Monday, March 15, 2010

 

DMHC ANNOUNCES HELP CENTER APPOINTMENT

(Sacramento) – Cindy Ehnes, Director of the Department of Managed Health Care (DMHC), has announced the appointment of Andrew George as Assistant Deputy Director of the Help Center, effective March 11, 2010.

“Andrew is a major asset to the DMHC, having worked as one of its consumer advocates for the past eight years, and will help further our goals to protect California health care consumers,” said Ehnes. “He is recognized as a leader, mentor and effective problem solver and will be able to seamlessly continue the excellent work produced by all Help Center staff.”

The Help Center assists consumers with health care issues, ensures that managed health care patients receive the medical care and services to which they are entitled, and has assisted more than 1 million consumers resolve complaints and problems with health plans. The Help Center has also recovered more than $11 million for consumers in payments or reimbursements owed by health plans, resolved more than 4,500 urgent cases within three days, and referred more than 9,000 cases to the independent medical review (IMR) process. In 2008 alone, nearly 60 percent of health plan treatment denials sent to IMR were overturned, resulting in requested healthcare services being provided to consumers.

Additionally, the Help Center has launched ten unscheduled investigations of health plans into issues such as health insurance cancellations, and claims payment and quality assurance problems, resulting in significant improvements in health plan processes and significant fines.

George has been a practicing attorney in state government for the past eleven years and served as a senior staff counsel in the Help Center for eight years, developing a strong commitment to Help Center customers, staff, and the public. He has played a prominent leadership role in the development of the Help Center while acquiring broad operational knowledge of all five of its divisions. He has also worked in the Office of Provider Oversight, where he was instrumental in streamlining the provider complaint process and enhancing efficiency.

The California Department of Managed Health Care is the only stand-alone HMO watchdog agency in the nation, touching the lives of more than 21 million enrollees. The DMHC has assisted more than 1 million Californians resolve their health plan problems through its Help Center, educates consumers on health care rights and responsibilities, and works closely with health plans to ensure a solvent and stable managed health care system.


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