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California Fines Blue Shield for Illegally Charging Patients for Contraceptives
UC Berkeley's Insurance Plan Change Will Limit Mental Health Care for Students, Therapists Say
Blue Shield Moving Headquarters From San Francisco to Oakland
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"content": "\u003cp>State \u003ca href=\"https://www.kqed.org/news/tag/health\">health\u003c/a> regulators have fined Blue Shield of California $250,000 for illegally charging hundreds of its members for contraceptive health care services.\u003c/p>\n\u003cp>The insurance company also paid $228,254 in reimbursements to the members who were incorrectly billed, the California Department of Managed Health Care announced on Thursday.\u003c/p>\n\u003cp>Under state law, health insurance companies must cover contraceptive drugs, devices and products such as birth control and intrauterine devices (IUDs) at no cost to the patient. The Department of Managed Health Care found that from 2016 through 2019, Blue Shield had charged more than 330 members for those services.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We always encourage health plan members who are having issues with their health plan — including billing issues like this, any kind of denials of healthcare services — file a complaint with your plan,” said Kevin Durawa, a spokesperson for the Department of Managed Health Care.\u003c/p>\n\u003cp>[aside postID=news_12001214 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240524-REGIONALMEDICAL-JG-1-KQED-1020x680.jpg']\u003c/p>\n\u003cp>Blue Shield of California, based in Oakland, has over 4.8 million members across the state. The department started its investigation after receiving a complaint from a member who was charged for an IUD removal.\u003c/p>\n\u003cp>In October 2017, the member requested the device to be removed after experiencing complications with it. Doctors were unable to remove it during a routine office visit and had to perform an outpatient surgery to pull out the device.\u003c/p>\n\u003cp>The patient was billed $3,439 after the procedure. After Blue Shield denied a grievance filed by the patient, they turned to state regulators.\u003c/p>\n\u003cp>“The member did the right thing — they filed a complaint with the Department of Managed Health Care help center, which led to a broader investigation by the DMHC, which uncovered a much bigger issue,” Durawa said.\u003c/p>\n\u003cp>A Blue Shield spokesperson said the company has been “cooperative throughout the process of this investigation” and has taken steps to correct the issue but did not respond to a KQED inquiry into why the members were charged for contraceptive health care services in the first place.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>State \u003ca href=\"https://www.kqed.org/news/tag/health\">health\u003c/a> regulators have fined Blue Shield of California $250,000 for illegally charging hundreds of its members for contraceptive health care services.\u003c/p>\n\u003cp>The insurance company also paid $228,254 in reimbursements to the members who were incorrectly billed, the California Department of Managed Health Care announced on Thursday.\u003c/p>\n\u003cp>Under state law, health insurance companies must cover contraceptive drugs, devices and products such as birth control and intrauterine devices (IUDs) at no cost to the patient. The Department of Managed Health Care found that from 2016 through 2019, Blue Shield had charged more than 330 members for those services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Blue Shield of California, based in Oakland, has over 4.8 million members across the state. The department started its investigation after receiving a complaint from a member who was charged for an IUD removal.\u003c/p>\n\u003cp>In October 2017, the member requested the device to be removed after experiencing complications with it. Doctors were unable to remove it during a routine office visit and had to perform an outpatient surgery to pull out the device.\u003c/p>\n\u003cp>The patient was billed $3,439 after the procedure. After Blue Shield denied a grievance filed by the patient, they turned to state regulators.\u003c/p>\n\u003cp>“The member did the right thing — they filed a complaint with the Department of Managed Health Care help center, which led to a broader investigation by the DMHC, which uncovered a much bigger issue,” Durawa said.\u003c/p>\n\u003cp>A Blue Shield spokesperson said the company has been “cooperative throughout the process of this investigation” and has taken steps to correct the issue but did not respond to a KQED inquiry into why the members were charged for contraceptive health care services in the first place.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "uc-berkeleys-insurance-plan-change-will-limit-mental-health-care-for-students-therapists-say",
"title": "UC Berkeley's Insurance Plan Change Will Limit Mental Health Care for Students, Therapists Say",
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"content": "\u003cp>Psychotherapist Orit Weksler operates out of a bright office in Berkeley outfitted with a big, yellow couch, a box filled with sand and shelves stocked with small plastic figurines for patients to play with.\u003c/p>\n\u003cp>“Take whatever speaks to you, put it in the sand, and it creates a kind of picture, kind of like a dream scene,” Weksler said. “It’s just a way to start a conversation.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">UC Berkeley\u003c/a> students make up about a third of Weksler’s practice. Navigating things like the red-tape imposed by insurance companies and erratic student schedules makes the job tough. “It’s a very big commitment on our part,” Weksler said. “We do this because we love working with students.”\u003c/p>\n\u003cfigure id=\"attachment_11737674\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737674\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Orit-Weksler-800x600.jpg\" alt=\"Psychotherapist Orit Weksler poses in her Berkeley office with her sand tray and shelves of figurines.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-536x402.jpg 536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Psychotherapist Orit Weksler in her Berkeley office with her sand tray and shelves of figurines. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now, Berkeley’s decision to change up its health insurance provider — for the third time in six years — is putting that love to the test.\u003c/p>\n\u003cp>The main issue is the choice of insurance provider: \u003ca href=\"https://www.blueshieldca.com/\" target=\"_blank\" rel=\"noopener\">Blue Shield\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Weksler is one of five mental health professionals interviewed for this story in person, on the phone or via email. All of them complained about the company’s low reimbursement rates and slow, bureaucratic processes.\u003c/p>\n\u003cp>“\u003ca href=\"https://www.anthem.com/\" target=\"_blank\" rel=\"noopener\">Anthem\u003c/a> and \u003ca href=\"https://www.aetna.com/\" target=\"_blank\" rel=\"noopener\">Aetna\u003c/a> before them only pay us about 50 percent of our regular full fee,” Weksler said of UC Berkeley’s current and previous two student medical insurance partners. “Blue Shield will offer even less, which will make it impossible for most of us to offer more than one or two slots per week for students, due to the cost of living.”\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Shana Charles, an assistant professor at Cal State Fullerton in the public health department']‘The UC system is a public system, and it does have a charge to take care of its students. This calls for possible government intervention or regulation of some kind.’[/pullquote]\u003c/p>\n\u003cp>Weksler said many of her colleagues have voiced their concerns on a community listserv about what the switch to Blue Shield might mean for students’ access to services going forward, in a climate where there are more students seeking therapy than there are therapists to provide it.\u003c/p>\n\u003cp>“People are going to get on the Blue Shield list to be able to continue to provide care for students who are currently on their caseload,” Weksler says. “But they’re not going to open any slots for new students.”\u003c/p>\n\u003cp>The new plan will serve around 20,000 students and is scheduled to begin Aug. 1.\u003c/p>\n\u003cp>Blue Shield spokeswoman Amanda Wardell said her company plans to make the transition as easy as possible and provide a high level of care.\u003c/p>\n\u003cp>“As a nonprofit health plan, Blue Shield of California is dedicated to meeting the healthcare needs of UC Berkeley students with our extensive network of providers,” Wardell said in a statement. “We are committed to working with UC Berkeley Student Health Insurance Plan (SHIP) to make this transition easy and ensuring access to high-quality care that is worthy of our family and friends.”\u003c/p>\n\u003cfigure id=\"attachment_11737676\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737676\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Bahar-Navab-800x600.jpg\" alt=\"Bahar Navab, associate director of insurance and business development for UC Berkeley's University Health Services.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-536x402.jpg 536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Bahar Navab, associate director of insurance and business development for UC Berkeley’s University Health Services. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UC Berkeley \u003ca href=\"https://uhs.berkeley.edu/home\" target=\"_blank\" rel=\"noopener\">University Health Services\u003c/a>’ (UHS) associate director of insurance and business development, Bahar Navab, defended the switch as being necessary in the face of ever-escalating healthcare costs.\u003c/p>\n\u003cp>“We have to find the right balance of let’s reimburse our providers a livable wage, while also not having the cost of the plan be unsustainable,” Navab said.\u003c/p>\n\u003cp>Navab said UHS considered bids from 10 insurance providers, and engaged students, the Berkeley administration and other campus stakeholders during the five-month-long bidding and evaluation process, before settling on Blue Shield. (The California-based provider is offering its services in collaboration with \u003ca href=\"https://wellfleetinsurance.com\" target=\"_blank\" rel=\"noopener\">Wellfleet\u003c/a>, a Massachusetts-based insurance firm that specializes in student insurance plans.)\u003c/p>\n\u003cp>[pullquote size='small' align='right' citation='Bahar Navab, University Health Services at UC Berkeley']‘We have to find the right balance of let’s reimburse our providers a livable wage, while also not having the cost of the plan be unsustainable.’[/pullquote]\u003c/p>\n\u003cp>Navab said her department has been working closely with Blue Shield to advocate for reimbursement rates on par with what the current insurer, Anthem, paid healthcare providers. She also said the new plan will not require doctors and other specialists to join the standard Blue Shield network. Instead, UHS has negotiated a special “carve out” for healthcare providers to work with UC Berkeley students.\u003c/p>\n\u003cp>“The carve out will offer providers more consistent rates,” Navab said. “Additionally, we have been working with Blue Shield to reduce administrative barriers, figure out how to streamline the transition and make it as seamless and painless as possible.”\u003c/p>\n\u003cp>Weksler is skeptical of phrases like “carve out”: “It’s just words,” she said.\u003c/p>\n\u003cp>She wants UHS leaders to engage health practitioners in more conversations about policy and best practices in order to serve students’ healthcare needs in a way that makes financial sense for the university, students and providers.\u003c/p>\n\u003cp>\u003cb>\u003c/b>“I want to see that they understand what the actual problems are and that they’re committed to helping us,” Weksler said.\u003c/p>\n\u003cfigure id=\"attachment_11737675\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737675\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-800x533.jpeg\" alt=\"UC Berkeley senior, Nuha Khalfay.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-1200x800.jpeg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay.jpeg 1600w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">UC Berkeley senior, Nuha Khalfay. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UC Berkeley student Nuha Khalfay, who studies public health, said she’s confident the university has students’ best interests at heart and is happy about some aspects of the new plan — such as the coverage of facial feminization surgery for transgender students for the first time.\u003c/p>\n\u003cp>[aside tag='mental-health' label='Mental Health Care in California']\u003c/p>\n\u003cp>But Khalfay said some of her friends on campus have had to travel far to find in-network providers willing to see them in recent months, and worries about the situation getting worse.\u003c/p>\n\u003cp>“If providers can’t be reimbursed at the rates that they need to take students who go to UC Berkeley, then UC Berkeley students will lose out on the diversity of providers that they could have access to,” Khalfay said.\u003c/p>\n\u003cp>According to Didi Wu, president of \u003ca href=\"https://sspc.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">Student-to-Student Peer Counseling\u003c/a>, a network of Berkeley students offering counseling services to their fellow students, the need for mental health care on campus has never been greater. “There has definitely been increasing demand for counseling among students,” Wu said.\u003c/p>\n\u003cp>A UC system spokeswoman said Berkeley was the only campus in the system to offer Blue Shield as a primary provider.\u003c/p>\n\u003cp>“To switch providers multiple times within a few years is kind of unusual,” said Shana Charles, an assistant professor at \u003ca href=\"http://www.fullerton.edu/\" target=\"_blank\" rel=\"noopener\">Cal State Fullerton\u003c/a> in the public health department and a faculty associate with the \u003ca href=\"https://healthpolicy.ucla.edu\" target=\"_blank\" rel=\"noopener\">UCLA Center for Health Policy Research\u003c/a>.\u003c/p>\n\u003cp>Charles said the fact that mental health specialists are speaking out against the new plan before it’s even been put into motion suggests “a broken system.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cb>\u003c/b>“The UC system is a public system, and it does have a charge to take care of its students,” Charles said. “This calls for possible government intervention or regulation of some kind.”\u003c/p>\n\n",
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"title": "UC Berkeley's Insurance Plan Change Will Limit Mental Health Care for Students, Therapists Say | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Psychotherapist Orit Weksler operates out of a bright office in Berkeley outfitted with a big, yellow couch, a box filled with sand and shelves stocked with small plastic figurines for patients to play with.\u003c/p>\n\u003cp>“Take whatever speaks to you, put it in the sand, and it creates a kind of picture, kind of like a dream scene,” Weksler said. “It’s just a way to start a conversation.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">UC Berkeley\u003c/a> students make up about a third of Weksler’s practice. Navigating things like the red-tape imposed by insurance companies and erratic student schedules makes the job tough. “It’s a very big commitment on our part,” Weksler said. “We do this because we love working with students.”\u003c/p>\n\u003cfigure id=\"attachment_11737674\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737674\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Orit-Weksler-800x600.jpg\" alt=\"Psychotherapist Orit Weksler poses in her Berkeley office with her sand tray and shelves of figurines.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler-536x402.jpg 536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Orit-Weksler.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Psychotherapist Orit Weksler in her Berkeley office with her sand tray and shelves of figurines. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now, Berkeley’s decision to change up its health insurance provider — for the third time in six years — is putting that love to the test.\u003c/p>\n\u003cp>The main issue is the choice of insurance provider: \u003ca href=\"https://www.blueshieldca.com/\" target=\"_blank\" rel=\"noopener\">Blue Shield\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Weksler is one of five mental health professionals interviewed for this story in person, on the phone or via email. All of them complained about the company’s low reimbursement rates and slow, bureaucratic processes.\u003c/p>\n\u003cp>“\u003ca href=\"https://www.anthem.com/\" target=\"_blank\" rel=\"noopener\">Anthem\u003c/a> and \u003ca href=\"https://www.aetna.com/\" target=\"_blank\" rel=\"noopener\">Aetna\u003c/a> before them only pay us about 50 percent of our regular full fee,” Weksler said of UC Berkeley’s current and previous two student medical insurance partners. “Blue Shield will offer even less, which will make it impossible for most of us to offer more than one or two slots per week for students, due to the cost of living.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Weksler said many of her colleagues have voiced their concerns on a community listserv about what the switch to Blue Shield might mean for students’ access to services going forward, in a climate where there are more students seeking therapy than there are therapists to provide it.\u003c/p>\n\u003cp>“People are going to get on the Blue Shield list to be able to continue to provide care for students who are currently on their caseload,” Weksler says. “But they’re not going to open any slots for new students.”\u003c/p>\n\u003cp>The new plan will serve around 20,000 students and is scheduled to begin Aug. 1.\u003c/p>\n\u003cp>Blue Shield spokeswoman Amanda Wardell said her company plans to make the transition as easy as possible and provide a high level of care.\u003c/p>\n\u003cp>“As a nonprofit health plan, Blue Shield of California is dedicated to meeting the healthcare needs of UC Berkeley students with our extensive network of providers,” Wardell said in a statement. “We are committed to working with UC Berkeley Student Health Insurance Plan (SHIP) to make this transition easy and ensuring access to high-quality care that is worthy of our family and friends.”\u003c/p>\n\u003cfigure id=\"attachment_11737676\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737676\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Bahar-Navab-800x600.jpg\" alt=\"Bahar Navab, associate director of insurance and business development for UC Berkeley's University Health Services.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1200x900.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1832x1374.jpg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1376x1032.jpg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-1044x783.jpg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-632x474.jpg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab-536x402.jpg 536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Bahar-Navab.jpg 2048w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Bahar Navab, associate director of insurance and business development for UC Berkeley’s University Health Services. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UC Berkeley \u003ca href=\"https://uhs.berkeley.edu/home\" target=\"_blank\" rel=\"noopener\">University Health Services\u003c/a>’ (UHS) associate director of insurance and business development, Bahar Navab, defended the switch as being necessary in the face of ever-escalating healthcare costs.\u003c/p>\n\u003cp>“We have to find the right balance of let’s reimburse our providers a livable wage, while also not having the cost of the plan be unsustainable,” Navab said.\u003c/p>\n\u003cp>Navab said UHS considered bids from 10 insurance providers, and engaged students, the Berkeley administration and other campus stakeholders during the five-month-long bidding and evaluation process, before settling on Blue Shield. (The California-based provider is offering its services in collaboration with \u003ca href=\"https://wellfleetinsurance.com\" target=\"_blank\" rel=\"noopener\">Wellfleet\u003c/a>, a Massachusetts-based insurance firm that specializes in student insurance plans.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Navab said her department has been working closely with Blue Shield to advocate for reimbursement rates on par with what the current insurer, Anthem, paid healthcare providers. She also said the new plan will not require doctors and other specialists to join the standard Blue Shield network. Instead, UHS has negotiated a special “carve out” for healthcare providers to work with UC Berkeley students.\u003c/p>\n\u003cp>“The carve out will offer providers more consistent rates,” Navab said. “Additionally, we have been working with Blue Shield to reduce administrative barriers, figure out how to streamline the transition and make it as seamless and painless as possible.”\u003c/p>\n\u003cp>Weksler is skeptical of phrases like “carve out”: “It’s just words,” she said.\u003c/p>\n\u003cp>She wants UHS leaders to engage health practitioners in more conversations about policy and best practices in order to serve students’ healthcare needs in a way that makes financial sense for the university, students and providers.\u003c/p>\n\u003cp>\u003cb>\u003c/b>“I want to see that they understand what the actual problems are and that they’re committed to helping us,” Weksler said.\u003c/p>\n\u003cfigure id=\"attachment_11737675\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11737675\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-800x533.jpeg\" alt=\"UC Berkeley senior, Nuha Khalfay.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-800x533.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-1020x680.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay-1200x800.jpeg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/04/Nuha-Khalfay.jpeg 1600w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">UC Berkeley senior, Nuha Khalfay. \u003ccite>(Chloe Veltman/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UC Berkeley student Nuha Khalfay, who studies public health, said she’s confident the university has students’ best interests at heart and is happy about some aspects of the new plan — such as the coverage of facial feminization surgery for transgender students for the first time.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But Khalfay said some of her friends on campus have had to travel far to find in-network providers willing to see them in recent months, and worries about the situation getting worse.\u003c/p>\n\u003cp>“If providers can’t be reimbursed at the rates that they need to take students who go to UC Berkeley, then UC Berkeley students will lose out on the diversity of providers that they could have access to,” Khalfay said.\u003c/p>\n\u003cp>According to Didi Wu, president of \u003ca href=\"https://sspc.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">Student-to-Student Peer Counseling\u003c/a>, a network of Berkeley students offering counseling services to their fellow students, the need for mental health care on campus has never been greater. “There has definitely been increasing demand for counseling among students,” Wu said.\u003c/p>\n\u003cp>A UC system spokeswoman said Berkeley was the only campus in the system to offer Blue Shield as a primary provider.\u003c/p>\n\u003cp>“To switch providers multiple times within a few years is kind of unusual,” said Shana Charles, an assistant professor at \u003ca href=\"http://www.fullerton.edu/\" target=\"_blank\" rel=\"noopener\">Cal State Fullerton\u003c/a> in the public health department and a faculty associate with the \u003ca href=\"https://healthpolicy.ucla.edu\" target=\"_blank\" rel=\"noopener\">UCLA Center for Health Policy Research\u003c/a>.\u003c/p>\n\u003cp>Charles said the fact that mental health specialists are speaking out against the new plan before it’s even been put into motion suggests “a broken system.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Blue Shield Moving Headquarters From San Francisco to Oakland",
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"content": "\u003cp>Blue Shield of California says it will save tens of millions of dollars by moving its headquarters and its 1,200 workers from San Francisco to Oakland.\u003c/p>\n\u003cp>The nonprofit health insurer, founded in San Francisco 78 years ago, announced Wednesday it plans to leave the city for the East Bay in 2019.\u003c/p>\n\u003cp>Blue Shield’s lease of its current Beale Street property in San Francisco is up in two years, and the company had to make a decision, said spokesman Steve Shivinsky.\u003c/p>\n\u003cp>“This was a move to find a location that would allow us to save us some money,” he said.\u003c/p>\n\u003cp>Some companies are finding it increasingly difficult to pay San Francisco’s skyrocketing rental rates, pushed up by the tech boom. The company estimates the move will save $150 million over the 13-year lease in Oakland.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Blue Shield will occupy part of a new 24-story office tower to be developed at 601 City Center. The building is being developed by Shorenstein Realty Services and MetLife.\u003c/p>\n\u003cp>Oakland Mayor Libby Schaaf said Blue Shield was a “strong corporate citizen” that would give a boost to the city's revitalization and add to its growing hub of health and tech companies, which include Kaiser Permanente and Pandora Media.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Blue Shield’s independent philanthropic organization, Blue Shield Foundation, will remain in San Francisco.\u003c/p>\n\n",
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"excerpt": "Blue Shield of California says the decision to move its HQ from San Francisco to Oakland will save the company tens of millions of dollars.",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"politicalbreakdown": {
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"radiolab": {
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"reveal": {
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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},
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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"snap-judgment": {
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"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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},
"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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