There’s a New SF Mayor in Town
POB president Fred Sanchez had a chance to meet with the new mayor and congratulate him on his win. POB looks forward to working with the new mayor and his administration to fix the many problems [...]
How to File an Expedited Appeal
Blue Shield of California offers an expedited appeal process for members who have a serious health concern, which they define as imminent and serious threat to health of the member. What qualifies for an expedited appeal? Severe [...]
CA Imposes Guardrails on Using AI in Healthcare Denials
from jdsupra.com SB 1120 (the “Bill”), which takes effect on January 1, 2025, amends existing California law to adopt guardrails around the use of artificial intelligence tools for the purpose of utilization management.[1] As discussed in a prior Proskauer [...]
AI Bots Denying Hundreds of Thousands of Medicare Healthcare Claims
From theGuardian.com: New AI tool counters health insurance denials decided by automated algorithms Class-action lawsuits allege algorithms turn down claims in seconds and critics say reform is needed for lasting change Insurance coverage denials have [...]
Acupuncture Treatments Being Downgraded Under New Plan
To: Health Services Board, Fred Sanchez, Protect Our Benefits From Lois Scott, Protect Our Benefits These discrepancies were brought to my attention by a distinguished local Doctor of Oriental Medicine and Licensed Acupuncturist, who has been [...]
POB Testifies to Supes About Multiple Problems Reported In Transition to Blue Shield CA
To: Members of the San Francisco Board of Supervisors Date: February 10, 2025 We are Protect Our Benefits, Inc., representing 19,100 retired San Francisco City and County employees who were impacted by the transition from United [...]