Cavanagh Acts To Ensure Quality
Healthcare for Managed Care Enrollees
By Anthony Perez

A broad managed care reform package became law in California on January 1, 2000. Included within the package's provisions were laws creating a first-of-its-kind regulatory agency, the California Department of Managed Health Care. This new department was charged with the mission and responsibility of ensuring that Californians enrolled in a managed care plan are provided with high quality health care. At the head of the Office of Enforcement for this new department sits Joan Cavanagh, a Sacramento attorney who has been with the department since its formation.

As an assistant deputy director, Cavanagh supervises the department's litigation matters, which include litigation enforcing the Knox-Keene Act, the laws which govern managed care entities in California, as well as litigation defending the department. Cavanagh's position is unique in state government in that the Department of Managed Health Care is one of only a handful of state departments that represent themselves in litigation rather than turning to the Attorney General's Office for representation.

Since the department was formed, Cavanagh's office of only 26 employees when fully staffed, has investigated numerous allegations of health plan violations of the Knox-Keene Act. These investigations have lead to enforcement actions imposing significant fines on health plans in amounts not seen before in California, ranging from $250,000 to $1.1 million. Details on the department's many enforcement actions may be found on the department's website: www.dmhc.ca.gov.

Cavanagh came to the Department of Managed Health Care after a short stint with the Department of Corporations, the state department that had regulatory enforcement authority over managed care plans prior to 2000. According to Cavanagh, the new Department of Managed Health Care differs from the Department of Corporations in that the new department's focus is solely on managed care and the mission of the department is clear.

Before her entering her current position and her position at the Department of Corporations, Cavanagh had no specific experience with managed care litigation. However, she possessed skills and expertise which the Department of Corporations and the new Department of Managed Health Care needed, those of a seasoned and successful litigator with management experience. Cavanagh partially gained this experience in her 12 years with Attorney General's Office in its correctional law section, her last eight years in a supervisory position.

Cavanagh left the Attorney General's Office at the urging of a colleague who coaxed her into joining the Department of Corporations and the soon to be formed Department of Managed Health Care. According to Cavanagh, it was time for a change and she was excited at the prospect of joining a new department as it was being created.

Prior to her position at the Attorney General's office, Cavanagh served with the State Public Defender's Office as a chief assistant for criminal appeals. Before that she served with Board of Prison Terms. It was with this board that Cavanagh's management skills were first noticed. She began her service with the board as a staff counsel and left as the Board's executive officer.

Although Cavanagh has had, and continues to have a very distinguished and successful legal career in public service, she never really intended to practice law. She says she went to law school simply to continue her education after obtaining her undergraduate degree.