What’s happening: The California Department of Managed Health Care (DMHC) has fined Blue Cross of California (Anthem Blue Cross) $500,000 after a health plan member was forced to file 17 grievances in order to obtain coverage for cancer care, including chemotherapy.
What else to know: Anthem Blue Cross has acknowledged its failure to respond to the member’s grievances and agreed to pay the fines, repay providers, and take corrective action involving the grievance process.
“Under the law,” a DMHC press release states, “the plan should have tracked these issues as urgent grievances and provided an expedited review, since they involved an imminent and serious threat to the health of the patient.”
CHA continues to work to hold insurers accountable for meeting their basic responsibilities to patients and advocating for increased oversight and accountability for insurance companies.
For more information, contact Patricia Blaisdell, vice president, policy, at pblaisdell@calhospital.org.
