Internal Documents Show CVS Adopted an HIV Prescription Drug Mail-Order Program to Increase Revenue Despite Health Risks
Los Angeles, CA - CVS was aware of the threat its prescription drug mail-order...
Los Angeles, CA -- An HIV-Positive consumer has joined a federal lawsuit against pharmaceutical manufacturer Gilead Sciences in a complaint alleging unfair and anti-competitive behavior in violation of multiple...
(Reuters) - A California appeals court has ruled that state regulators and health insurers cannot deny coverage for an intensive autism treatment on the grounds that the therapy was...
Santa Monica, CA - Parents of autistic children scored a major victory in a California Court of Appeal decision issued late yesterday, which now bars state regulators and health...
Law360, Los Angeles (April 23, 2014, 9:42 PM ET) -- A California appeals court on Wednesday again held that the Department of Managed Health Care is required by law...
This week the California Court of Appeal granted Consumer Watchdog's petition for rehearing in its seminal lawsuit against the Department of Managed Health Care over treatment for autistic children.
Consumer...
This week Consumer Watchdog filed a brief urging the California Court of Appeal to reconsider part of a recent ruling ending autism discrimination that could be read to put...
The Second District Court of Appeal in Los Angeles last week ruled that the Department of Managed Health Care cannot use licensure as a basis for denial of a...
The California Court of Appeals has ruled that all insurance plans will now have to cover perhaps the most effective treatment for autism, whether the therapist is licensed or...
We're very proud of the legal team's recent victory in a lawsuit to bar discrimination against children.
The California Court of Appeal's decision ended the Department of Managed Health Care’s...
Santa Monica, CA -- In a complex opinion issued yesterday, the California Court of Appeal ended the Department of Managed Health Care’s (DMHC) discriminatory practice of allowing HMOs to deny treatment for autistic children of state employees and low-income families enrolled in the Healthy Families program on the basis that such treatment can only be administered through state-licensed providers.
LOS ANGELES - Two state agencies that regulate slightly different kinds of health insurance plans are taking dramatically different views on the same state law that requires mental health...
A panel of the California Court of Appeal today took up the long standing dispute about insurance companies’ obligations to cover a critical treatment for autistic children. At stake is whether the autistic children of many firefighters, cops and state employees will get the appropriate care when they need it.
Santa Monica, CA– A California Appellate Court in Los Angeles will consider a long-running dispute at a Tuesday afternoon hearing about insurance companies’ obligations to cover a critical treatment for autistic children. The case, brought by the non-profit Consumer Watchdog, will also determine if families previously forced to pay tens of thousands of dollars out-of-pocket for autism treatment should be re
Private insurance companies are required to cover an expensive treatment for children with autism, but that same coverage is being denied to children insured under MediCal and CalPers policies. As CBS 2's Randy Paige tells us, a court battle is underway to try and change that.
Consumer Watchdog praised Insurance Commissioner Dave Jones' announcement today opposing Blue Shield's plan to close 23 health insurance policies, and echoing concerns raised by Consumer Watchdog in a recently-filed class action lawsuit.
Blue Shield has used enormous rate hikes, and the threat of rate increases, to force patients into lower-benefit and higher-deductible health coverage in violation of state law, according to a class action lawsuit filed today by Blue Shield policyholders and consumer advocates.
Parents of children with autism lauded the governor's decision to sign into law a bill that requires health insurers to cover behavioral health treatments for their kids, but questions...
Appeals court sides with patient, giving hope to others
Health insurance providers can expect new litigation - and pressure from existing litigants - after a federal appellate court decision on Friday said they are responsible for covering mental health treatment on par with care for physical conditions.
Multiple lawsuits and a piece of state legislation are already underway to force insurance coverage of treatment for autism, and advocates fighting for that coverage say Friday's ruling brings momentum to their cause.
SACRAMENTO, Calif.—The California Department of Managed Health Care (DMHC) overstepped its constitutional authority in issuing a memorandum to health insurance companies on how to handle consumer complaints about autism treatment, a state judge ruled Dec. 30 (Consumer Watchdog v. California Department of Managed Health Care, Cal. Super. Ct., No. BS121397, 12/30/10).
LOS ANGELES - A Superior Court judge overseeing an unusual consumer lawsuit against state regulators found that a 2009 policy that has allowed health insurance plans to more easily deny coverage for some costly autism therapies constituted an "underground regulation," but has declined to intervene.
On Other Key Issues, Ruling Leaves Autistic Children at Risk; Brown Administration Urged to Take Action
A Los Angeles County Superior Court issued a ruling late Monday finding in part that the Schwarzenegger Administration illegally changed state policy relating to autism coverage without following the required public process. However the ruling failed to address key legal issues, including California’s mental health parity law, and leaves children at risk of additional coverage denials for autism treatments, according to Consumer Watchdog.
We have cleared the final hurdle before going to trial next Monday on our suit against the Department of Managed Health Care (DMHC), the state's largest health insurance regulator, for illegally siding with insurance companies over autism treatment delays.
Ever play a game with a poor loser who tries to change the rules when the chips are down?
The Department of Managed Health Care (DMHC) is trying to do...
What does "health care reform" promising "access" to health care services really mean if children can be denied the medical care they need?
California HMOs and health insurers are denying...
Californians, including those stricken by autism, and their parents and caregivers, expect regulators to enforce the law, not to side with insurance companies seeking to boost their profits by denying patients the care they need.
Consumer Watchdog Sues California Department of Managed Health Care for Permitting HMOs to Deny Treatments to Autistic Children after Secret Meetings Between State Employees and HMO Execs
Several families of autistic children denied treatments by their health plans have won administrative appeals, in a sign that a recent court ruling scrutinizing regulators may be having an effect on the state's handling of the cases.
LOS ANGELES, CA -- A lawsuit claiming the California Department of Managed Care improperly allowed health insurers to decline payment for autism treatments will proceed to trial after a Los Angeles County Superior Court judge rebuked the state in a preliminary ruling. A Consumer Watchdog representative said regulators should stop denying
coverage on the grounds that ABA providers are certified not by the
state but by a national board. Continuing to do so would risk legal
damages, the advocacy group said in a statement. "The DMHC has to change its practices going forward, and the department
should immediately reverse its previous denials," Pam Pressley,
litigation director for Consumer Watchdog, said in a statement. "Gov.
Schwarzenegger, a long-time and vocal supporter of the Special Olympics
and developmentally disabled children, should require his regulators to
abide by the law."
A lawsuit alleging state regulators allow insurance companies to
deny necessary but expensive treatment for autistic children in
violation of state law has enough merit to proceed to trial, a Los
Angeles Superior Court judge has ruled. The lawsuit, filed in July by Santa Monica-based Consumer Watchdog,
seeks to compel the California Department of Managed Health Care to
order health plans to cover applied behavioral analysis (ABA) if a
member complains the treatment was denied though it is deemed medically
necessary and is provided by licensed personnel or under the
supervision of licensed personnel.
A lawsuit seeking health care coverage for the use of applied
behavioral analysis in the treatment of autism has been cleared for
trial by the Los Angeles County Superior Court. Consumer Watchdog et. al. vs. California Department of Managed Health
Care et. al. involves Kaiser Permanente’s denial of coverage for a
child’s ABA treatment because the provider wasn’t licensed by the
state. The Oakland, Calif.-based health maintenance organization cited
regulations issued by the California Department of Managed Health Care
as its reason for denying coverage for ABA treatment.
Santa Monica, CA – A Los Angeles County Superior Court judge issued
a ruling finding that the Schwarzenegger Administration has illegally
sided with health insurance companies that deny access to care for
autistic children. A memo circulated by the Schwarzenegger
Administration to health insurers was also ruled to be an illegal
“underground regulation” because it violated state law requiring a
public process for changing insurance regulations.
Refusing to cover a costly behavioral therapy because the care provider lacks a state license violates California law, a Los Angeles County judge finds.
Consumer
Watchdog President Jamie Court said the ruling was reason enough for
Gov. Arnold Schwarzenegger to order the department to stop fighting the
suit and start ordering insurers to provide the treatment to their
autistic members. "For an administration that is so involved
with the Special Olympics to not understand the harm it's causing every
day that an autistic child doesn't get the care they need, is not only
legally inexcusable, but morally reprehensible," Court said.
The lawsuit, filed by Consumer Watchdog in Los Angeles Superior Court, claims DMHC has permitted the denial of "critically needed, medically necessary" treatments. The advocacy group alleged Department Director Cindy Ehnes illegally permitted insurers to deny coverage for Applied Behavioral Analysis, a common autism treatment, in violation of the California Mental Health Parity Act. Also, DMHC improperly withheld public documents requested by Consumer Watchdog, it claims.
A nonprofit consumer group has filed a lawsuit against state regulators alleging they allow insurance companies to deny necessary but expensive treatment for autistic children in violation of state law. Santa Monica-based Consumer Watchdog filed the lawsuit against the California Department of Managed Health Care Tuesday in Los Angeles Superior Court.
Consumer Watchdog asks a judge to order the state Department of Managed Health Care to enforce the law and require insurers to serve autistic members. The agency says it's doing its job.
"Californians, including those stricken with autism and their parents
and caregivers, expect regulators to enforce the law, not to side with
insurance companies seeking to boost their profits by denying patients
the care they need," said Harvey Rosenfield, founder of the nonprofit
Consumer Watchdog and author of the landmark automobile insurance
reform initiative Proposition 103.
Consumer Watchdog, a Santa Monica group that monitors insurance practices, has asked the court to order the Department of Managed Health Care to require insurers to provide autistic children with treatments ordered by their doctors. The group also wants the department to turn over records showing the agency's violations in this area.
LOS ANGELES, CA -- California regulators are being challenged in court
for siding with insurance companies, rather than patients, over some
costly autism therapies. In a lawsuit filed Tuesday, consumer advocates complain that the
Department of Managed Health Care broke state law by precluding expert
doctors from deciding whether an insurer must provide treatments for
autism.
The non-profit Consumer Watchdog and a doctor who works with autistic
children are suing the California Department of Managed Health Care.
Their lawsuit alleges that the agency is allowing insurance companies
to refuse to pay for effective but expensive treatments for kids with
autism.
"Point of the suit is simply -- it's doctors, not insurance company bureaucrats or politicians or government lawyers, that should decide what kind of care a child could get," says Jerry Flanagan with Consumer Watchdog.
Wednesday, the group Consumer Watchdog sued the California Department of Managed Health Care, alleging the agency and its director have allowed private health insurers to refuse to provide health care to autistic children like Aidan. "The department responsible for overseeing many of the state's insurance companies has been siding with insurance companies and denying access to necessary autism care," said Jerry Flanagan, Consumer Watchdog.
Santa Monica, CA -- The mother of an autistic child joined Consumer
Watchdog and its attorneys today to announce a lawsuit against the
California Department of Managed Health Care (“DMHC”), the
Schwarzenegger Administration agency responsible for regulating many of
California’s health insurers. The suit alleges that the DMHC has
wrongfully allowed insurance companies to refuse to pay for autism
treatments, resulting in the denial of critically needed, medically
necessary treatment for autistic children.
Consumer Watchdog filed a lawsuit Tuesday against the state agency that oversees HMOs, accusing it of violating state law by siding with insurance companies in denying treatment for children with autism. The suit accuses the department of changing its policies, forcing
parents to appeal insurance denials through an internal grievance
process rather than letting an independent panel of doctors make
treatment decisions. "We want the department to follow the law. Doctors - not insurance
companies and government lawyers - decide what care kids should get,"
said Jerry Flanagan, Consumer Watchdog's director of health policy.
Kaiser, Blue Cross and Other Health Insurers Illegally Deny Treatment to Autistic Children, Says Consumer Watchdog
Santa Monica, CA -- Parents of autistic children and their families
joined Consumer Watchdog today in warning California regulators not to
side with health insurance companies that are scheming to avoid paying
for autism treatment that is required by state law.
The final approval today of the merger of HMO giants WellPoint Health Networks and Anthem Inc. by the Georgia insurance commissioner is "a 9-figure Christmas gift for company executives at a time when patients have to fight for basic health care coverage," according to Jerry Flanagan of the Foundation for Taxpayer and Consumer Rights (FTCR).
The Foundation for Taxpayer and Consumer Rights has filed a taxpayer lawsuit on behalf of all California taxpayers calling upon California Controller Steve Wesley and the Board of Equalization to collect hundreds of millions of dollars in gross premiums taxes unpaid by Wellpoint subsidiary Blue Cross of California during the last eight years.
Following the Schwarzenegger Administration's approval this morning of the pending buy-out of Blue Cross of California's parent company, WellPoint, by Anthem, the Foundation for Taxpayer and...
As California regulators review the impact on the California health care system of the proposed merger of Blue Cross of California's parent company, WellPoint Health Networks, and Anthem Inc,...
At public hearings today on the buy-out of Blue Cross of California's parent-company, WellPoint Health Networks, by Anthem Inc., patients and taxpayers called on legislators and regulators to derail the deal and investigate Blue Cross' special tax status that has allowed the company to avoid paying about $500 million dollars in gross premium taxes since 1994.
Blue Cross of California, whose parent company WellPoint has yet to receive approval for its pending merger with Anthem Inc., has avoided paying hundreds of millions of dollars in annual gross premium taxes