DMHC Actions Against Insurers Have Dropped Significantly Since 2011
The number of fines and enforcement actions levied against health insurers by the state Department of Managed Health Care have decreased significantly since 2011, Payers & Providers reports.
Between 2009 and 2011, DMHC levied nearly 1,000 enforcement actions against health insurers and fined them nearly $9 million.
On Aug. 11, 2011, Gov. Jerry Brown (D) appointed Brent Barnhart -- a former health plan lawyer and lobbyist -- to lead DMHC.
Details of DMHC Actions Under Barnhart
After Barnhart was appointed, DMHC issued 74 enforcement actions during the remainder of the year, compared with 433 in the first half of 2011.
In 2012, DMHC issued 90 enforcement actions, significantly lower than its annual average for the previous 10 years.
Last year, DMHC issued $451,000 in fines -- or just over $5,000 per enforcement action -- compared with 2010 when the agency issued $2.2 million in fines, with an average fine of more than $20,000 per enforcement action.
Response From DMHC
Marta Green, a DMHC spokesperson, disputed the findings by Payers & Providers, which used information from DMHC's public database.
In an email, she said, "[F]or some enforcement actions, a monetary penalty is appropriate.Â For others, an order barring a plan, medical group or provider from engaging in an illegal practice is a more appropriate and effective strategy." She added, "The most potent strategy may be to force a plan to reimburse consumers for care that was denied or delayed or providers for inappropriate claims payment."Barnhart was not available for comment (Payers & Providers, 2/28). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.