California Watch
News stories in this section spotlight activities in California, including actions by the state Assembly and state Senate; proposed legislation; regulators like the Department of Managed Health Care and Department of Insurance; and the state ACA exchange, Covered California.
An ambitious California Democrat wants the world’s fifth-largest economy to create its own National Institutes of Health and vaccine program, saying the state can’t rely on the administration to support research and science.
The powerful health care interests who put Proposition 35 on the ballot last November had a simple pitch for the complex initiative: a tax no voter paid would provide a long-awaited pay bump to doctors and hospitals who serve the state’s lowest-income residents.
On March 19, 2025, the California Department of Managed Health Care (DMHC) issued an All Plan Letter (APL 25-005) directing its regulated health plans to provide specific flexibilities to providers who were displaced by the devastating wildfires in Los Angeles and Ventura counties earlier this year.
The request comes on top of a $3.44 billion loan proposed last week, with costs for undocumented residents running higher than expected.
The $3.44 billion loan, first floated to lawmakers Wednesday, will cover obligations for Medi-Cal, through March, but it’s raising questions about a bigger budget hole that may need to be filled later on. Lawmakers said they were caught off guard by the news and still don’t understand the extent of the shortfall.
Blue Shield of California CEO Lois Quam is stepping down after two months on the job. The nonprofit health plan will begin a search for a permanent CEO and has appointed CFO Mike Stuart as interim president and CEO, according to a March 11 news release. Mr. Stuart was appointed Blue Shield’s CFO in 2022 and previously ...
Two companies have agreed to a $1.3 million settlement after they were accused of selling “sham” health insurance plans, the California Department of Justice said. According to the CA DOJ, Sedera, Inc. and Sedera Medical Cost Sharing Community, LLC (SMC) billed customers monthly in exchange for the payment of medical services, a plan which they ...
According to reporting by The Mercury News, one of California’s leading daily newspapers, about one-fourth of all health insurance claims in the Golden State were denied last year. Some may have been denied due to Artificial Intelligence (AI). However, new legislation prohibits health insurers from relying solely on AI to deny a claim based on medical necessity. ...
Shortly before returning to the courtroom, Sutter Health has reached an “agreement in principle” to settle a long-running and recently revived antitrust class-action lawsuit, according to a Sunday evening legal filing and statement from the legal counsel for the plaintiffs shared Monday morning. The case, Sidibe et al v. Sutter Health, was filed in the ...
Proposed legislation could make California one of only a handful of states that require insurers to disclose denial rates and reasoning, which the industry often considers proprietary information.