Biden Team, UnitedHealth Struggle to Restore Paralyzed Billing Systems After Cyberattack
By Darius Tahir and Bernard J. Wolfson and Daniel Chang
The cyberattack on a unit of UnitedHealth Group’s Optum division is the worst on the health care industry in U.S. history, hospitals say. Providers struggling to get paid for care say the response by the insurer and the Biden administration has been inadequate.
Computer Glitches and Human Error Still Causing Insurance Headaches for Californians
By Bernard J. Wolfson
Covered California and Medi-Cal share a computer system for eligibility and enrollment. Nearly a decade since the Affordable Care Act expanded coverage options in the state, enrollees can be diverted to the wrong program — or dropped altogether — if erroneous information gets into the system.
Fallas informáticas y errores humanos en la cobertura de seguros siguen siendo un dolor de cabeza para los californianos
By Bernard J. Wolfson
Es cierto que pequeños cambios en los ingresos pueden hacer que la elegibilidad cambie, pero si se ingresa información incorrecta en un sistema informático compartido por Covered California y Medi-Cal, o se elimina información precisa, eso les puede causar grandes dolores de cabeza a los afiliados.
California’s Resolve Questioned After It Grants Medi-Cal Contract Concessions
By Bernard J. Wolfson and Samantha Young
After the Department of Health Care Services canceled Medi-Cal contract awards under pressure from major insurers, some consumer advocates question the administration’s willpower to improve care in the safety-net program.
New Covered California Leader Urges Renewal of Enhanced Federal Aid for Health Premiums
By Bernard J. Wolfson
Jessica Altman took over in March as executive director of California’s health insurance marketplace, which serves 1.8 million people. She warns that if Congress does not renew the tax credit enhancements that have made health plans more affordable, consumers will face significantly higher premiums, which could cause many to forgo coverage.
California Opens Medi-Cal to Older Unauthorized Immigrants
By Bernard J. Wolfson
Starting May 1, low-income unauthorized immigrants over age 49 become eligible for full Medi-Cal health coverage, a significant milestone in California’s effort to expand coverage.
Battle Lines Are Drawn Over California Deal With Kaiser Permanente
By Bernard J. Wolfson
A controversial proposal to grant HMO giant Kaiser Permanente a no-bid statewide Medi-Cal contract is headed for its first legislative hearing amid vocal opposition from a coalition of counties, competing health plans, community clinics, and a national health care labor union.
“Peor de lo que la gente cree”, cambios en Medicaid crean caos en los estados
By Phil Galewitz and Katheryn Houghton and Brett Kelman and Samantha Liss
Tanto beneficiarios como defensores de pacientes dicen que los funcionarios de Medicaid enviaron formularios de renovación obligatoria a direcciones viejas, calcularon mal los niveles de ingresos e hicieron malas traducciones de los documentos.
Record Fines Might Mean California Is Finally Serious About Improving Medi-Cal
By Bernard J. Wolfson
California regulators issued record fines against L.A. Care, the state’s largest Medi-Cal managed-care plan, for providing inadequate care to its enrollees. But whether the penalties are a sign that the state will make a more forceful effort to improve Medi-Cal’s overall quality of care remains to be seen.
Multas récord podrían significar que California finalmente se toma en serio la mejora de Medi-Cal
By Bernard J. Wolfson
El estado impuso una multa de $55 millones a L.A. Care por múltiples violaciones en sus procesos de asistencia médica.