(Sacramento) – The California Department of Managed Health Care (DMHC) has taken enforcement action including a $5 million fine against Blue Cross of California (Anthem Blue Cross) for systemic grievance system violations. Anthem Blue Cross has demonstrated a pattern and practice of failing to identify, timely process and resolve enrollees’ grievances. Anthem Blue Cross has also failed to fully and timely provide information to the Department during the investigation of member complaints.

“The grievance process is fundamental to protecting consumers’ health care rights and ensuring consumers receive the care they need,” said DMHC Director Shelley Rouillard. “Anthem Blue Cross’ failures to comply with the law surrounding grievance and appeals rights are longstanding, ongoing and unacceptable. The plan must correct the deficiencies in their grievance and appeals system and comply with the law.”

(Sacramento) – California Department of Managed Health Care (DMHC) Director Shelley Rouillard issued the following statement today following the release of new federal regulations regarding contraception coverage.

“We are reviewing the details of the new federal regulations and possible impacts to Californians enrolled in plans licensed by the DMHC,” said DMHC Director Shelley Rouillard. “However, it is important to note that California has a long history of expanding timely access to birth control to prevent unintended pregnancy. California has enacted laws that promote gender equity and women’s health, and state regulated health plans must cover contraceptives for women without cost sharing with very narrow exceptions offered for religious employers as defined in California law.”

The Department of Managed Health Care invites you to the Financial Solvency Standards Board (FSSB) public meeting on October 18, 2017. For more information please click here.

The Department of Managed Health Care 2016 annual report and infographic are now available online. Both of these documents highlight the DMHC’s activities during 2016 and include key statistics about the Department.

DMHC 2016 Annual Report

2016 Infographic