News Headlines Article

DMHC Fining More Reluctant Payers
Payers and Providers

For years, health plans in California have been required to pay providers in a timely manner for services that have been rendered. After a years-long lull, the agency regulating such payments has been issuing significant penalties and fines. The Department of Managed Health Care has issued an average of six penalties a year since the late 1990s. So far this year, the DMHC has issued seven penalties against health plans for not making payments in a consistently timely manner – usually within 45 days of receiving a claim or five days within determining a dispute of a payment. Those penalties have also been accompanied by $172,500 in fines.