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The X12 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers. The Health Insurance Portability and Accountability Act (HIPAA) requires that all health plans or health insurance carriers accept a standard ...
California was the first state in the U.S. to set up a health insurance marketplace. [ 1 ] [ 2 ] The California Health Benefit Exchange was created in September 2010 when then-Governor Arnold Schwarzenegger signed Assembly Bill 1602, (the "California Patient Protection and Affordable Care Act"), [ 3 ] by Assembly Speaker John Perez, and Senate ...
The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
2002-2005 County Medical Services Program (CMSP) program (Solano and Napa counties). 2007-2014 PartnershipAdvantage, a Special Needs Plan Medicare Advantage program (Yolo, Napa, Solano counties only) 2010-2013 Healthy Families, the California version of the federal Children's Health Insurance Program (Napa, Sonoma, Solano, Yolo counties only).
California was one of the states to expand its Medicaid program. [6] As of 2018, about one-third of California was covered by Medi-Cal. It is administered by the California Department of Health Care Services, which operates it in accordance with California's Medicaid State Plan and Title XIX of the Social Security Act. [7]
Health exchanges first emerged in the private sector in the early 1980s, and they used computer networking to integrate claims management, eligibility verification, and inter-carrier payments. These became popular in some regions as a way for small and medium-sized businesses to pool their purchasing power into larger groups, reducing cost.
The Healthy Families Program (HFP) was the California implementation of the federal Children's Health Insurance Program (CHIP) that provided low-cost insurance that provides health, dental, and vision coverage to children who do not have insurance and do not qualify for no-cost Medi-Cal.
In Division 2, the Knox-Keene Health Care Service Plan Act of 1975 in Division 2. Chapter 2.2., 1340 - 1399.864, [13] which is enforced by the California Department of Managed Health Care and regulates most health insurance in California, although some plans are regulated by the California Department of Insurance (CDI) with sometimes similar "companion" statutes in the California Insurance ...