DMHC Fines Health Net $100,000 for Late Payments to Providers
The Department of Managed Health Care yesterday fined Health Net $100,000 for failing to pay claims on time, the second-largest penalty ever levied by the agency, the Los Angeles Times reports. The department said that Health Net did not reimburse doctors and hospitals in the 45-day window required by state law and will have to pay providers $54,000 in interest on "overdue claims" (Gellene, Los Angeles Times, 9/26). Health Net, the state's fourth-largest HMO with two million members, attributed the late claims to a problem with its computer tracking system between 1996 and 2000 and said that the error had been corrected (Colliver, San Francisco Chronicle, 9/26). The largest fine handed down by the DMHC came in March, when PacifiCare Health Systems was ordered to pay $250,000 for similar violations. Yesterday, the agency also fined Heritage Provider Network $50,000 for "alleged late payment violations" and ordered it to pay $200,000 in interest (Los Angeles Times, 9/26). DMHC Director Daniel Zingale, discussing the late payments, said, "It's posing a threat to patient care. ... We'll see more of these [fines] until the HMOs start paying their bills on time" (San Francisco Chronicle, 9/26).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.