California Healthcare News

Browse by article below or view full newsletters in PDF format

DMHC Issues Additional Missed Deadline Penalties Against Arcadian Health Premium Content
Apr 20, 2017

The Department of Managed Health Care has fined Medicare Advantage insurer Arcadian Health Plan $50,000 for failing to inform the regulator of multiple material changes in its operations in a timely manner.

            The penalty was imposed after the DMHC determined that Arcadian had failed to notify it of three plan-to-plan transactions, primarily to expand the number of in-network providers.

California Cities Lead Nation With Polluted Air Premium Content
Apr 20, 2017

Cities in California held the majority of the top 10 cities in the United States with ozone and particulate matter pollution, according to new data from the American Lung Association.

Consumer Complaints To DMHC Double Premium Content
Apr 13, 2017

The Affordable Care Act has delivered health insurance to millions of Californians over the past four years, but that does not necessarily mean the recipients are completely happy with their change in situation.

            That’s borne out by data from the Department of Managed Health Care, which indicated that complaints to the agency about health plans essentially doubled between 2013 and 2015.

California Lawmakers Trying To Rein In Big Pharma Premium Content
Apr 13, 2017

In November, California voters defeated a ballot proposal that would have given state government more control over drug prices. It was a victory for pharmaceutical companies, which spent more than $100 million campaigning against the measure.

Hospitals Receive Healthgrades Awards For Patient Safety Premium Content
Apr 13, 2017

Fifty-one hospitals in California have received awards from Healthgrades for excellence in patient safety.
            The hospitals were rated in five different areas for patient outcomes, including joint replacement, orthopedics, spinal surgery, cardiology and pulmonary care. The hospitals selected for the award were at least 1.6 times more likely to have outcomes above the nationwide average.

FDA Grants 23andMe Right To Perform Risk-Assessment Genetic Tests Premium Content
Apr 13, 2017

23andMe, the Mountain View-based genetics laboratory, has received clearance from the U.S. Food and Drug Administration to perform direct-to-consumer genetic risk reports.

            23AndMe received clearance from the FDA to perform tests to assess the risks of 10 different partly genetic-predictive conditions, including late-onset Alzheimer's disease, celiac disease, Gaucher disease and Parkinson's disease, among others.

Kindergarten Vaccination Rates Rise Significantly Premium Content
Apr 13, 2017

The California Department of Public Health has announced that the rate of kindergarten students vaccinated statewide rose to 96% for the 2016-17 school year, up from 93% during the prior school year.

            CDPH officials credited the increase to a recently enacted state law that eliminated the personal belief exemption for vaccinations, as well as campaigns to increase public awareness about vaccinations.

Health Net Says It Is Addressing CFO Issue Premium Content
Apr 13, 2017

A spokesperson for Woodland Hills-based Health Net said it would work with the Department of Managed Health Care after the insurance regulator issued a cease-and-desist order related to its acquisition last year by Midwest health insurer Centene.

Study Closely Ties California Hospital Pricing To Revenue Premium Content
Apr 6, 2017

Few patients pay a hospital’s full price for a procedure or test. But a new study shows why those charges still matter.

Economists at the Federal Reserve Board and the American Enterprise Institute found that list prices, often dismissed as meaningless by the hospital industry, are a critical gauge of which hospitals ultimately receive higher payments.

New UCSF Study Shows Some Ethnic Groups May Not Get Proper Health Screenings Premium Content
Apr 6, 2017

A new study led by researchers at UC San Francisco concludes that Americans of Latino and South Asian descent are far more likely than whites to be at high risk for heart disease, stroke and diabetes, even when their weight is in a normal range.

DMHC Says Centene, Health Net Violated Merger Terms Premium Content
Apr 6, 2017

The Department of Managed Health Care has issued a cease and desist order against Health Net and its parent company, St. Louis-based insurance giant Centene, claiming they violated a key provision of the agency's terms and conditions pertaining to their merger last year.

Kaiser Names New Norcal CFO Premium Content
Apr 6, 2017

Chandrika “C.J.” Bhalla has been named the new chief financial officer for Kaiser Permanente's Northern California division.

Sharp Hospital Gets $2.9 Million NIH Grant Premium Content
Apr 6, 2017

The neonatal research institute at Sharp Healthcare's Mary Birch Hospital for Women & Newborns has received a $2.9 million grant from the National Institutes of Health.

Relief At Demise – For Now – of AHCA Premium Content
Mar 30, 2017

Had it gotten through Congress and signed into law, the American Health Care Act would have been utterly disastrous for Californians, two leading healthcare policy researchers have concluded.

            According to the numbers from UCLA Center for Health Policy Research, the implementation of the AHCA would have led to higher premiums, lower subsidies for many lower and middle-income Californians who rely on them to purchase health insurance, and a thicket of confusing regulations that could have only served to exacerbate the situation.

DMHC Said It Revoked Avante's License To Protect Public Premium Content
Mar 30, 2017

The Department of Managed Health Care revoked the license of Avante Behavioral Health Plan earlier this month due to the Fresno-based insurer's ongoing financial difficulties, according to the agency.

            DMHC spokesperson Rodger Butler acknowledged that while Avante planned to surrender its Knox-Keene license on July 1, it still needed to take regulatory action before that date. In an email, Butler described the action as “taken to protect the public from a financially troubled plan.”

Vasectomies Meld With March Madness Premium Content
Mar 30, 2017

Doctors say it all started eight years ago, when a urology clinic in Oregon ran an ad promoting the benefits of scheduling a vasectomy in March.

“You go in for a little snip, snip and come out with doctor’s orders to sit back and watch nonstop basketball,” the voice-over promised. “If you miss out on this, you’ll end up recovering during a weekend marathon of ‘Desperate Housewives’!”

DMHC Fines L.A. Care $75,000 Premium Content
Mar 30, 2017

The Department of Managed Health Care has fined L.A. Care Health Plan $75,000 for failing to correct issues with its enrollee grievance, preauthorization and communications processes, records show.

Monning's Bill Would Curb Some Hospital Business Practices Premium Content
Mar 30, 2017

State Sen. Bill Monning, D-Carmel, has introduced a bill that would some business practices of hospital networks.

DHCS Says ACA Repeal Would Cost California Tens of Billions Premium Content
Mar 23, 2017

On the eve of what could be a historic vote in Congress to repeal key portions of the Affordable Care Act, the California Department of Health Care Services has issued an analysis of how that might impact future funding of the Medi-Cal program.

DMHC Revokes License of Avante Health Premium Content
Mar 23, 2017

The Department of Managed Health Care has issued a rare license revocation for an insurer, although that company's top executive said it had already planned to surrender its license this summer.

            The agency revoked the license of Fresno-based mental health insurer Avante Behavioral Health Plan on March 16, records show. Although the agency has revoked or suspended the licenses of several individual insurance agents, this appears to be the first case in recent memory where it revoked the license of an insurer to conduct business.