Significant Enforcement Actions
The Office of Enforcement investigates a number of health care service plans and/or takes enforcement actions that receive media attention.
The links below take you to the enforcement actions that have been recently publicized.
- PacifiCare of California: Letter of Agreement Re: Failure to pay claims timely, March 21, 2008.
- California Physicians' Service d.b.a. Blue Shield of California: Letter of Agreement Re: Independent Medical Review Process, November 21, 2007
- Health Net of California, Inc. Re: Consent Agreement November 16, 2007
- Molina Healthcare of California: Letter of Agreement Re: Misdirected Claims,
August 2, 2007 - Kaiser Foundation Health Plan, Inc: Consent Agreement Re: Oversight of Quality Assurance Programs,
July 30, 2007 - Blue Cross of California: Consent Agreement Re: Provider Notification of Change in Rates,
June 5, 2007 - Kaiser Foundation Health Plan, Inc: Letter of Agreement Re: Reasonable Person Standard for ER Claims,
May 3, 2007 - Kaiser Foundation Health Plan, Inc.: Letter of Agreement Re: Post Claims Underwriting,
March 1, 2007 - Kaiser Foundation Health Plan, Inc.: Letter of Agreement Re: Post Claims Underwriting,
December 13, 2006 - Vision Plan of America: Order Adopting Proposed Decision,
September 6, 2006