DMHC Puts Renewed Focus on Unfair Health Plan Payment Practices
Two new developments show renewed focus by the state’s principal health plan regulator, the Department of Managed Health Care (DMHC), on unfair health plan payment practices.
CHA Letter Asks HHS Secretary to Address Unfair Payment Practices
CHA has sent a letter to Mark Ghaly, MD, secretary of the California Health & Human Services Agency, asking him to direct the state’s health plan regulators to take immediate action to address the plans’ unfair payment practices.
New Reporting Process for Managed Care Plan Issues
For leaders of case management and utilization review, directors of reimbursement, directors of managed care
Newspaper Editorials Voice Concerns About Single-Payer Legislation
Among the most hotly debated issues in the state Legislature this year is whether California should dismantle its existing health care system in favor of a government-run single-payer system.
CHA to Host Member Forum on Draft Medi-Cal Managed Care RFP
On June 17 from 3 to 4 p.m. (PT), CHA will host a member forum to present an overview of the draft request for proposal for the Medi-Cal managed care plan (MCP) contract and the upcoming Medi-Cal MCP procurement that was released by the Department of Health Care Services on June 1. Ryan Witz, CHA vice president of health care […]
DMHC Releases Guidance on General Licensure Regulation
The Department of Managed Health Care (DMHC) has released final guidance on its Knox-Keene licensure regulation, which applies to any contract entered into, amended, or renewed on or after July 1. The regulation, among other things, defines various types of risk and requires entities that assume any amount of global risk to either obtain a license under the Knox-Keene Health Care Service Plan Act of 1975 or receive an exemption from DMHC.
May 20 Marks Comment Deadline for DMHC Draft Implementation Guidance on Licensure Regulation
The Department of Managed Health Care (DMHC) has released draft guidance and accompanying forms — a confidentiality request form and an expedited exemption request form — related to its Knox-Keene licensure regulation. The regulation, among other things, defines various types of risk and requires entities that assume any amount of global risk to either obtain a license under the Knox-Keene Health Care Service Plan Act of 1975 or receive an exemption from DMHC.
Hospitals Should Consult With Counsel on Expanded DMHC Licensure Requirements
The California Department of Managed Health Care (DMHC) has promulgated a new general licensure regulation, effective July 1, that greatly expands the types of health care service plans requiring a license. CHA encourages members to consult with their counsel to determine how the new regulation will impact their organization.
Senate Health Committee Holds Hearing on Improving Performance in Commercial Health Insurance and Medi-Cal
Earlier this week, CHA attended a Senate Health Committee informational hearing that examined strategies across all purchasers and programs that have the objective of improving the care delivered to people with chronic conditions.
Department of Managed Health Care Releases Timely Access Report
A new report from the Department of Managed Health Care examines the degree to which providers were able to offer timely appointments in response to patients’ requests, based on provider-reported data from measurement year 2017.