L.A. Care, the nation’s largest publicly operated health plan, was fined $55 million for failing to authorize care for thousands of at-risk members, causing health-threatening treatment delays, California regulators announced Friday.
, the nation’s largest publicly operated health plan, was fined $55 million for failing to authorize care for thousands of at-risk members, causing health-threatening treatment delays, California regulators announced Friday.
"The scope and breadth of its violations indicate deep-rooted, systemic failures that threaten the health and safety of its members," said Michelle Baass, director of the California Department of Health Care Services. "My hope is that this sends a strong message to the entire industry that the state takes very seriously protecting all consumers, but particularly our most vulnerable enrollees," said Mary Watanabe, director of the Department of Managed Health Care.
The state regulatory agencies said their investigations were prompted by an article published two years ago in the Los Angeles Times, which noted that patients seeking specialty care with a referral from their primary doctor had to wait months for approval instead of the required 15-day limit for the health plan to offer appointments.
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