August 20, 2007

 

DMHC Announces Deputy Director Appointment

(Sacramento) – Lucinda (Cindy) Ehnes, Director of the Department of Managed Health Care (DMHC), has announced the appointment of Richard Martin as Deputy Director, Financial Solvency Standards Board. He will assume his duties immediately.

“Rick will fill a critical leadership role on my senior staff and will be key to working with our health care and consumer advocacy partners to help maintain health care access for patients,” said Cindy Ehnes, Director of the DMHC. “He has proven to be a consensus-builder on several key issues affecting the health care delivery system in California.”

Martin will work with the seven-member Financial Solvency Standards Board (FSSB), appointed by the Director to advise on matters to keep the health plan industry financially stable. In recent years, the Board has been involved in setting up standards to monitor the financial condition of risk-bearing organizations (RBOs) such as medical groups that contract with health plans to deliver health care services. The Board can also review and provide input on proposed DMHC regulatory changes.

Currently serving as Assistant Deputy Director for Provider Oversight, Martin has been instrumental in establishing the DMHC’s Provider Complaint Unit (PCU), which examines claim payment issues on behalf of doctors and hospitals. The PCU operates a Web-based system that gives providers an independent mechanism to solve disputes with health plans over the timely and fair payment of claims.

To date, the PCU has recovered more than $2 million in additional payments to providers since it was established in late 2005.

“Paying providers fairly and on time is key to maintaining a stable and accessible network of doctors and specialists for patients,” said Ehnes. “Through Rick’s dedication, for the first time, California providers have an independent system to decide fair payment in their disputes with health plans.”

Previously, Martin was a Supervising Examiner for the DMHC’s Division of Financial Oversight where he was responsible for the managing financial and administrative examinations of health plans. He has also worked for the California Department of Health Services where he conducted fiscal, management, and internal audits of various hospitals, health systems, public health programs and skilled nursing facilities subject to state and federal laws and regulations.

He received his bachelor of science in accounting from California State University, Fresno and a master’s degree in business administration from Saint Mary’s College of California. 


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