CMS, State Officials Halt Participation of CalOptima in Dual-Eligible Plan

 

On Friday, January 24 Federal officials declared Orange County's CalOptima insurance company had "multiple, serious violations" in its program for seniors and the disabled.

The insurer denied legally-required prescription coverage, failed to process provider payments in a timely manner and failed to pay for covered emergency services, among other charges, according to a letter released Friday by CMS officials.

The 10-day audit found these problems to be "widespread and systemic."

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