State Intelligence — California
Signals referencing this state across all sources.
37 signals
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CMS defers $1.2B in Medicaid funds from California, puts New York on notice after raid
The Trump administration is withholding additional funds from California as part of its war with certain states over Medicaid fraud.
Policy / Regulatory Changes · 140 signals · last 30 days -
White House defers $1.2B more in California Medicaid payments
The White House is withholding another $1.2 billion in federal Medicaid payments to California, citing growth in the state’s personal care services spending. CMS Administrator Mehmet Oz, MD, made the announcement Oct. 20 in the Oval Office on behalf of HHS Secretary Robert F. Kennedy Jr. He pointed to concerns over California’s In-Home Supportive Services […] The post White House defers $1.2B more in California Medicaid payments appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days -
SCAN partners with Mosaic’s CareMore on Medicare Advantage plan
SCAN Health Plan launched a Medicare Advantage HMO with CareMore Health, an integrated care delivery system and primary care provider under Mosaic Health, with coverage beginning Jan. 1. According to an Oct. 13 news release, CareMore Health Plan by SCAN will be available in California’s Los Angeles and Orange counties. Plan members will have access […] The post SCAN partners with Mosaic’s CareMore on Medicare Advantage plan appeared first on Becker's Payer Issues | Payer News .
SCAN CaliforniaSCAN Health Plan · 12 signals · last 30 days -
Blue Shield of California adds former Lyft CFO to board
Erin Brewer is joining Blue Shield of California’s board of directors. Ms. Brewer had served as CFO of Lyft since 2023, and she now serves the company in an advisory capacity. Previously, she held leadership roles at Charles Schwab, Atlassian, and McKesson Corp. An Oct. 15 news release said her experience across industries will contribute […] The post Blue Shield of California adds former Lyft CFO to board appeared first on Becker's Payer Issues | Payer News .
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
Catching up with Blue Shield of California CEO Mike Stuart one year in
In August 2025, Blue Shield of California named Mike Stuart as its CEO. Now, a year later, he's reflecting on months of work toward addressing affordability, member access and the patient journey.
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
Cigna accused of underpaying ground ambulances to boost its own fees
Cigna is facing a lawsuit claiming it made a profit by underpaying out-of-network ground ambulances, according to a class-action complaint filed Oct. 12 in a California federal court. The lawsuit centers on self-funded employer health plans that Cigna administers under administrative services only agreements. The plaintiff, who was covered by one of these plans, alleged […] The post Cigna accused of underpaying ground ambulances to boost its own fees appeared first on Becker's Payer Issues |...
Cigna CaliforniaCigna · 15 signals · last 30 days -
Kaiser Permanente to repay nurses 'potentially tens of millions' in mistakenly withheld wages
Following an arbitration agreement, more than 1,000 nurses will be compensated for a payment error that began in 2021, the California Nurses Association said. The major nonprofit confirmed the plans but did not comment on the total amount.
Kaiser CaliforniaKaiser Permanente · 4 signals · last 30 days -
SCAN, Sutter Health expand service area for co-branded Medicare Advantage plans
SCAN Health Plan and Sacramento, Calif.-based Sutter Health are bringing their co-branded Medicare Advantage plans to four more Northern California counties in 2027, up from six in 2026. SCAN and Sutter first announced their collaboration in 2025, with Sutter hinting at possible future expansion beyond the region. According to a SCAN news release from Oct. […] The post SCAN, Sutter Health expand service area for co-branded Medicare Advantage plans appeared first on Becker's Payer Issues | Pay...
SCAN CaliforniaSCAN Health Plan · 12 signals · last 30 days -
SCAN, Costco roll out Medicare Advantage plans in California, Nevada
SCAN Health Plan and Costco shared Oct. 1 that their co-branded Medicare Advantage plans will go live in California and Nevada in 2027. The HMO will be available in 17 California counties and two Nevada counties on Jan. 1, a SCAN news release said. This is Costco’s first time offering MA. “Entering Medicare Advantage is […] The post SCAN, Costco roll out Medicare Advantage plans in California, Nevada appeared first on Becker's Payer Issues | Payer News .
SCAN Health Plan · 12 signals · last 30 days -
Judge narrows California pension fund lawsuit against UnitedHealth
A federal judge has thrown out most of a securities fraud lawsuit brought by the country’s largest pension fund against UnitedHealth Group, but will let claims that the company misled investors about previous asset sales move forward. The California Public Employees’ Retirement System (CalPERS) originally sued in May 2024, alleging UnitedHealth, former CEO Andrew Witty […] The post Judge narrows California pension fund lawsuit against UnitedHealth appeared first on Becker's Payer Issues | Pay...
UnitedHealth CaliforniaUnitedHealthcare · 46 signals · last 30 days -
Blue Shield of California must face mental health ‘ghost network’ claims
A federal judge allowed portions of a putative class action lawsuit against Blue Shield of California and Magellan, the insurer’s contracted mental health services administrator, to move forward over allegations that they published an inaccurate directory of mental health providers, according to a Sept. 23 court order. The plaintiffs are Blue Shield subscribers who alleged […] The post Blue Shield of California must face mental health ‘ghost network’ claims appeared first on Becker's Payer Is...
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
CMS to expand IRF claim review demonstration to all facilities billing the jurisdiction that includes Alabama, Georgia, Tennessee
The Centers for Medicare & Medicaid Services announced Sept. 25 that it will expand the Inpatient Rehabilitation Facility Review Choice Demonstration to include all IRFs that bill Medicare Administrative Contractor Jurisdiction J, which generally includes Alabama, Georgia and Tennessee. The demonstration, which is currently active for IRFs in Alabama, California, Texas and Pennsylvania, subjects 100% of all Original Medicare IRF claims to either pre-claim or post-payment review. For IRFs newl...
Policy / Regulatory Changes · 140 signals · last 30 days -
Molina’s California president leaves role
Abbie Totten, Molina Healthcare’s California plan president, left her role Sept. 4. Ms. Totten had been approaching six years with the health plan, overseeing growth, forging strategic alliances and ensuring quality performance, according to her LinkedIn profile. Now, Ms. Totten is working on a healthcare consulting firm she co-founded. Prior to her recent role with […] The post Molina’s California president leaves role appeared first on Becker's Payer Issues | Payer News .
Molina CaliforniaMolina Healthcare · 2 signals · last 30 days -
Blue Shield of California’s virtual program to reach 260,000 more members in 2027
Blue Shield of California is expanding its virtual care program, Virtual Blue, in January 2027, with total enrollment in plans containing the benefit to increase from 150,000 to more than 410,000 members. This boost includes 200,000 mid-size employer PPO members — enrolled through fully insured organizations with 101 to 3,000 employees — and 60,000 individual […] The post Blue Shield of California’s virtual program to reach 260,000 more members in 2027 appeared first on Becker's Payer Issues...
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
Air ambulance company suspends base operations amid BCBS reimbursement dispute
PHI Air Medical, an air ambulance company, suspended operations at the Red Bluff Air Medical Base at Red Bluff Airport in California amid reimbursement tensions with insurers. A Sept. 14 PHI news release shared with Becker’s specifically blamed Elevance Health, alleging more than 1,000 No Surprises Act federal arbitration awards that total about $30 million […] The post Air ambulance company suspends base operations amid BCBS reimbursement dispute appeared first on Becker's Payer Issues | Pay...
Elevance Health + Blue Cross Blue Shield plans · 48 signals · last 30 days -
Blue Shield of California to expand Virtual Blue program in 2027
The upcoming expansion will increase the plan’s total enrollment to more than 410,000 participants, executives say.
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
Blue Shield of California fined $800K over delayed member complaint resolution
California’s Department of Managed Health Care fined Blue Shield of California $800,000 due to grievance system issues that ultimately delayed complaint resolution. In California, health plans are required to maintain a grievance and appeal system to address member complaints in a timely manner. State law requires health plans to supply details regarding member complaints to […] The post Blue Shield of California fined $800K over delayed member complaint resolution appeared first on Becker's...
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
Centene’s Health Net to exit commercial group market in California, Oregon
Centene subsidiary Health Net is pulling out of the commercial employer group market in California and Oregon, the company confirmed to Becker’s. “Health Net has made the decision to exit the traditional commercial group business in California and Oregon in order to focus on government sponsored healthcare,” a spokesperson for the insurer said in a […] The post Centene’s Health Net to exit commercial group market in California, Oregon appeared first on Becker's Payer Issues | Payer News .
Centene · 13 signals · last 30 days -
Blue Shield of California names COO
Frank Caporusso will serve as COO of Blue Shield of California, effective Sept. 1. According to an Aug. 27 news release, the company reconfigured its COO role. Mr. Caporusso will lead enterprise-wide operations, collaborate with the executive leadership team on Blue Shield’s strategy and focus on the member and provider experience. He has been with […] The post Blue Shield of California names COO appeared first on Becker's Payer Issues | Payer News .
Blue Shield CaliforniaBlue Cross Blue Shield plans · 36 signals · last 30 days -
Cigna named in addiction treatment providers’ lawsuit claiming $12.8M underpayment
Ten California addiction providers filed a lawsuit against Cigna on Aug. 19, claiming the insurer shortchanged them by $12.8 million. The lawsuit spans March 1, 2022, through March 15, 2026. Before 2015, Cigna would pay billed charges in full or at a “reasonable and customary” rate but eventually changed that policy, according to the complaint, […] The post Cigna named in addiction treatment providers’ lawsuit claiming $12.8M underpayment appeared first on Becker's Payer Issues | Payer News .
Cigna CaliforniaCigna · 15 signals · last 30 days -
Mental health workers say algorithmic triage is hurting patients
When Kaiser Permanente triage clinician Harimandir Khalsa began working in the psychiatry department at Kaiser’s Walnut Creek Medical Center in Northern California, she was on a team of nine people. Today, just over three years later, she is one of only three triage clinicians left. Some of the work once handled by employees has shifted […]
Kaiser CaliforniaKaiser Permanente · 4 signals · last 30 days -
Listening to the Frontlines: Kaiser Permanente’s Lessons on Integrating Doulas for Medi-Cal
Kaiser Permanente's experience with California's doula benefit reveals the importance of listening to the people closest to the work. The post Listening to the Frontlines: Kaiser Permanente’s Lessons on Integrating Doulas for Medi-Cal appeared first on California Health Care Foundation .
Kaiser CaliforniaKaiser Permanente · 4 signals · last 30 days -
Alignment looks to dismiss whistleblower complaint from former executive
Alignment Healthcare is asking a federal court to throw out a whistleblower lawsuit brought by a former executive who alleged retaliation from company leadership after reporting concerns over its accounting practices. The Medicare Advantage insurer filed its motion to dismiss Aug. 18 in the U.S. District Court for the Central District of California, targeting claims […] The post Alignment looks to dismiss whistleblower complaint from former executive appeared first on Becker's Payer Issues |...
Alignment Healthcare CaliforniaAlignment Healthcare · 3 signals · last 30 days -
Centene’s Health Net to end assisted living transition service for Medi-Cal members
Centene’s Health Net is rolling back an assisted living transition service for Medi-Cal members, a health plan spokesperson confirmed to Becker’s on Aug. 18. Through the California Advancing and Innovating Medi-Cal initiative — a multiyear transformation plan for the state’s Medicaid program — Community Supports are optional services to address health-related social needs. For example, […] The post Centene’s Health Net to end assisted living transition service for Medi-Cal members appeared fi...
Centene CaliforniaCentene · 13 signals · last 30 days -
Medi-Cal plans brace for ‘devastating’ asset limit crunch
California’s Medicaid program, Medi-Cal, is slashing asset limits 84% in July 2027. As a result, Medi-Cal members risk losing eligibility — and insurers are feeling the pressure. In 2022, California lifted the asset limit from $2,000 to $130,000 for individuals. CMS eventually approved a state proposal to drop the asset test, but California resurfaced the […] The post Medi-Cal plans brace for ‘devastating’ asset limit crunch appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 140 signals · last 30 days