Members who live in rating regions 1, 7, and 10 and who transition into a new Anthem EPO plan for 2018 can apply for Continuity of Care coverage if their current provider is no longer in network. They can call member services and ask for assistance with their ongoing treatment with their current providers.
These benefit changes will reduce member cost share for Mental Health, Behavioral Health and Substance Use Disorder (MH/SUD) and emergency medical transportation benefits. Previously filed claims will be retroactively adjusted back to dates of service on or after January 1, 2016. Members who paid the incorrect cost sharing amount will receive a separate letter and refund, as appropriate.
California Department of Insurance detectives, assisted by multiple law enforcement agencies, arrested Chris Bathum and Kirsten Wallace on multiple felony counts of grand theft, and identity theft for allegedly conspiring to defraud patients and insurers out of more than $176 million through an elaborate conspiracy. Simultaneously, search warrants were also executed at 15 locations throughout Los Angeles and Orange County.