With the strength of a San Andres Fault spasm, California officials have retaliated against managed care organizations following a number of alleged missteps.
It seems like a week doesn't go by without a negative managed care article with a California city dateline. In this past week alone, two stories perpetuated the image of managed care as heartless.
The Los Angeles city attorney sued the state's largest health insurer charging that Anthem Blue Cross unlawfully canceled the coverage of as many as 6,000 Californians. In the other case, the state Department of Managed Health Care announced an independent arbiter will review policies canceled by five major insurers over the last four years to make sure they were not wrongly canceled. If rescinded in error, the state will reinstate the individual policies and require the insurer to pay the patient's medical bills that were incurred while the person was not covered.
Many officials have taken aim at the industry because of individual coverage cancellations, also called rescissions. Officials have supported the causes of individuals who have lost coverage and face mounting health bills and declining health. Cindy Ehnes, director of the Department of Managed Health Care, called rescission "a harsh practice," and has already ordered three of the state's largest insurers to reinstate 26 patients' policies.
Health Plan Insider readers have surely followed the proceedings in California, which plays into the perception of health insurers as unfeeling bean counters. Beyond this week's news, here are four stories from the Golden State that have blackened the eyes of managed care over the past four months:
Taken separately these articles are not pretty, but collectively they have created a climate where managed care is forced to explain itself. Elected officials are pursuing health insurers, and managed care reform could be the ultimate result.
Some of the problems are surely managed care's fault, but there are some overarching unanswered questions:
Managed care officials should keep tabs on California. The aftershocks from the Golden State could shake the industry to its core.
Les Masterson is senior editor of Health Plan Insider. He can be reached at email@example.com.