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In 2007, the California Department of Managed Health Care (DMHC) investigated Anthem's policies for revoking (rescinding) health care insurance policies. The DMHC randomly selected 90 instances where Anthem canceled the insurance of policy holders who had been diagnosed with costly or life-threatening illnesses, to find how many of these ...
Amerigroup is an American health insurance and managed health care provider. Amerigroup covers 7.7 million seniors, people with disabilities, low-income families and other state and federally sponsored beneficiaries, and federal employees in 26 states, making it the nation's largest provider of health care for public programs. [1]
Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts are driven by the need to generate profits and not providing health care. [5]
Aetna, Humana, Anthem and Cigna cited the Affordable Care Act, popularly known as Obamacare, which was passed by Congress in 2010 to significantly expand access to affordable health insurance.
The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
In 2013, CareMore expanded into the Medicaid managed care space by partnering with another Anthem subsidiary, Amerigroup, to provide coverage in Tennessee, Iowa, and Ohio. Unlike its traditional model, in the Medicaid space CareMore serves only as the patient care delivery organization, while Amerigroup provides the insurance layer. [13]
Managed care delivery systems grew rapidly in the Medicaid program during the 1990s. In 1991, 2.7 million beneficiaries were enrolled in some form of managed care. Currently, managed care is the most common health care delivery system in Medicaid. In 2007, nearly two-thirds of all Medicaid beneficiaries are enrolled in some form of managed care ...
53 million Medicaid patients rely on Deloitte software—but the technology has generated notices with errors, sent paperwork to the wrong addresses, and been frozen for hours at a time, according ...
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