Imagine purchasing health insurance with the belief that mental health services are within reach—only to discover that in-network providers are unreachable, unresponsive, or simply don’t exist. This happened to Arizona resident Ravi Coutinho, whose tragic story exposes the dark reality of so-called “ghost networks.” Ravi’s case is a stark example of how insurers can hide... Read More »
Last April, the California Hospital Association (CHA), a nonprofit member organization representing over 400 hospitals and health systems throughout California, sued Anthem Blue Cross in Los Angeles County Superior Court, alleging that certain Anthem practices were depriving patients of timely post-hospital health care and forcing hospitals to provide (and pay for) additional care after... Read More »
The Department of Managed Health Care (DMHC) is a California state agency charged with regulating insurance companies offering health plans in the state. When insurers violate laws intended to protect consumers and ensure access to adequate healthcare, the DMHC’s Office of Enforcement has many tools at its disposal to punish violators and order corrective... Read More »
The California Department of Managed Health Care (DMHC) licenses and monitors health plans operating in the state. The DMHC Office of Enforcement works to change plan behavior to comply with the law, utilizing enforcement actions including cease and desist orders, administrative penalties (fines), freezing enrollment, and requiring corrective actions. In some cases, the DMHC... Read More »
When a health insurance company denies a valid claim, it’s more than just a financial setback—it’s a betrayal of trust at a time when policyholders are most vulnerable. Unfortunately, pursuing legal action against an insurance company for a wrongful denial isn’t as simple as it may seem. Health insurance denial cases are legally and... Read More »
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