The lawsuit alleges that Anthem fails to meet its legal obligations to arrange for timely access to care for its members as required under California law. Anthem is also accused of not responding in a timely manner — or at all — “to requests for authorization” for post-acute care for its members.
Court Agrees with Key CHA Arguments in Anthem Lawsuit But Will Not Hear Rest of Case
What’s happening: A Los Angeles Superior Court Judge has ruled on CHA’s lawsuit against Anthem Blue Cross, finding that it is the responsibility of health plans to arrange for and transition to post-acute care services for their members.
What else to know: Despite finding in favor of CHA on key points, the judge nonetheless decided to “abstain” from further involvement in the case.
Judge Delays Jan. 27 Hearing on Anthem’s Motions in CHA Lawsuit
What’s happening: A Los Angeles Superior Court judge has delayed the Jan. 27 court hearing on two motions by Anthem Blue Cross — to dismiss CHA’s lawsuit and strike requested remedies — to Feb. 14. In the lawsuit, CHA claims Anthem failed to provide timely post-hospital care for its members.
What else to know: CHA has filed opposition to each of the motions, disputing both Anthem’s legal arguments and its characterization of the facts. The judge’s decision could come as soon as the hearing, but no later than May 14. The judge gave no reason for delaying the hearing.
Judge to Hear Anthem’s Motions in CHA Lawsuit on Jan. 27
What’s happening: A Los Angeles Superior Court judge will hear two motions by Anthem Blue Cross on Jan. 27 to dismiss CHA’s lawsuit and strike requested remedies. In the lawsuit, CHA claims Anthem failed to provide timely post-hospital care for its members.
What else to know: CHA has filed opposition to each of the motions, disputing both Anthem’s legal arguments and its characterization of the facts. The judge’s decision could come as soon as the hearing, but no later than April 28.
Additional Participation Information Now Available on Blue Cross Blue Shield Settlement
What’s happening: With additional information available on the Blue Cross Blue Shield (BCBS) antitrust claims settlement process, hospitals will benefit from reviewing the recent BCBS antitrust settlement agreement’s potential impact with their legal counsel, including whether to remain in or opt out of the settlement.
What else to know: BCBS plans (referred to as Blue Plans) have agreed to a $2.8 billion settlement to resolve legal allegations from a slew of providers who claim the insurers colluded to prevent competition and lower reimbursements. The settlement will bring a decade-long legal battle to a close, should it secure final approval.
DMHC Fines Blue Cross of California $3.5 Million, Second Grievance-Related Fine in Recent History
What’s happening: On. Dec. 16, the California Department of Managed Health Care (DMHC) announced that it fined Blue Cross of California (Anthem Blue Cross) $3.5 million for mishandling member grievances and not responding on time.
What else to know: Anthem Blue Cross has paid the $3.5 million fine and acknowledged its failure to follow law, which states that “health plans must resolve a standard grievance within 30 days and send a written resolution to the member.”