When a health insurance company denies a request for coverage, most policyholders focus on the outcome: the treatment will not be approved. But under California law, how that denial is communicated is just as important as the decision itself. A denial letter is not a formality. It is a legally required document that must... Read More »
Last month we reported on a $15 Million penalty levied on Blue Cross of California d.b.a. Anthem Blue Cross by the California Department of Managed Health Care (see Department of Managed Health Care Hits Anthem with $15 Million Penalty and Corrective Action, posted on February 17, 2026). While significant, it is not the only... Read More »
Health insurance denials do not always come in the form of a written refusal. Sometimes the most damaging conduct is delay. A postponed authorization. A referral that sits unprocessed. A surgery cancelled days before it was scheduled. A specialist appointment pushed out for months. Under California law, timely access to care is not optional.... Read More »
What the Enforcement Action Reveals About Systemic Health Insurance Violations in California When a state regulator takes formal enforcement action against a major health insurer, it is rarely about a single mistake. It is usually about systemic breakdowns that affect thousands of policyholders. A recent enforcement matter involving Anthem Blue Cross by the California... Read More »
Medi-Cal is California’s Medicaid program, providing health coverage to millions of low-income children, seniors, people with disabilities, and working families. But most Medi-Cal beneficiaries do not receive care directly from the State. Instead, the California Department of Health Care Services (DHCS) contracts with large commercial insurance companies, known as Medi-Cal managed care plans, to... Read More »
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