Department of Managed Health Care - What's New

WEBINAR: How to spot dishonest Medicare Advantage marketing tactics

Tue, 5 May 2011 1:00:48 GMT

WEBINAR: How to spot dishonest Medicare Advantage marketing tactics

Kern Health Systems request for lower standards to provide timely care to patients denied

Fri, 29 April 2011 1:00:48 GMT

(DMHC) has rejected a Kern Health Systems request to use time-elapsed standards that are not as strict as new state regulations that went into effect this year to provide predictable wait times for appointments.

DMHC declares May 1 Anthem Blue Cross rate increase unreasonable

Fri, 29 April 2011 1:00:48 GMT

DMHC has determined that a May 1 rate increase for 120,000 Anthem Blue Cross members is unreasonable under the spirit of a new state law which allows regulators to review rate increases.

DMHC questions recent Blue Shield individual rate increase calculations averaging 37.5 percent

Tue, 19 April 2011 1:00:48 GMT

DMHC has sent a letter to Blue Shield of California asking for an explanation of the calculations used to twice increase rates recently for approximately 70,000 enrollees in the individual market.

DMHC asks Anthem Blue Cross to explain why rate increases for approximately 120,000 enrollees in individual coverage policies are justified

Thu, 7 April 2011 1:00:48 GMT

DMHC has sent a letter to Anthem Blue Cross asking the plan to explain why it is moving forward with a May 1 rate increase for individual PPO products under the jurisdiction of the DMHC when rates for comparable benefit level products under the jurisdiction of the California Department of Insurance were recently decreased.

Health Net Security Breach Information

Mon, 14 March 2011 1:06:48 GMT

Health Net Security Breach Notices Are On Their Way to Affected Consumers

Premium Rate Review

Tue, 19 April 2011 1:06:48 GMT

Effective January 1, 2011, new legislation gives the Department of Managed Health Care (DMHC) authority to review health plan premium rate increases. The DMHC is committed to providing the public with information in order to expand consumer understanding about rate increases and promote more accountability within the health care industry.

Federal Health Care Reform

Tue, 19 April 2011 1:06:48 GMT

The Department of Managed Health Care will have a significant role in implementing many parts of the federal health care reform proposal. Many of the changes in the federal law such as guaranteed coverage, cost controls and prevention goals were also part of the Governor’s 2007 reform proposal.

Options for Uninsured Children

Tue, 19 April 2011 1:06:48 GMT

Under Federal and California law, health plans can no longer deny or limit coverage to a child under 19 because of a pre-existing health condition. Health plans must offer and sell coverage to children at all times of the year. California’s law, AB 2244, creates “open enrollment” periods, during which a child (or a parent on behalf of a child) can apply for coverage at a lower premium rate than if you wait.

Right Care Initiative

Tue, 19 April 2011 1:06:48 GMT

The objective of the Right Care Initiative is to measurably improve clinical outcomes through enhancing the practice of patient-centered, evidence-based medicine.

Financial Solvency Standards Board

Tue, 19 April 2011 1:06:48 GMT

The purpose of the Financial Solvency Standards Board (FSSB) is to advise the director on matters of financial solvency that affect the delivery of health care services and to develop and recommend financial solvency requirements and standards relating to plan operations, plan-affiliate operations and transactions, plan-provider contractual relationships, and provider-affiliate operations and transactions.

Events / Meetings