One of California’s largest health insurance providers has distinguished itself, and not in a good way! The following article dives into penalties and enforcement actions of ten California insurance providers. 

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The federal government is actively pursuing cases of fraud with respect to ACA/Obamacare policies within the substance use treatment industry. This case is about residency. Where did the patient actually live when treatment was being provided? Some insurers have begun verifying residency of virtually every substance use treatment patient often resulting in denial of the claims based upon their inability to verify the patient resided in a state. 

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The Pennsylvania Insurance Department has fined United Healthcare for violations of the Mental Health Parity and Addiction Equity Act. If you have outstanding claims from 2015 forward you should develop a strategy to appeal those claims based upon this news.

United Healthcare fined $1 million by Pennsylvania for violations of mental-health law

Per Harris Meyer at Modern Healthcare:

The company that runs Blue Cross and Blue Shield plans in five states is unlawfully denying behavioral health benefits to members in violation of generally accepted medical standards, according to a federal lawsuit seeking class action status.

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Patient advocates cautioned HHS against loosening patient privacy protections surrounding substance use disorder records, warning it could lead people to avoid treatment.

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Although millennials may seem to have a greater investment in health and wellness than generations before them, findings from the Blue Cross Blue Shield Association (BCBSA) suggest millennials will be substantially less healthy as they age.

Follow this link to read the top 10 conditions affecting millennials, ranked by adverse health impact:

https://www.healthline.com/health-news/top-10-health-conditions-affecting-millennials

Addiction Treatment Advocacy Coalition
http://atac.nationbuilder.com/

In the Los Angeles Fire Department's continuing efforts to meet the challenges of our increasing EMS call load and the increasing number of homeless individuals, our EMS Bureau is in the process of implementing a pilot program called the LAFD SOBER (Sobriety Emergency Response) Unit. This pilot project is anticipated to be staffed by a Firefighter, working alongside a Los Angeles Homeless Services Authority (LAHSA) outreach worker.

Ken Alltucker, The Republic | azcentral.com

The only "Obamacare" health insurer in metro Phoenix and Pima County is ensnared in a legal dispute with several addiction treatment centers over the cost of care amid an Arizona opioid epidemic that is taking an average of two lives each day.

Nine alcohol and drug rehabilitation centers claim in a Maricopa County Superior Court lawsuit that the health insurance company Health Net of Arizona improperly withheld or delayed lucrative payments for treatment of people struggling with addiction.

But Health Net says in a counterclaim that there was widespread fraud among Arizona and California drug rehab centers in 2015 and 2016, when it alleges"teams of brokers" recruited out-of-state clients to fraudulently obtain insurance policies and to seek treatment in Arizona.

Those actions have cost the insurance company — and Arizona consumers through higher monthly premiums — tens of millions of dollars, the Health Net counterclaim says.