[courtesy of California Progress Report]

By Hanh Kim Quach
Health Care Policy Coordinator
Health Access California

The most exciting thing this week (other than Health Access' report release) was the release of the California Medical Association's annual "Knox-Keene Health Plan Expenditures Report,'' which replaces my old dog-eared copy from a couple years ago.

The report gathers data reported by health plans to the Department of Managed Health Care to show which ones spend the most on medical services for their enrollees (and which ones spend the most on administration and profit). This is called the "Medical Loss Ratio,'' you know, because plans ''lose'' money when they spend it on health care for you. The percentage of premium dollars spent on patient care is an important (though not the only) measure of a plan’s value.

[courtesy of California Progress Report]

• Tale of two health care committees
• Senate fails to pass bill that would license and regulate "discount" health cards while Assembly passes legislation to fill out benefits on some bare bones plans
• Bills to allow local county-run health plans to expand, compete; children's coverage, mandatory Medi-Cal managed care, benefits

By Hanh Kim Quach
Health Care Policy Coordinator
Health Access California

CALIFORNIA SENATE HEALTH COMMITTEE

The Senate Health Committee heard nearly two dozen bills on Wednesday in the final hearing before Friday’s policy committee deadline to get bills to a fiscal committee. Following is a roundup of the fate of some of the bills of interest to health and consumer advocates:

DISCOUNT CARDS:

SB 1603 (Calderon) would have directed the state Department of Managed Health Care to license and regulate so-called discount health cards, which promise consumers deep (though often unverified) discounts on medical services from a network of providers (also often unverified). Consumers purchase a list of discount providers at a cost of up to $120/month. The state is in the process of promulgating regulations to address these plans, but current state law bans them, even though some currently operate in California.

[courtesy of California Progress Report]

• Lawmakers question Department of Managed Healthcare’s oversight of health insurers
• Inquiry into regulations for timely access, discount plans, rescissions, language access and mental health parity
• Laws passed more than five years ago still not implemented

By Hanh Kim Quach
Health Care Policy Coordinator
Health Access California

At a special hearing of the Senate Health Committee on Thursday, Department of Managed Health Care Director Cindy Ehnes was questioned for over nearly seven hours about her department’s handling of five separate regulations and whether it had met its charge as a consumer protection agency in implementing and enforcing laws to help patients.

“This hearing is meant to provide a level of oversight to ensure that legislation that is passed gets implemented in a way that is consistent with the way it was intended,’’ said Sen. Sheila Kuehl, chair of the Senate Health Committee.

[courtesy of California Progress Report]

Oversight by Schwarzenegger Administration of Timely Access, Language, So-Called Discount Health Plans, Retroactive Denials Of Coverage, and Mental Health to be Reviewed in 5 Hour Hearing

By Anthony Wright
Executive Director of Health Access California

Victoria Colliver at the San Francisco Chronicle has a preview of today's Senate Health Committee hearing--which is expected to be at least five hours of grilling on a range of meaty issues.

The Senate Health Committee, chaired by Senator Sheila Kuehl, will hold a hearing today on "Consumer Protection under the California Department of Managed Health Care: Adequacy of Implementation and Enforcement," reviewing the DMHC's oversight in five key areas: timely access, language access, so-called discount health plans, retroactive denials of coverage; and mental health.

In all these issues, they strike to the core of whether the coverage is meaningful, and whether the consumer is getting value for what they paid for. And on all these topics, there are pending decisions regarding regulations or implementation issues at the DMHC.

[courtesy of California Progress Report]

By David Dayen
d-day

It looks as if the Foundation for Taxpayer and Consumer Rights is planning on going to the ballot in 2010 with a proposal to basically do to the health insurance industry what Proposition 103 did to the auto insurance industry.

“We are going ahead with this,” said Jamie Court, president of the Santa Monica-based Foundation for Taxpayer and Consumer Rights. “The only thing that would block this is if the single-payer (universal health care) folks want to go ahead and go to the ballot, or if a new president wants to do something more ambitious. In that case, we would back off.” [...]

by David Dayen [courtesy of Calitics - Front Page]

[courtesy of California Progress Report]

Department of Managed Health Care Seen as Fox Guarding the Chicken Coop

By Anthony Wright
Executive Director of Health Access California

Dale Bonner was confirmed this last week by the Senate Rules Committee as the Secretary of Business, Transportation and Housing, cabinet position within the Schwarzenegger Administration.

But not before several Senators asked a series of tough questions about his oversight over the Department of Managed Health Care. This was part of a wide-ranging hearing that reflected the broad scope of the department, from housing to transportation issues as well.

Senator Padilla asked about the level of fines levied at Blue Cross and other insurers over rescissions, and said he's "not convinced [they] get to the level of deterrence needed" and that he's thinks that "all of the players have not gotten the message." After being asked about how the Department is made aware of consumer complaints, Bonner stated "I don't think [the Department] is sufficiently pro-active."