Archive for August, 2015

… results.

August 31, 2015
Step Guide to Reviewing Your State’s 2017 Essential Health Benefits Benchmark
Michelle Lilienfeld Issue Brief
Introduced by the Affordable Care Act, Essential Health Benefits (EHB) are a set of ten health care service categories that certain health plans must cover. The EHBs are defined through a benchmark approach where states either select or get assigned a benchmark plan which serves as a reference plan…
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August 31, 2015
Lessons from CA: Ensuring Due Process in Medi-Cal Renewals & Applications
dfitzgerald Issue Brief
This month's Lessons from California highlights unlawful notices of action in Medicaid and successful advocacy to ensure due process in redetermination and eligibility notices.
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August 28, 2015
Motion to Reconsider Denied: Korean Community Center of the East Bay v. Kent
External Source Court Document
Plaintiffs, who are organizations representing the interests of and assist Medi-Cal beneficiaries, including many with limited-English proficiency, sought a peremptory writ of mandate and/or declaratory and provisional and permanent injunctive relief to enjoin the State of California from proceeding with the 2014 redetermination process for Medi-Cal beneficiaries until the…
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August 28, 2015
Verified Petition for Writ of Mandate: Korean Community Center of the East Bay v. Douglas
External Source Court Document
Plaintiffs, who are organizations representing the interests of and assist Medi-Cal beneficiaries, including many with limited-English proficiency, seek a peremptory writ of mandate and/or declaratory and provisional and permanent injunctive relief to enjoin the State of California from proceeding with the 2014 redetermination process for Medi-Cal beneficiaries until the…
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August 14, 2015
Managed Care in California Series, Issue 4: Internal Grievances and External Review
Abbi Coursolle Issue Brief
Federal and state law and the state and federal constitutions require that beneficiaries in Medi-Cal managed care plans receive notice, and grievance and appeal rights when they are denied access to medically necessary services. Frequently, however, enrollees fail to receive the required notice, get an inadequate notice, or do…
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August 14, 2015
Managed Care in California Series, Issue 5: Internal Grievances and External Review for Service Denials in Covered California Plans
Abbi Coursolle Issue Brief
Federal and state law and the Constitution ensure that enrollees in publicly-funded health care plans receive notice, grievance and appeal rights when they are denied access to medical services. Enrollees in Covered California plans have the right to a notice when their plan denies access to a service, and…
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