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April 23, 2008
Golden State Backlash
Les Masterson, Senior Editor-Managed Care

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. [Read More]

Editor's Picks
Insurer says economy has dented its prospects
In announcing its disappointing first-quarter earnings, UnitedHealth Group blamed the economy for its current difficulties, namely that fewer businesses and employees are signing up for its health insurance. UnitedHealth is the first of the nation's largest insurers to report earnings this period, and UnitedHealth's difficulties are causing alarm. [Read More]
L.A. city attorney sues insurer for canceling coverage
Los Angeles' city attorney is suing Anthem Blue Cross for allegedly unlawfully canceling thousands of Californians' healthcare coverage. Rocky Delgadillo says Anthem Blue Cross, its parent company, WellPoint Inc., and another subsidiary illegally revoked the policies of as many as 6,000 members. Delgadillo's lawsuit seeks $2,500 per violation or $5,000 if the victim is a senior or disabled. Total fines and restitution could exceed $1 billion. [Read More]
Minnesota health plans post operating losses
Healthcare premiums may soon be on the rise after Minnesota health plans spent more on medical and administrative costs than they received in premiums in 2007. Minnesota's eight nonprofit health plan companies posted losses of $71 million, the third straight year of operating losses. [Read More]
California to review canceled health insurance policies
An independent arbitrator will review thousands of canceled health policies in California to see whether health plans were correct in canceling the policies. The state Department of Managed Health Care will reopen policies dropped over the last four years by the state's five major insurers. Meanwhile, health insurers are developing their own third-party reviews. [Read More]
Managed Care Headlines
CIGNA to stop hospital reimbursements for medical mistakes
AP/Yahoo News, April 18, 2008
Florida Senate passes healthcare bill
Miami Herald, April 17, 2008
Michigan doctors, nurses back healthcare proposal
Detroit Free Press, April 22, 2008
Three insurers bid for Connecticut plans
Hartford Courant, April 17, 2008
White House backs appeal on San Francisco healthcare
San Francisco Chronicle, April 17, 2008
GAO backs states on child healthcare
AP/Chicago Tribune, April 21, 2008
Parties' split most apparent on healthcare
Wall Street Journal (subscription required), April 21, 2008
Minnesota county's HMO gets $6 million bailout
Minneapolis Star Tribune, April 22, 2008
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Staying Legal
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Developments in DM
Momentum grows for Medicaid DM
There is considerable momentum among the states to move beyond fee-for-service in Medicaid to more coordinated care approaches for certain subsets of the beneficiary population. [Read More]
From HealthLeaders Magazine
Claims Quagmire

HealthLeaders April 2008
Despite federal laws to facilitate transactions, reimbursement claims processing remains mired in a complex tangle. [Read More]
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