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 »  Home  »  SoCalPhys Archives  »  2007  »  08 August  »  DMHC Delays Hearing Examining Blue Cross Business Practices
 »  Home  »  News  »  Policy News  »  DMHC Delays Hearing Examining Blue Cross Business Practices
DMHC Delays Hearing Examining Blue Cross Business Practices
By Chris Womack | Published  08/1/2007 | 08 August , Policy News
The move causes extreme concern to California's physician community.

In a move tagged by the California Medical Association as "the cause of extreme concern to California's physician community," the California Department of Managed Health Care delayed from July 19 to Aug. 7 a public hearing examining the business activities of Blue Cross of California since it was acquired. In 2004, Blue Cross parent WellPoint Health Networks was purchased by Indianapolis-based Anthem.

"It is our hope and expectation that DMHC will be vigilant and forceful in the demands required of Blue Cross in meeting its regulatory obligations," said CMA President Anmol Mahal, MD, in a statement. "It is clear that Blue Cross will continue any and all efforts to delay action by the DMHC in order to protect profits at the expense of consumers."

The hearing will review vows Anthem made as a condition of its Blue Cross acquisition, including obligations to uphold its level of service to state programs. Also, DMHC plans to examine the insurer's dedication to the California market and complaints from consumers and providers. The CMA, the Los Angeles County Medical Association and physician leaders will testify.

WellPoint spokeswoman Shannon Troughton told the Los Angeles Times that the hearing notice and agenda lacked enough detail to satisfy open-meeting laws allowing the company to fully address the issues, according to a July 17 article.

The DMHC has received more than 1,600 complaints about Blue Cross since the 2004 business deal, according to the Times. The DMHC says that consumer complaints have alleged that Blue Cross raised premiums and retroactively revoked coverage following serious illnesses or injuries, while physicians have complained about delays and other problems collecting fees.

In addition, the CMA accuses Blue Cross in a statement of spending less on medical care and treatment than before the acquisition, while maintaining less administrative capacity to meet Knox-Keene Act legal obligations.



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