Part One of a series

May 3, 2013

By Katy Grimes

One of the original pioneers of the Obamacare patient networks, HealthCare Partners, has been operating in California without the required state license. But according to health care experts and a new lawsuit, the California Department of Managed Care has known this, and allowed it for 10 years, saving HealthCare Partners millions of dollars.

HCP has flown under the radar of the California Department of Managed Health Care regulatory authority by claiming it’s a medical group, while in fact operating as an unlicensed Health Maintenance Organization. It has done so by taking standard HMO global risk for the patient — hospital care, medication and physician services.

The Affordable Care Act, also known as Obamacare, works through a network of Accountable Care Organizations providing managed health care services to all people throughout the country. Health care experts have said all along there is not enough money in the system to do what the ACA purports it can do.

The acronyms are confusing. What’s the difference between an HMO and an ACO? “ACOs amount to… Read More

SACRAMENTO — Californa’s desire to be the first state to do everything has never been more evident now that Obamacare has been signed into law.

And California lawmakers haven’t let any grass grow under their feet since passage of the Affordable Care Act in 2010. In January, Gov. Jerry Brown issued a proclamation to convene an extraordinary session of the Legislature to continue the work of implementing the federal Patient Protection and Affordable Care Act.

Obamacare cheat sheet

Under the Patient Protection and Affordable Care Act, also known as federal health care reform, or Obamacare, the state has the option to expand its Medi-Cal Program to cover over one million low–income adults who are currently ineligible.

Unlike some states, which have refused to implement the Obamacare health exchanges, California has embraced the federal health care plan and already began the process of implementation.

This means beginning January 1, 2014, the federal government will pay all of the costs associated with the Medi-Cal expansion, and do this for three years. Beginning January 1, 2017, the federal government will begin to decrease its portion,… Read More