Author Archive | Judi Hilman

Blue Shield Tries To Back Out Of $140 Million Commitment to California Communities

When nonprofit insurer Blue Shield California made a $1.2 billion bid to acquire Care1st, a Medi-Cal managed care plan serving 500,000 Southern California patients, it agreed to conditions set forth by DMHC (Department of Managed Health Care), including a commitment to increase its investment in the state’s safety net by an additional $140 million over 10 […]

Continue Reading

Fifth Circuit Appeals Court Ruling on President Obama’s Executive Order on Immigration: What It Means for #Health4All in California

Last Monday the U.S. Fifth Circuit Court of Appeals voted 2-1 to block President Obama’s 2014 executive order on immigration, dealing a major setback to efforts to shield an estimated five million immigrants living in the U.S. from deportation (learn more here). Issued in November 2014, the President’s executive order would have allowed millions of […]

Continue Reading

Obamacare in the Ballot Box: Quick Take on Kentucky Governor’s Race from California

Heading into last Tuesday’s mid-term election, there was plenty at stake for the future of health reform (HBO’s John Oliver tried to warn us), particularly in states that have refused or have yet to decide whether to implement the optional Medicaid expansion—or had decided, like Kentucky, to opt in, not because the political winds were blowing […]

Continue Reading

DHCS & CMS Agree to Medi-Cal 2020 Waiver Framework!

This past Saturday (Halloween), the California Department of Health Care Services announced it had reached a new “conceptual agreement” with the federal Centers for Medicaid and Medicare Services (CMS) on the general framework of “Medi-Cal 2020,” the renewal of the 2010-2015 Medi-Cal waiver. Toplines With details to be specified in the coming months, the framework is […]

Continue Reading
BrowsePlansSampleCovCANov1_1300pix

Covered California Open Enrollment Started Sunday!

Yesterday marked the official start of Covered CA open enrollment, which will run through January 31, 2016. For coverage effective January 1, people must enroll by December 31, 2015. As always, Medi-Cal enrollment is open year-round and individuals experiencing any life transitions (losing a job or moving, among many qualifying events for Special Enrollment) may […]

Continue Reading

HHS Proposed Regulations Barring Discrimination on Basis of Sex, Gender, Gender Identity, Race and National Origin, Disability, and Age Need Work: Deadline to Comment is November 9, 2015

Last month the federal Department of Health and Human Services (HHS) released a proposed rule implementing Section 1557 of the Affordable Care Act, which extends civil rights protections under Title VI, Title IX, the Age Discrimination Act, and the Americans with Disabilities Act (ADA), among others, to health programs that receive any federal funds.  No […]

Continue Reading
OPA_ReportCard_screenshot

Q & A with the California Office of the Patient Advocate OPA: 2015-16 Report Cards Release

Background Last week the California Office of the Patient Advocate released the newest edition of its 2015/16 Quality Report Cards. The Report Cards provide a tool to assist Californians in comparing quality scores for health plans and medical groups in order to make fully informed health care decisions based on the latest quality data and not […]

Continue Reading

DHCS Stakeholder Advisory Committee October 14, 2015: Highlights for Consumer Advocates

Update on MCO (Managed Care Organization) Tax DHCS Director Jennifer Kent opened with an update on the MCO tax and the need to revise it to meet new federal guidelines to broaden the base to all health plans (learn more here).  Last Spring, the Governor called a special session to resolve this and related Medicaid financing […]

Continue Reading
CovCAPlanQuality2014to2015_10-8-5

Covered California Board Meeting Highlights from October 8, 2015

With less than one month before open enrollment (November 1 – January 31), the Board focused mainly on this year’s research-driven “no wrong door” approach to maximizing enrollment and facilitating thoughtful plan selection using shop and compare tools, quality ratings, and reaching out to enrollees who look like they could benefit from enhanced silver plans […]

Continue Reading

Governor Brown Signs Key Patient Protections Bills Against Unfair Out-of-Pocket Costs

California Governor Jerry Brown yesterday signed four patient protection bills that will address unfair out-of-pocket costs, including out-of-network bills due to inaccurate provider directories, huge cost-sharing for specialty drugs, double deductibles in family plans, as well as extend protections against “junk insurance” to benefits offered by large employers. These Health Access-sponsored bills address some of the […]

Continue Reading