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Industry Updates

This broad category includes articles concerning health insurance costs, carrier and health plan news, changing benefits technology, and surveys by the Kaiser Family Foundation and others on employee benefits.

Some California Transit Agencies Ask Riders To Still Wear Masks, Despite Court Decision

Some public transit agencies in California are asking riders to continue wearing masks on buses and trains, despite a federal court ruling in Florida on Monday that struck down the masking mandate on public transportation.

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DMHC Guidance Confirms that California Law, Not the Federal No Surprises Act, Governs Payment and Dispute Resolution Processes for Certain...

Executive Summary The California Department of Managed Health Care (“DMHC”) issued a recent guidance interpreting the application of the No Surprises Act (“NSA”)—a new federal law prohibiting out-of-network healthcare providers from balance-billing patients for certain emergency and non-emergency services—in California.  Significantly, when determining which payment and dispute resolution processes will apply in a dispute regarding the value ...

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Nevada Health Insurance Exchange Gets New Director

Ryan High has been named the new director of the Silver State Health Insurance Exchange.

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Supreme Court Weighs Employer’s Challenge To California Labor Law

The Supreme Court on Wednesday weighed an employer’s challenge to a California labor law that authorizes private attorneys to sue on behalf of thousands of workers, even if those workers had agreed to arbitrate their claims individually.

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Record Fines Might Mean California Is Finally Serious About Improving Medi-Cal

A few weeks ago, state regulators imposed a record $55 million in fines on L.A. Care, California’s largest Medi-Cal managed-care plan, for failing to ensure adequate care and allowing treatment delays that threatened enrollees’ health. Patient advocates hope the move signals stricter enforcement against other Medi-Cal insurers, which have many of the same shortcomings for which the regulators just fined L.A. Care.

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California Setting Up Statewide Medical Data-Exchange Grid

California is developing a long-sought statewide health information exchange for providers and payers to deliver better care for patients. The health information exchange, or HIE, has received little public attention. But it would cover 40 million people in California’s 58 counties, and would in part quickly inform emergency room doctors and nurses of a patient’s ...

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CalChamber Releases 2022 Job Killer List

The California Chamber of Commerce yesterday released the first wave of bills to be included on its 2022 job killer list. The preliminary list includes 9 new bills and two carry-over proposals from 2021. The CalChamber expects several additions to the list in the coming weeks.

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DMHC Reverses Course – No Surprises Act Does Not Apply to Out-of-Network Emergency Services Governed by the Knox-Keene Act

The DMHC issued its final guidance on the No Surprises Act, confirming that the Knox-Keene Act constitutes a “specified state law” under the Act. The out-of-network reimbursement requirements for emergency services and the dispute resolution process in the NSA will therefore not apply to DMHC claims. Instead, health plans must continue to comply with the Knox-Keene Act ...

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New Job Killer Bill Allows Employees to Refuse to Show Up for Work

A newly identified California Chamber of Commerce job killer bill that is opposed by more than 60 organizations passed the Senate Labor, Public Employment and Retirement Committee yesterday. The bill, SB 1044 (Durazo; D-Los Angeles), allows employees to leave work or refuse to show up to work if the employee subjectively feels unsafe regardless of existing health and ...

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Single-Payer Gets A Price Tag

It would cost California between $494 billion and $552 billion annually to operate the single-payer health care system envisioned in a bill that died last month in the supermajority-Democratic Legislature, according to a Tuesday analysis. The cost estimate from the nonpartisan Legislative Analyst’s Office is significantly higher than one prepared by committee staffers in January.

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