Wednesday, September 19, 2018

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CMA publishes guide for physicians affected by EHS contract terminations

The California Department of Managed Health Care (DMHC) issued a cease-and-desist order on December 26, 2017, requiring nine health plans to terminate their contracts with Employee Health Systems (EHS) Medical Group Inc. This order comes after SynerMed—a company closely affiliated with EHS—was accused of blocking patient access to specialists to hold down costs.

EHS has 600,000 patients statewide—90 percent of whom are Medi-Cal managed care patients. As required by the DMHC, health plans affected by this order were required to submit a transition plan by January 3, 2018 and have begun the transfer all EHS patients to different health care providers due to be completed by February 5, 2018.

The California Medical Association (CMA) has published a guide intended to help physicians understand the impact these recent changes may have on their practices and where patients are being moved so they can determine whether to explore contract relationships with other entities.

The guide is free to our members along with other helpful resources in the CMA Resource Library.

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