Managed Health Care Department Sued Over Alleged Delays In Review Process
The agency is responsible for reviewing cases where the insurance company has denied coverage. In other news about the California Managed Health Care Department, Sylvia Mathews Burwell was questioned at a congressional hearing about the agency's decision last spring on some plans' abortion coverage.
KQED:
California Regulator Sued Over Delayed Mental Health Appeals
Let’s say you have a son who develops a drug problem or becomes suicidal. His doctor says he needs extensive treatment at a residential mental health center. But your insurance company denies the coverage. Consumers can appeal those decisions to California’s Department of Managed Health Care, which will review the insurance company’s decision and either uphold it or overturn it. Under law, the agency has six days to complete an urgent review, upon receipt of a complete application. A lawsuit filed late Tuesday alleges that the agency routinely violates review deadlines, sometimes taking weeks or longer to render a decision. (Dembosky, 2/24)
The Hill:
Obama Health Chief Admits Abortion Law Inquiry Too Slow
Health and Human Services Secretary Sylvia Mathews Burwell acknowledged Wednesday that the administration has not moved fast enough in investigating an alleged violation of abortion law. Burwell was questioned at a congressional hearing Wednesday about a California state agency’s decision in 2014 to require all health insurance plans in the state to cover abortions, which Republicans say is a clear violation of the federal Weldon Amendment, protecting insurance plans from discrimination if they decline to cover abortions. The HHS Office of Civil Rights, which has the responsibility of enforcing the Weldon Amendment, said in December 2014 it had opened an investigation into California’s actions. But the investigation is still not complete. (Sullivan, 2/24)