DMHC Fines Anthem Blue Cross $690,000 for Delaying Reimbursements to Providers & Members
January 4, 2024
The DMHC has taken enforcement action against Blue Cross of California (Anthem Blue Cross) including a $690,000 fine for failing to timely reimburse providers and health plan members for services provided. The plan has paid the fine and implemented several corrective actions, including improving its policies and procedures involving Independent Medical Review decisions.
Read January 4, 2024 Press Release
DMHC Reports Health Plan Prescription Drug Costs Increased by $1.3 Billion in 2022
December 26, 2023
The DMHC Prescription Drug Cost Transparency Report for Measurement Year 2022 looks at the impact of the cost of prescription drugs on health plan premiums and compares this data across the reporting years, 2017 through 2022. Among other findings, the report reveals that health plan spending on prescription drugs increased by $3.4 billion since 2017, including an increase of almost $1.3 billion in 2022.
Read December 26, 2023 Press Release
DMHC Fines Blue Shield of California $200,000 for Mishandling Provider Claims
December 13, 2023
The DMHC took an enforcement action against California Physicians’ Service (Blue Shield of California), including a $200,000 fine for mishandling provider claims which resulted in a health plan member not getting the care they needed. The plan has paid the fine and implemented corrective actions, including updating its claim processing procedures to ensure claims are processed correctly.
Read December 13, 2023 Press Release
Mailing Address: California Department of Managed Health Care 980 9th Street, Suite 500 Sacramento, CA 95814-2725
(916) 445-7442
media@dmhc.ca.gov
Read more news about the DMHC
Stay in touch! Join our mailing list to receive the latest DMHC updates.
February 22, 2024 - State Reaffirms Right to Contraceptive Care
January 4, 2024 - DMHC Fines Anthem Blue Cross $690,000 for Delaying Reimbursements to Providers & Members
December 26, 2023 - DMHC Reports Health Plan Prescription Drug Costs Increased by $1.3 Billion in 2022, $3.4 Billion Since 2017
December 13, 2023 - DMHC Fines Blue Shield of California $200,000 for Mishandling Provider Claims
October 12, 2023 - DMHC, Kaiser Permanente Reach Settlement Agreement to Transform Plan’s Behavioral Health Care Delivery System and Improve Behavioral Health Statewide
June 15, 2023 - DMHC Fines Kaiser Permanente $450,000 for Violating Enrollee Confidentiality
April 10, 2023 - Joint Statement from California Health & Human Services Leaders on Governor’s Announcement of an Abortion Medication Emergency Stockpile
March 30, 2023 - Joint Statement from California Health & Human Services Leaders on Affordable Care Act Federal Ruling
March 30, 2023 - DMHC Announces Transgender, Gender Diverse, or Intersex Working Group Members, First Meeting
March 27, 2023 - DMHC Fines Health Net Health Plan for Failing to Accurately Pay $1.2 Million in Provider Claims
January 22, 2023 - Joint Statement from California Health and Human Services Agency Leaders on 50th Anniversary of the Roe v. Wade Decision
January 18, 2023 - DMHC Fines L.A. Care Health Plan $300,000 for Deceptive Enrollment Tactics
December 27, 2022 - DMHC Report Shows Prescription Drug Costs Increased by $2.1 Billion Over Five Years
December 21, 2022 - DMHC Adopts Health Equity and Quality Measures for Health Plans
November 7, 2022 - DMHC-Regulated Health Plans Must Provide Access to Emergency & Urgent Care Abortion Services Out-of-State
August 15, 2022 - DMHC Monitoring Access to Services at Kaiser Permanente During Strike
June 24, 2022 - Joint Statement from California Health and Human Services Agency Leaders on Continued Access to Reproductive Health Services
June 17, 2022 - DMHC Fines Molina $1 Million in Enforcement Actions for Delaying Provider Payments
June 9, 2022 - DMHC Fines Anthem Blue Cross $1.1 Million, Requires Corrective Actions to Protect Consumers
March 4, 2022 - State Fines L.A. Care Health Plan $55 Million in Enforcement Action to Protect Consumers
February 1, 2022 - DMHC Announces Health Equity and Quality Committee Members, First Meeting
December 30, 2021 - DMHC Approves Centene’s Acquisition of Magellan with Conditions to Protect Consumers
December 27, 2021 - DMHC Report Shows Prescription Drug Costs Increased $1.5 Billion Over Four Years
January 28, 2021 - California Joins President Biden in Responding to COVID-19 Pandemic by Announcing Special Enrollment to Help People Get Insurance
January 5, 2021 - DMHC Takes Action to Ensure Health Plans Comply with California’s Mental Health and Substance Use Parity Law
December 30, 2020 - DMHC Report Shows Health Plans’ Prescription Drug Costs Increased $1 Billion since 2017
December 16, 2020 - DMHC Directs Health Plans to Remove Administrative Burdens on Hospitals During COVID-19 Surge
December 11, 2020 - DMHC Reminds Californians Approved COVID-19 Vaccines Will Be Provided at No Cost
October 28, 2020 - Blue Cross of California Partnership Plan Fined $1.2M for Failing to Authorize Medically Necessary Services
August 25, 2020 - DMHC Orders Aetna to Stop Wrongfully Denying Payment for Emergency Medical Services
July 29, 2020: California to Give Consumers More Time to Sign Up for Health Care Coverage by Extending Special Enrollment Deadline During COVID-19 Pandemic
June 23, 2020: California Extends Special-Enrollment Deadline to Give Consumers More Time to Sign Up for Health Care Coverage During COVID-19 Pandemic
March 20, 2020 - California Responds to COVID-19 Emergency by Providing Path to Coverage for Millions of Californians
March 5, 2020 - Governor Newsom, State Health Officials Announce More than 22 Million Californians Now Eligible for Free Medically Necessary COVID-19 Testing
January 10, 2020 - DMHC Report Shows Health Plans Paid More Than $400 Million Increase for Prescription Drugs in 2018
December 18, 2019 - DMHC Fines 12 Health Plans $1.9 Million for Improperly Denying Care to Enrollees
December 17, 2019 - DMHC Monitoring Access to Behavioral Health Services at Kaiser Permanente During Strike
November 8, 2019 - The DMHC Requires Orange County Doctor to Stop Balance Billing Enrollees
June 28, 2019 - DMHC Announces Members to Task Force on Pharmacy Benefit Management Reporting
June 6, 2019 - DMHC Reaches Agreement with Anthem Blue Cross to Protect Consumers