Earlier this week, CHA took the next step in an important lawsuit against Anthem Blue Cross. The good news: A Los Angeles Superior Court previously sided with CHA on the merits of the case and recently denied Anthem’s efforts to close off appeal. The bad news: The court previously decided it would “abstain” from further involvement — that is, from providing a remedy. CHA has now filed paperwork to appeal that abstention and seek remedy.
What’s happening: U.S. Department of Health and Human Services leadership has received commitments from multiple insurance companies to streamline prior authorization processes by cutting red tape, accelerating care decisions, and enhancing transparency for patients and providers.
What’s happening: On June 30, CHA submitted comments to the Centers for Medicare & Medicaid Services (CMS) in support of data collection and audit proposals that would increase Medicare Advantage Organization (MAO) transparency and accountability, ensuring appropriate and timely access to Medicare services.
What’s happening: In a letter sent June 12, CHA urged all members of the California congressional delegation to support bipartisan legislation that would improve access to care for seniors enrolled in Medicare Advantage plans.
A couple of weeks ago, California’s Senate and Assembly appropriations committees determined which bills should move forward and which should be held this year based on estimated costs to the state.
What’s happening: On May 15, the U.S. departments of Labor, Health and Human Services, and the Treasury announced that they will not enforce the 2024 mental health parity final rule that aimed to improve access to mental health services by requiring health plans to make changes when inadequate access is provided.
What’s happening: Multiple bills addressing insurer accountability have been introduced in the California State Assembly during the current legislative session. On behalf of its member hospitals, CHA is supporting several bills that would improve the prior authorization process by reducing response times, clarifying reviewer qualifications, and/or reducing or eliminating prior authorization for certain services.
What’s happening: In its finalized changes to the Medicare Advantage (MA) and Part D prescription drug programs for contract year 2026, the Centers for Medicare & Medicaid Services (CMS) struck most of the Biden-era proposals and declined to finalize additional insurer accountability provisions.
What else to know: The rule, which did not address several other proposals (detailed below), is effective Jan. 1, 2026.
What’s happening: The California Department of Managed Health Care (DMHC) has issued All Plan Letter (APL) 25-007, which provides guidance to health care service plans on requirements for reimbursing claims for health care services with a date of receipt on or after Jan. 1, 2026. What else to know: The updated guidance reflects the provisions […]