Letters

Letter to DMHC Regarding Contract Ending Between Scripps Health and Anthem Blue Cross

January 28, 2025

Mary Watanabe, Director
Department of Managed Health Care
980 9th Street, Suite 500
Sacramento, CA 95814-272
 

Dear Director Watanabe,
 

We, the undersigned members of the San Diego legislative delegation, write to address the recent contract termination between Scripps Health and Anthem Blue Cross in the San Diego region. This contract expiration has severely impacted our constituents. We seek your immediate attention and action.

Overnight on December 31, 2024, thousands of Scripps Health patients were left without coverage by Anthem Blue Cross. The impact from this event has disrupted necessary health care access for many of our residents. Patients with acute conditions, chronic illnesses, and those undergoing critical treatments are facing interruptions in their care, compromising their wellbeing.

The Department of Managed Health Care (DMHC) has the responsibility to protect consumers' health care rights and ensure a stable health care delivery system.

We strongly urge the Department to utilize all available enforcement authorities to address this situation. Specifically, we request:

  1. An assessment of Anthem Blue Cross' network adequacy in light of this contract termination. According to California Code of Regulations, Title 10, Section 2240.1, all insurers must maintain networks sufficient in number, capacity, and specialty to provide covered health care services within a region.
  2. A description of oversight conducted by DMHC demonstrating that patients of Scripps Health previously receiving coverage through Anthem’s network still have adequate access to primary care services and continuation of medical services for conditions for which they received treatment at Scripps Health.
  3. Details of any accountability requirements DMHC placed on Anthem Blue Cross before, during, and after termination of the contract with Scripps Health.
  4. Implementation of measures to ensure continuity of care requests are considered as expeditiously as possible, especially for patients with ongoing treatments or chronic conditions.
  5. Review of any enrollee notices and correspondence related to the contract termination that may have provided advice on where patients could seek medical treatment.
  6. Verification that Anthem provides adequate access to emergency services as required by law.

We request a formal response detailing DMHC's next steps to monitor and support affected patients. Supporting Californians in circumstances like this demonstrates the State’s commitment to providing high quality health care access.

The undersigned stand ready to work with DMHC to ensure our constituents receive the quality, accessible health care they deserve. We appreciate your attention to this matter and look forward to your response outlining DMHC's actions to address these concerns.

Sincerely,

 

Catherine Blakespear

Senator, CA District 38

 

Chris Ward

Assemblymember, CA District 78
 

Darshana Patel

Assemblymember, CA District 76

 

Akilah Weber Pierson, M.D.

Senator, CA District 39

 

Tasha Boerner

Assemblymember, CA District 77

 

Stephen Padilla

Senator, CA District 18

 

CC:      Secretary Kim Johnson, Health and Human Services Agency

            Senator Caroline Menjivar, Chair of Senate Health Committee

            Assemblymember Mia Bonta, Chair of Assembly Health Committee