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Going From No-Show to Showing Teeth

It was two weeks ago that the California Department of Managed Health Care was a sort of agency-non-grata at a legislative oversight hearing. The Assembly budget subcommittee hearing was targeted at the DMHC’s perceived lack of response to complaints that the insurance industry was short-changing emergency departments across the state.

When the DMHC didn’t show up to that oversight hearing, it prompted a fair share of derision and antipathy — and it confirmed emergency department officials’ fears that the agency was ignoring their complaints.

Yesterday, the agency showed that it has been listening, by levying nearly $5 million in fines on seven health care insurers.

Those two events — the pressure on the agency and its action a fortnight later — would seem to be related, but not according to consumer advocate Anthony Wright of Health Access California.

“These settlements took a lot longer than two weeks to hash out,” Wright said. “The hearing was because of longstanding complaints about insurer payment practices. And so was the fine. The fact that those complaints continue to come up, that’s probably the similar genesis in those problems.”

At the time, the DMHC issued a statement that it didn’t attend the oversight hearing because it didn’t have enough time to prepare for it — but that didn’t gibe with Assembly member Dave Jones’ statements that they had tried unsuccessfully to reschedule the hearing to accommodate the DMHC.

Jones said in six years of Assembly work he had never heard of a government agency abstaining from an oversight hearing where it needed to answer complaints.

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