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Legislature passes bill that would require annual reports from insurers on provider network adequacy

The legislature has passed a bill that would require Medi-Cal managed plans and insurers offering individual plans through Covered California to provide annual reports to the California Department of Managed Health Care (DMHC) about the adequacy of their provider networks. The bill also requires DMHC to post annual reviews regarding plan compliance on its website.  This California Medical Association (CMA) supported the bill, SB 964 (Hernandez), which passed late last week and is now on the governor's desk awaiting his signature.  With roughly 1.4 million Californians newly enrolled in ...

Covered CA Materials for Your Patients

The CMA Foundation (CMAF) and California Medical Association (CMA) have been awarded a grant from Covered California, the state's new health benefit exchange/marketplace.  The purpose of the grant is to educate doctors and their health care team about Covered California and resources that are available for patients on where to go for additional information on programs that may be available based on their specific needs.  The CMA Foundation, in partnership with San Bernardino County Medical Society, can provide you with patient education materials to distribute to patients asking for ...

Health Benefit Exchange Toolkit Now Available

In 2010, Congress passed historic sweeping health care legislation, the Patient Protection and Affordable Care Act (ACA), which reformed the for-profit health insurance industry and beginning in 2014 will provide health insurance to most of the nation’s uninsured. Under the ACA, two thirds of California’s uninsured will be covered by private insurance through a health insurance exchange purchasing pool. The exchange’s goal is to start pre-enrollment in October 2013. CMA has developed a new toolkit titled, CMA’s Got You Covered: A physician’s guide to Covered California, the state’s health benefit ...