Posts Tagged: insurers
News
Almost 2 million of California’s poorest and most medically fragile residents may have to switch health insurers as a result of a new strategy by the state to improve care in its Medicaid program. A first-ever statewide contracting competition to participate in the program, known as Medi-Cal, required commercial managed-care plans to rebid for their contracts and compete against others hoping to take those contracts away.
Opinion
OPINION: Increasingly, California residents have been left with no choice but to accept the California FAIR Plan, the insurer of last resort, and the typically higher rates that come with it. The FAIR Plan provides basic fire insurance coverage when traditional insurance is not available, often for properties that other insurers decline to cover because they are considered high-risk.
Recent News
The latest chapter in a decades-long battle between physicians and lawyers is unfolding through compromise in Sacramento and so far, almost everyone involved has come aboard. The political battle revolves around California’s Medical Injury Compensation Reform Act (MICRA) which limits the amount of money patients can receive if injured by a physician in connection with medical treatment.
News
For at least the immediate future, single-payer health care in California seems dead. It died on Jan. 31, when its author withdrew legislation creating it from the Assembly floor, citing insufficient votes. But there are rumblings. And since nothing ever seems to die in the Capitol, the question now being asked is: After being sidelined in the Legislature, will single-payer make a comeback in California?
Opinion
OPINION: Due to cost-cutting policies, health insurers often become a barrier to access for medicines that providers prescribe to patients. One such practice is referred to as step therapy. Step therapy forces patients to try several medications before approving the medication originally prescribed by the doctor.
Opinion
OPINION: Step therapy forces patients to try insurer-preferred medications before approving the medication initially prescribed by the doctor. Utilized by both public and private insurers, step therapy undermines the clinical judgment of doctors and puts patients’ health at risk.
News
Landmark legislation to improve California’s notoriously fractured mental-health system has been passed and sent to the governor in the waning days of a chaotic legislative session disrupted by the COVID pandemic. “This package of legislation is a game-changer,” said Maggie Merritt, executive director of the Steinberg Institute.
Opinion
OPINION: It’s never a good idea when insurers cut costs by interfering in the decision-making process between patients and their doctor. But during a national pandemic, it’s a particularly bad idea. I am thinking specifically of an insurance strategy called step therapy.
Recent News
The Madera patient says he likes his Kaiser doctor and has no desire to switch to publicly funded Medicare, even though he qualifies. But if Senate Bill 1156 is approved, Adames likely wouldn’t get that choice. The bill would require that patients like him receiving third-party assistance would either need to enroll in Medicare or Medi-Cal (for those who are low income), or if they choose to stay on private insurance, they will only receive reimbursement at Medicare or Medi-Cal’s much lower rates.
Opinion
OPINION: My insurance company has entirely ignored my doctors’ medical expertise and flatly refused to pay for the physician-prescribed treatment. I’ve learned that my plight is not unique, that there is a systematic failure to hold insurers accountable for unfair delays and inappropriate denials of recommended cancer care. California’s insurance commissioner, Dave Jones, can fix this.
A man receives a one-shot vaccination against COVID-19 in Covina. (Photo: Ringo Chiu, via Shutterstock)
