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Deny and Delay? California Seeks Penalties for Insurers That Repeatedly Get It Wrong - KFF Health News

KFF Health News
Summary
Nutrition label

81% Informative

A California proposal seeks to penalize insurers who repeatedly deny care they shouldn’t.

The measure could be one of the boldest attempts in the nation to rein in health insurer denials.

California could become one of only a handful of states that require insurers to disclose denial rates and reasoning.

If passed, the measure would cover roughly 12.8 million Californians on private insurance.

It would not apply to patients on Medi-Cal , the state’s Medicaid program, or Medicare .

Wiener 's bill grew out of a narrower proposal that failed last year aimed at improving mental health coverage for children and adults under age 26 .

VR Score

83

Informative language

85

Neutral language

16

Article tone

informal

Language

English

Language complexity

58

Offensive language

possibly offensive

Hate speech

not hateful

Attention-grabbing headline

not detected

Known propaganda techniques

not detected

Time-value

short-lived

External references

20

https://ajronline.org/doi/10.2214/AJR.07.3663#:~:text=Inflammatory%20Pseudotumor%20of%20the%20Bladder,-Inflammatory%20pseudotumor%20of&text=The%20bladder%20is%20a%20common,have%20been%20reported%20%5B15%5D.https://portal.ct.gov/cid/-/media/cid/reports/consumer-report-card/2024-consumerreportcard.pdf?rev=94d0c6b1e170408b974006006dbe6751https://www.nbcnews.com/health/health-news/ceo-shooting-health-insurance-frustration-denied-claims-rcna183805https://jamanetwork.com/journals/jama/fullarticle/2802915https://app.powerbi.com/view?r=eyJrIjoiNDNlNTJjNzItNjQyNS00NjVmLTk4MjItZDYzZjBlNTQ0ZDA2IiwidCI6IjM4MmZiOGIwLTRkYzMtNDEwNy04MGJkLTM1OTViMjQzMmZhZSIsImMiOjZ9https://www.dmhc.ca.gov/Portals/0/Docs/DO/2023Infographic.pdfhttps://www.uhc.com/news-articles/newsroom/uhg-responsehttps://www.commonwealthfund.org/publications/issue-briefs/2024/aug/unforeseen-health-care-bills-coverage-denials-by-insurershttp://www.californiahealthline.org/https://whyy.org/articles/pennsylvania-health-insurance-denials-data/https://dfr.oregon.gov/business/reg/health/Documents/mental-health-parity/20240915-mental-health-parity-report.pdfhttp://www.chcf.org/https://www.pbs.org/newshour/health/analysis-health-insurance-claim-denials-are-on-the-rise-to-the-detriment-of-patientshttps://apnews.com/article/luigi-mangione-unitedhealthcare-brian-thompson-shooting-b53fde08980d160ee93fd08b1664108dhttp://www.latimes.comhttps://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202520260SB363https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB294https://www.kff.org/medicare/issue-brief/nearly-50-million-prior-authorization-requests-were-sent-to-medicare-advantage-insurers-in-2023/https://www.kff.org/private-insurance/issue-brief/claims-denials-and-appeals-in-aca-marketplace-plans-in-2023/https://www.uhc.com/news-articles/newsroom/false-statements-response

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