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CA Department of Insurance

Department of Insurance receives $1.84 million healthcare grant

News: 2016 Press Release

For Release: October 31, 2016
Media Calls Only: 916-492-3566
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Department of Insurance receives $1.84 million healthcare grant
Federal grant will enhance department’s consumer protection efforts
SACRAMENTO, Calif. — The Centers for Medicare and Medicaid Services at the U.S. Department of Health & Human Services announced today it awarded a $1.84 million grant to the California Department of Insurance to enhance enforcement of key market reforms under the Affordable Care Act.

The Health Insurance Enforcement and Consumer Protection Grant awarded to the Department of Insurance will provide resources to enable the department to enhance existing efforts to protect consumers by making sure insurers are in compliance with a number of requirements of the Affordable Care Act. The department was awarded federal funds to:
  • enhance existing enforcement of non-discrimination standards in health insurer plan, network and formulary designs; 
  • enhance existing enforcement of no-cost coverage for preventive care services under Section 2713 of the Public Health Service Act;
  • enhance existing review of Medical Loss Ratio reports; and
  • enhance existing enforcement processes of parity in coverage of mental health and substance use disorder benefits under the Mental Health Parity and Addiction Equity Act of 2008.
"There continues to be more work to do to ensure consumers receive all the health insurance benefits they are entitled to without delay," said Insurance Commissioner Dave Jones. "This federal grant will enhance our existing consumer protection and enforcement efforts to make sure insurers are delivering on the promise of the Affordable Care Act in key areas of reform such as preventative health care and mental health parity."

The department will use the two-year grant in areas such as market conduct examinations, consumer complaint investigations, enforcement of the laws relating to parity in mental health and substance use disorder benefits, preventive services, and medical loss ratio compliance. In some areas, the department will contract with medical professionals whose clinical expertise will assist the department in enhancing existing enforcement of the law.  

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Media Note: The grant period is from 10/31/16 – 10/30/18.

The California Department of Insurance, established in 1868, is the largest consumer protection agency in California. Insurers collect $310 billion in premiums annually in California. Since 2011 the California Department of Insurance received more than 1,000,000 calls from consumers and helped recover over $469 million in claims and premiums. Please visit the Department of Insurance website at Non-media inquiries should be directed to the Consumer Hotline at 800.927.4357. Telecommunications Devices for the Deaf (TDD), please dial 800.482.4833.

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