According to the analysis, fines against Anthem represented about 44 percent of the $21.7 million in penalties the California Department of Managed Health Care handed down to insurers during the roughly six-year period. Fines were related to many of the 553 enforcement actions the department issued against Anthem, such as not promptly responding to enrollee grievances and inappropriately denying claims.
In a statement to Kaiser Health News, Anthem said it “has been making significant changes in its grievance and appeals process, as well as investments in system improvements to help ensure we are simplifying the healthcare experience for consumers.”
The penalties are high despite Anthem’s smaller footprint in California. The insurer covers 10-13 percent of residents in California. In contrast, Kaiser Permanente covers almost a third of residents and received 11 percent of penalties issued in the time period.
Read the full article here.
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