Covered California: This is what a ‘broken’ system looks like

Covered California: This is what a ‘broken’ system looks like

[A] state investigation just acknowledged insurance companies listed on the exchange violated the law by publishing sham lists that significantly overstated the number of doctors in their networks.

The Breitbart October 5, 2014 exposé revealed that the California State Insurance Department and Department of Managed Health Care knew when officials approved a 4.2% increase for 2015 Covered California individual care premiums that insurers were engaging in “narrow networks” to limit patient access to doctors and hospitals. It appears regulators knew that without narrow networks, Covered California premium rates would have skyrocketed.

Less than two weeks later, the Covered California website’s on-line directory of doctors and hospitals available under for the 12 health-insurance plans listed on the state exchange was taken off-line “due to errors”…

Department of Managed Health Care acknowledged on November 18, 2014 over 25% of physicians listed in the medical services directories for Blue Shield of California and for Anthem Blue Cross were not taking Covered California patients or no longer had offices at their listed location.

The new revelations come as Covered California began on November 15, 2014 enrolling about 1.2 million new and continuing subscribers. Yet, the Covered California website on November 19th was not allowing customers to login and the automated phone prompt stated that the “expected wait time is two hours.” …

The Los Angeles Times reported unsuspecting patients appear to have suffered huge additional medical bills for using advertised network doctors and hospitals for medical tests and procedures, but were actually “out-of-network.”

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