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.
A little more than two weeks ago, the deadline passed for California lawmakers to introduce bills for this year’s legislative session. In all, some 2,350 bills are in play this year — a number in line with historical trends.
Current California standards require health plans to ensure that their enrollees have timely access to medical care — such as being within 15 miles or a 30-minute drive from a hospital. Unfortunately, many people covered by Medi-Cal still face significant hurdles to access care.
California standards that ensure timely access to care for Medi-Cal enrollees will expire in less than a year.
What’s happening: In December, CHA’s board approved three advocacy priorities for California hospitals in 2025: Insurer Accountability, Office of Health Care Affordability (OHCA), and Securing Hospitals. New and updated advocacy materials on these priority issues are now available on CHA’s website.
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’s happening: CHA submitted comments in response to the Centers for Medicare & Medicaid Services’ (CMS) proposed policy and technical changes to Medicare Advantage (MA) and Part D programs for contract year 2026.
What else to know: Finalization of the proposed rule is expected in April — in time for MA plans to bid to CMS and offer MA products for plan year 2026. The rule, once finalized, will take effect Jan. 1, 2026.
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’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.
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What’s happening: The Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure has responded to a congressional letter, signed by several members of the California delegation, that urged CMS to take steps that will ensure Medicare Advantage (MA) plan beneficiaries have access to medically necessary inpatient rehabilitation facility (IRF) care.
What else to know: In the letter, Ms. Brooks-LaSure notes several recent rules issued by CMS that seek to ensure that MA plans adhere to CMS requirements, including network adequacy, prior authorization, and data collection. Ms. Brooks-LaSure also agrees to take the writers’ comments into consideration for future policy development.