Health insurance companies have enormous power in California. In fact, 94% of the commercial health insurance market is controlled by just six companies. They are increasingly denying enrollees access to care, and even refusing to pay for care that’s already been delivered, all while padding their bottom lines. CHA is working to hold insurers accountable for meeting their basic responsibilities to patients and advocating for increased oversight and accountability for insurance companies.
Latest News
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CHA Comments on DMHC Network Adequacy Standards
CHA News -
Office of Inspector General to Examine Medicare Advantage Use of Prior Authorization for Post-Acute Care
CHA News -
DMHC Provides Additional Guidance Regarding Post-Stabilization Care Requests
CHA News -
Creators of the Vitality Index Payer Scorecard Announce Partnership with HFMA
CHA News
Litigation
In April 2024, CHA filed a lawsuit against Anthem Blue Cross alleging that the insurance giant is harming patients due to its disregard for state requirements to maintain an adequate network of care providers and not paying for the additional hospital care it forces to be provided to patients. Read more:
Hospital Association Files Lawsuit Against Anthem Blue Cross for Violating Patient Protection State Laws
SACRAMENTO (April 23, 2024) — Anthem Blue Cross, one of California’s largest health insurance companies, consistently leaves thousands of its patients stranded in hospital beds long after they have been medically cleared for discharge, a violation of California law. These victims of discharge delays are forced to stay in hospitals longer, are deprived of timely post-hospital health care services, and cause backlogs for other patients who have to wait longer for hospital beds.
Contact: Patricia Blaisdell, vice president, policy
Legislative Advocacy
AB 1842 | Facilitate Access to Medication-Assisted Treatment
Would ban prior authorization for medication-assisted treatment
AB 3221 | Increase Oversight of Health Plan Practices
Pellerin, D-Santa Cruz
Would require records, books, and other documentation from health plans to be available for inspection, including in electronic form, by the Department of Managed Health Care
AB 3275 | Improve Timely Payment for Financially Challenged Hospitals
Soria, D-Merced and R. Rivas, D-Salinas
Would require health plans and insurers to reimburse services provided by small or rural providers, critical access hospitals, or financially distressed hospitals in a timely manner
SB 999 | Ensure Patients Receive Medically Necessary Care
Would require health plans and insurers to have qualified health care providers make review decisions, be available for authorization requests during normal business hours, and provide clinical citations used for care denials
SB 1320 | Promote Parity in Mental and Physical Health Care
Would require health plans and insurers to create a process to reimburse providers for mental health and substance use disorder treatment services that are integrated with primary care services
Resources
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Issue Brief
State Regulators Must Take Action to Ensure Patients Get Care When They Need It
![](https://calhospital.org/wp-content/uploads/2023/04/Medi-Cal-landing-page-banner-image-1024x683.jpg)
Statewide Survey on Insurer-Driven Discharge Crisis
Insurance Company Red Tape, Inadequate Networks, and Authorization Denials Leave Patients Stranded in Hospitals
On-Demand Education
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