Help is Here for Healthcare Consumers

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Help is Here for Healthcare Consumers

Today, the California Chronic Care Coalition (CCCC) launched, an online resource for California health care consumers who are denied coverage, experience delays or are dissatisfied with the decisions made by their health plan.

“ is a beacon of light in a stormy health care sea,” said Liz Helms, president and CEO of the CCCC. “As health plans are moving to reduce access to new lifesaving medicines, create one-size-fits-all treatment pathways and restrict access to specialists, we must provide consumers with the help and confidence they need to demand the care they deserve.”

The CCCC, an alliance of more than 30 leading consumer, health and provider organizations, is working to help ensure consumers know their rights and avenues of recourse under managed care organizations. Through this website, the coalition will help educate consumers about their health care rights and direct them in where to file complaints with their health plan and/or the California Department of Managed Health Care (DMHC). The DMHC has a strong track record of helping the more than 20 million Californians in DMHC-regulated plans. In 2014, the DMHC assisted more than 100,000 Californians in resolving issues or complaints with their health plan.

The types of complaints regulators collect include:

  • Denials to specialists
  • Denials to important procedures
  • Barriers to prescription medicines
  • Delays receiving tests for chronic diseases
  • Medical bills from out-of-network providers
  • Balanced billing issues

“California’s health plans claim they receive very few complaints from patients, yet we know that the majority of consumers do not complain because they do not know how to do so or are intimidated by the process. By ensuring that complaints are registered, we will be able to determine where there are pervasive access and affordability issues for California consumers, rather than rely on anecdotal information from news stories, advocacy organizations, and providers,” said Joan Werblun, RN, board member of the California Health Collaborative, a CCCC partner.

Several members of the CCCC, including Helms, have been fighting for patient rights for the past twenty years. They were leaders in the creation of the Office of the Patient Advocate (OPA) and the Department of Managed Health Care (DMHC).

The website includes a list of patient rights and step-by-step instructions to file a complaint with a health plan, DMHC and/or DOI. It also includes testimonials from real patients who have experienced lengthy delays or denials. In addition, the website will collect patient stories to provide a true picture of the quality of care provided throughout the state.

“Navigating today’s health care system is complicated enough without having to figure out how to file a complaint and ensure your voice is heard,” said Bill Remak, board member of the CCCC and California Hepatitis C Task Force. “By helping patients file a complaint with the DMHC and DOI and contact their health plan, we have the opportunity to change the system and keep Californians healthy.”

The website will only be successful if consumers know it exists. To ensure it reaches those in need, the coalition is asking every patient advocacy organization in the state to add a widget to their website(s) and will educate and engage California legislators and other elected officials, medical providers, pharmacies, consumer groups and the media to help spread the word.

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State and federal law protects your rights. When you sign up for a health plan and/or if you have problems accessing care through your health plan, it is important to know your rights.