Focused/non-routine Studies

A number of focused studies regarding critical health care issues, including analysis on:

Post-Claims Underwriting/Policy Rescission & Cancellation.

MHU was requested by the DHMC to investigate allegations of post-claims underwriting by five of the largest health plans in California. MHU developed research and review tools, and conducted onsite visits to review each plan's pre-enrollment underwriting and post-enrollment rescission or cancellation practices.

 

Implementation of Mental Health Parity Act in California. 

MHU evaluated the seven largest health plans in California to determine compliance with the Parity Act and identify the challenges of implementation from the plans’ perspective, and to investigate problems voiced by the public, the Legislature, and stakeholders.  Prepared individual plan reports and an extensive issue-oriented analysis of parity implementation in California.

 

Timely Access Regulation-required annual reports. 

MHU analyzed data submissions from 40 health plans to assess their reporting and compliance with newly implemented regulations on appointment availability and wait times. The final statewide report included extensive recommendations for improving monitoring and reporting of compliance.

 

Adequacy of health plan provider network for the newly instituted mandatory Medi-Cal managed care Section 1115 Waiver demonstration program for SPDs.

 

Claims payment and management practices of a major health plan.

Prepared a detailed report including causes, effects, ongoing issues, and recommendations.

Contact Us Today

Managed Healthcare Unlimited, Inc
133 The Promenade North Unit #323
Long Beach, CA, 90802

Phone: (562) 436-3451
Fax: (562)437-8334

Email Contacts
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Pat Schano: This email address is being protected from spambots. You need JavaScript enabled to view it.

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