Provider participation in Medi-Cal does not keep pace with growth of enrollment New 2015 data shows that the percentage of physicians participating in Medi-Cal has declined since 2013, while during the same period, Medi-Cal enrollment increased by 39 percent. The numbers show that provider participation in Medi-Cal has not kept pace with the growth in enrollment, and raise serious concerns about whether the numbers of physicians participating in Medi-Cal can meet the increased demand. A California Healthcare Foundation survey of California physicians shows that Medi-Cal participation declined from 69 percent in 2013 to 63 percent in 2015. The numbers of specialty care ... August 5, 2016 Medi-Cal Prop. 55, Prop. 56 (tobacco tax), Tobacco Tax, Medi-Cal, Political Advocacy 0 0 Comment Read More »
HHS begins second phase of HIPAA audits The second phase of audits for compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations is underway. The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) selected a total of 167 health plans, health care providers and health care clearinghouses to be audited. Selected physician practices would have received an email from OCR on July 11. The email may be incorrectly classified as spam, so check your spam and junk folders to make sure you didn't miss it. The 2016 phase 2 HIPAA audit program ... August 5, 2016 General HIPAA, HIPAA Privacy Rule, Audits 0 0 Comment Read More »
Covered California announces sharp rate hike Covered California has announced an average 13.2 percent hike in insurance premiums for 2017, a sharp increase that is likely to reverberate nationwide in an election year. The California Medical Association (CMA) is concerned the premium increases may hinder the ability of some patients to obtain insurance and access necessary medical treatment. The rise in Covered California premium rates was driven largely by its two biggest insurers, which account for about half of its enrollment. Blue Shield of California said its average rate hike is 19.9 percent, the biggest statewide ... August 5, 2016 Managed Care Covered California, Exchange Plans, Health Insurance Exchange, Affordable Care Act 0 0 Comment Read More »
CMA applauds U.S. Justice Department lawsuit against health insurance mega-mergers The California Medical Association (CMA) today applauded the U.S. Department of Justice (DOJ) for filing two lawsuits challenging the proposed merger of Anthem and Cigna and of Aetna and Humana — all of which are among the largest health insurance companies in the country. “We applaud the DOJ for protecting patients against mega-mergers that would drastically reduce competition in the health insurance market, leaving patients at a huge disadvantage in the pursuit of timely and affordable health care,” said CMA President Steven Larson, M.D., MPH. “We also commend California Insurance ... August 5, 2016 Managed Care Aetna, Anthem Blue Cross, Cigna, Department of Justice, DOJ, Advocacy, Humana 0 0 Comment Read More »
DOJ files lawsuit to block two health insurance mega-mergers The U.S. Department of Justice (DOJ) today filed two lawsuits to block health insurance mega-mergers that would compromise patients’ access to care, and negatively impact the quality and affordability of health care across the country. “If allowed to proceed, these mergers would fundamentally reshape the health insurance industry,” U.S. Attorney General Loretta Lynch said at a press conference. “They would leave much of the multi-trillion dollar health insurance industry in the hands of three mammoth insurance companies, restricting competition in key markets.” The California Medical Association (CMA) has long-held concerns over ... August 5, 2016 Managed Care Cigna, Department of Justice, DOJ, Aetna, Anthem Ble Cross, Humana 0 0 Comment Read More »
