Timely access to healthcare isn’t just a regulatory requirement in California; it’s a fundamental right for policyholders under managed care plans. Despite the protection in law, some insurers and health plans fail to meet their obligations, leaving patients without the care they need. The California Department of Managed Health Care (DMHC) enforces these rules,... Read More »
When you or a loved one needs medical care, how soon you can get that care often matters as much as what kind of care you receive. In California, insured patients under managed care plans have legal rights to timely access, meaning that their health plan must ensure covered services are provided without undue... Read More »
As more California residents face health insurance denials for medically necessary care, the need for skilled legal advocacy has never been greater. Insurance companies have a legal and ethical duty to act in good faith, meaning they must handle your claim fairly and promptly. Unfortunately, many fail to live up to that obligation, leaving... Read More »
California law is quite clear. State statutes and regulations require health plans to cover “basic health care services” among other requirements, but even this simple mandate seems beyond the willingness or ability of many health plans to meet. Here’s a look at some of the law’s most basic requirements, along with recent examples of... Read More »
California Insurer Didn’t Meet Minimum Threshold in Spending Its Money on Medical Services and Quality Care The Department of Managed Health Care (DMHC), responsible for protecting consumers’ health care rights and ensuring a stable health care system by overseeing managed health care plans in California, recently found Anthem sorely lacking in the amount of... Read More »
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