Regulators Win $4.6 Million ACA Grant

Three California agencies that play a large role in regulating and monitoring the state’s healthcare market have received a $4.6 million federal grant to beef up consumer protections and education.

Funded under the Affordable Care Act to help bolster the protection of consumers when dealing with health plans and providers, the money will be used by the Department of Managed Health Care, the Department of Insurance and the Office of the Patient Advocate to strengthen their own assistance systems and those of nongovernmental organizations. It was the largest of the ACA-related consumer assistance grant given to any state.

The OPA, which acts as a coach for consumers on how to deal with their providers, said it would use its portion of the

grant to help build the construction of a platform for airing grievances. 

“These new funds will support OPA’s first-time effort to collect and publicly report complaint data across both private and public healthcare coverage systems,” said OPA Director Sandra Perez.  “This data will be an important resource for consumers to make informed health care choices and for policymakers to address emerging issues.”

The DMHC, which is the watchdog agency for HMOs, said it would use its funding to assist those who call seeking help. The DMHC often fines insurers and providers who violate regulations regarding their handling of patient grievances.

The Department of Insurance, which serves a similar role for most PPOs, said it would also expand its ability to respond to consumer grievances.