Sacramento - The California Medical Association (CMA) is pleased to support the Department of Managed Health Care (DMHC) in its recent announcement that it has issued a “cease and desist” order to Anthem Blue Cross (Anthem) for violating California's fair payment practices law.
In June 2011, CMA asked DMHC to investigate improper overpayment refund requests after hearing complaints from a number of physicians across the state. Anthem Blue Cross was requesting payment outside the 365-day period allowed by California law. A full copy of the letter sent to DMHC can be found here.
“Anthem’s practices interfere with physicians trying to run their practices and also increases the overall cost of care,” said James T. Hay, M.D., CMA president. “DMHC’s commitment to investigate these violations is a move in the right direction. We look forward to working with the Department through the next steps to correct this process.”
In a statement this week, DMHC said that between “2008 and 2011, Anthem sought reimbursement from at least 535 providers for claims that were more than one year old.”
“We must put an end to these egregious practices,” added Dr. Hay. “Fighting unjust violations by insurers like Anthem takes time away from patient care. The order from DMHC will help pave the way so that we can get back to treating our patients.”
For a full copy of DMHC’s press release and order, visit its website.