state regulators

Over the past three years the state of California has logged more than 1,600 consumer, physician and hospital complaints about Blue Cross of California (BCC) business practices. Sparked by these complaints, the state's Department of Managed Health Care (DMHC) now plans to hold a public hearing to look at whether the Blue plan has kept promises it made when it was acquired in 2004 by WellPoint. The hearing, which will take place next week, follows a Department of Insurance report …

A maverick California cardiologist continues to expand his burgeoning hospital empire, which now stands to challenge some of the biggest chains in the state. While the rapid pace of his acquisition is drawing attention--he's acquired six hospitals during the past year alone--what's really got the industry buzzing is the fact he's canceling all of the hospitals' contracts with health insurance plans.

Dr. Prem Reddy's Prime Healthcare Services now owns eight hospitals in California, …

This isn't an easy time to be a California-based health plan. In recent times, the plans have been under heavy fire from state regulators, who have imposed large fines and launched ongoing investigations into potential violations of state law. The health plans are also taking a beating from the media and facing a raft of lawsuits. What's more, this is only the beginning. As the state inches toward healthcare reform, insurers should continue to be in the spotlight, according to one analysis. Article

New York state regulators have cited Stony Brook University Medical for 17 code violations, with problems ranging from procedural concerns such as credentialing process flaws to drug dosing errors and a missed diagnosis leading to the death of a patient. In the case of the deceased patient, who died from head injuries related to a traffic accident, the took 20 hours to provide the patient with proper care, regulators said. When his condition was discovered it was too late to save him. The …

> A consumer advocacy group has sued Aetna, along with Connecticut state regulators, claiming that a new low-end product approved for sale by the state offers inadequate coverage. Article

> While the Utah health system is in decent shape, providers could do a better job of providing preventive care, one study suggests. Article

> Another one …

A new report released by the state of Connecticut suggests that the state's hospitals are in a uniquely difficult financial position. The report, issued by the state's Legislative Program Review and Investigations Committee, concluded that Connecticut hospitals "appear not as healthy financially as hospitals in the rest of the country." This is music to the ears of the Connecticut Hospital Association, which has been making this point for more than a decade, according a piece in the …

A religious organization that describes itself as a "medical bill sharing ministry"--but functions something like a health insurance company--is facing scrutiny from state regulators in Kentucky. The Melbourne, FL-based Christian Care Ministry collects monthly checks from its 19,000 participants, who pay in based on family size and the amount of their medical care they're willing to fund out of pocket. The Ministry then divides the money and cuts checks to health care …

Another California health plan is making headlines after wrangles with state regulators. In this case, the state has ordered Kaiser Foundation Health Plan to reinstate the coverage of a woman whose policy it says was illegally canceled. The woman, who lives in Northern California and has been a Kaiser beneficiary for more than 20 years, is undergoing treatment for kidney stones. Recently, Kaiser had canceled her policy, claiming that she left out key information from her application when …

Blue Cross of California has settled a group of 70-odd lawsuits and claims filed by patients who alleged that the health plan canceled their insurance after they got sick. The settlement comes in response to pressure from state regulators, which already fined the health plan $200,000 for canceling one California woman's policy, according to the Los Angeles Times. While the dollar …

Disturbing news continues to come out of the failure of Kaiser Permanente's kidney transplant program, which closed in May when extremely serious deficiencies were discovered. So critical were the problems with Kaiser's program that they triggered a national investigation of …