In Brief: Report Suggests Merger Of DMHC, CDI; Molina Healthcare Makes More Acquisitions
Should DMHC, CDI Be Merged?
A new report by the California Health Care Foundation and the Kelch Policy Group has recommended that that the California Department of Insurance and the Department of Managed Health Care be merged into a single agency.
The report noted that the implementation of the Affordable Care Act and the regulation of the Covered California health insurance exchange has been made more challenging by the existence of the two separate agencies. “Covered California requires contracted health plans to comply with either CDI or DMHC provider network standards depending on the product, but the CDI and DMHC standards, while similar, are not identical.”
The DMHC is run by a gubernatorial appointee, while the CDI is run by an elected official. Both tend to take different approaches to their jobs.
The regulatory differences between the two agencies means that some insurers have tailored their policies to comport with one regulator over another in recent years, depending on which one is seen as more lenient at the time, industry observers say.
The report added that the existence of the two agencies means “oversight by policymakers, the press and the public is constrained by the complexity and, on occasion, by the competing views and approaches of CDI and DMHC. The multiple layers and disparate standards make it more difficult for policymakers to remedy identified deficiencies in a manner that yields consistent statewide solutions.”
Molina Makes Acquisitions In Florida, Illinois
Long Beach-based Molina Healthcare has acquired Medicaid managed care assets in both Florida and Chicago, the company has announced.
In Florida, Molina acquired the assume the Medicaid managed care contracts of Preferred Medical Plan, Inc. in Dade and Monroe Counties in Florida, which cover about 25,000 lives in total.
“We are committed to providing continuity of care to our new members in South Florida and we will work closely with Preferred Medical Plan to coordinate a smooth transition,” said Maritza Borrajero, president of Molina Healthcare’s Florida operations. “This transaction helps us to continue solidifying our presence in the region while also demonstrating our commitment to the Medicaid program and to the state.”
Molina also agreed to acquire “certain assets” of the MyCare Chicago Medicaid managed care plan, although specifics about the number of lives involved in the transaction were not disclosed.
King Hospital Reopens
The Martin Luther King, Jr. Community Hospital reopened in the South Los Angeles community of Willowbrook earlier this month.
The 114-bed hospital is a reincarnation of a previous hospital that opened on the same site in 1972, but closed in 2007 after many cases of patient neglect and mismanagement.
The newer hospital is about one-third the size of the old Martin Luther King-Drew Medical Center. The facility is focused on basic services such as maternity care. It also operates a large outpatient clinic.
