm heading to Philly to attend the Medical Group Management Association's annual conference. As usual, I'm expecting it to be an intriguing show.... Read more...
CA regulators plan limits to health policy cancellations
Two powerful state regulators have come together in California to propose rules limiting health plans' ability to retroactively cancel policies. The state's Department of Managed Health Care (DMHC)... Read more...
Antitrust case highlights tensions over MD-owned hospitals
An Overland Park, KS-based physician-owned specialty hospital is moving ahead with a federal antitrust suit against a group of area health systems, claiming that the systems conspired with managed... Read more...
