Health Plan Review May be Intensified

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The state’s top HMO regulator said Monday that health plans should be required to get outside review before dropping a policyholder, a dramatic step up in oversight that probably would face stiff challenges from the industry, the Los Angeles Times reports.


Cindy Ehnes, director of the Department of Managed Health Care, said she hadn’t yet developed details on how such a requirement would work. But she said any external input , possibly by the department or some independent panel , could significantly enhance policyholders’ safeguards against the loss of coverage.


“It is clear to me that we have to have some independent oversight,” Ehnes said.


Her call for outside review came after a public meeting she called in Los Angeles to hear from consumers, health plans and providers on what her agency could do to curtail the controversial practice of insurers canceling health coverage after policyholders have submitted claims for care.


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