Leading the Nation in Serving the Health Care Needs of Low-Income Families and Undocumented Residents Starting on January 1 this year, California became the first state in the nation to ensure that all low-income residents qualify for Medi-Cal, the state’s version of Medicaid. The expansion includes undocumented immigrants who are otherwise eligible for Medi-Cal... Read More »
California’s Department of Managed Health Care (DMHC) routinely surveys health plans in the state to ensure they are complying with the law. Outside of its routine, whenever DMHC has good cause to investigate issues of compliance with the law, it initiates an investigatory survey known as a non-routine survey. In 2019, DMHC conducted one... Read More »
The Department of Managed Health Care (DMHC) is a California government agency tasked with protecting the rights of consumers to receive the benefits and services their health plans are supposed to provide. When health insurers fail to do their jobs, the DMHC Office of Enforcement is there to hold them accountable for their failings... Read More »
The fact that insurance companies cannot deny claims unreasonably or otherwise act in bad faith toward their policyholders seems so obvious that one would expect such has always been the case. But the truth is that the concept of bad faith insurance in California is not that old; the concept was still being laid... Read More »
When it comes to health insurance, two common types of plans are Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. While both types of plans offer essential health coverage, they differ in structure, cost, and flexibility. They can also have profound differences when it comes to requesting a referral to a specialist... Read More »
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