California Healthcare News

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Anthem Sued Over Plan Changes Premium Content
Feb 16, 2017

The Santa Monica-based advocacy group Consumer Watchdog has filed a class-action suit against Anthem Blue Cross of California, claiming it illegally moved consumers into health plans where they no longer have coverage for out-of-network services.

            The suit, filed in Los Angeles County Superior Court, claims that Anthem moved enrollees from preferred provider organization coverage to exclusive provider organization plans, which do not include provisions for care delivered out-of-network.

Kaiser Opens Offices In Santa Cruz County Premium Content
Feb 16, 2017

Kaiser Permanente has opened its first provider services in Santa Cruz County.

Appeallate Court Rejects Part Of Health Insurers' Challenge On Grace Periods Premium Content
Feb 16, 2017

A state appellate court has rejected a challenge by a group of carriers to grace period regulations promulgates by the California Department of Insurance.

ER Visits Tied To Seniors Falling On Rise Premium Content
Feb 15, 2017

The number of California seniors who land in emergency rooms after falling has risen sharply in recent years, as their population grows and they live longer with more chronic illnesses often requiring an array of medications.

            The number of visits to California emergency rooms by people over 65 who fell surged 38% from 167,785 in 2010 to 232,146 in 2015, according to data from the state’s Office of Statewide Health Planning and Development.

California Has Big Lab Technician Shortage Premium Content
Feb 15, 2017

California is facing an acute shortage of medical laboratory technicians, a situation that is particularly stark when compared to the situation in other states, according to a new report by researchers at UC San Francisco.

Covered California Is Working, Says Brookings Institution Premium Content
Feb 15, 2017

California took bold steps to ensure the success of its state health insurance exchange, making Covered California among the most robust examples in the entire country.

            That's the conclusion of new reports commissioned by the Brookings Institution, which studied health insurance exchanges in several states. An examination of California was conducted by the Bay Area Council Economic Institute.

Prime Close To Acquiring Texas Hospital Premium Content
Feb 9, 2017

The non-profit arm of Ontario-based Prime Healthcare Services is close to acquiring Mission Regional Medical Center in the border town of Mission, Texas.

            Mission's board of directors signed a letter of intent with the Prime Healthcare Foundation, which operates 14 non-profit hospitals. The 297-bed Mission has had struggles with its finances as of late, and has had to cut jobs in recent weeks. Talks with another buyer recently fell through, according to local media reports.

Covered California Says 412,000 Signed Up For 2017 Premium Content
Feb 9, 2017

The Covered California health insurance exchange said it had a surge of enrollment prior to the Jan. 31 enrollment deadline.

            Altogether, the exchange said it signed up more than 412,000 enrollees for calendar year 2017 – meeting prior enrollment projections.  About 12% of those signed up in the last two days of eligibility.

Immigration Restrictions Haven't Impact California Providers – Yet Premium Content
Feb 9, 2017

The chaos caused by President Donald Trump's executive order that nominally barred travel from seven predominantly Muslim countries has yet to impact providers in California, but the incident has left some in the healthcare sector wary that the order could be expanded.

            Trump's order, issued late last month, barred for 90 days travelers from Iran, Iraq, Syria, Sudan, Libya, Yemen and Somalia. It also banned refugees from those countries for 120 days, and from Syria indefinitely.

Vendor Blamed For DMHC Reporting Fiasco Premium Content
Feb 9, 2017

The Department of Managed Health Care's third try to measure timely access to care provided by health insurers was not a charm.

Kaiser Finds Link To Birth Complications, Autism Premium Content
Feb 1, 2017

A new study by Kaiser Permanente has uncovered a link between birth complications and an elevated risk of the newborn developing autism spectrum disorder.

            Kaiser researchers studied the births of 594,638 children at its hospitals in Southern California between 1991 and 2009. Of those births, 6,255 children were diagnosed with autism spectrum disorder, and 37% experienced some complication shortly before or during birth.

DMHC Fines Health Net $65,000 Premium Content
Feb 1, 2017

The Department of Managed Health Care has fined Woodland Hills-based Health Net $65,000 for a series of incidents in which enrollee grievances were mishandled.

DHCS Fines Kaiser $2.5 Million Premium Content
Feb 1, 2017

California officials have fined health care giant Kaiser Permanente $2.5 million for failing to turn over required data on patient care to the Medi-Cal program.
            The California Department of Health Care Services said this was the first fine imposed against one of its Medicaid managed care plans since at least 2000. The state relies on the data to help set rates, ensure adequate care is available and monitor how taxpayer dollars are being spent in the Medi-Cal program.

CDPH Cites Two Nursing Homes For Patient Deaths Premium Content
Feb 1, 2017

The California Department of Public Health has cited and fined nursing facilities in Los Angeles and San Francisco Counties for negligence that endangered patient safety.

Studies Raise More Worries About ACA Repeal Premium Content
Feb 1, 2017

Two new studies released by leading California healthcare institutions this week provided further evidence of the hardships the state's residents would endure if the Affordable Care Act is repealed.

Despite Treatment Advances, Women Still Face Obstacles In Breast Cancer Care Insurance Status, Ethnic Background Pose Big Barriers Premium Content
Jan 26, 2017

Although treatments for breast cancer continue to make improvements, obtaining that care can be an obstacle for women in California.

That's the conclusion of researchers at the UCLA Center for Health Policy Research. In a recent report, it raised significant concerns that women with breast cancer enrolled in Medi-Cal or other public insurance programs were less likely to obtain treatment for their breast cancer in a timely manner and live longer than those enrolled in private insurance.

Blue Shield, Hill Physicians Launch Hospice Program Premium Content
Jan 26, 2017

Blue Shield of California and Hill Physicians Medical Group have started a primary care-based palliative care program in conjunction with Snowline Hospice, which provides services in Sacramento and El Dorado Counties.

"This new program enables primary care providers to offer palliative care services to patients with advanced illness in collaboration with hospice providers who are expert in palliative care," said Marcus Thygeson, M.D., Blue Shield's Chief Health Officer. "This will improve care for seriously ill people and support for their caregivers."

In Brief: Molina CEO Hedges On Future ACA Participation Premium Content
Jan 26, 2017

Molina Healthcare Chief Executive Officer J. Mario Molina, M.D., hedged on whether his Long Beach-based Medicaid managed care plan would continue to offer insurance in various state exchanges beginning next year.

“There are just too many unknowns at this point to give a definitive answer,” Molina told the publication Axios earlier this week.

Brown Pledges To Fiercely Protect ACA Premium Content
Jan 26, 2017

In an unusually impassioned speech, Gov. Jerry Brown vowed this week to protect California’s health care gains under Obamacare against Republican attempts in Washington, D.C., to roll them back.

“More than any other state, California has embraced the Affordable Care Act,” Brown told state legislators and appointees in his annual State of the State address at California’s Capitol. “I intend to join with other Governors and Senators, and with you, to do everything we can to protect the healthcare of our people.”

Consumers Union Blasts CDPH On Corraling Hospital Infections Premium Content
Jan 26, 2017

The California Department of Public Health has come under fire from a leading consumer advocacy organization that is claiming the agency has taken little action in investigating hospitals with high rates of patients who contract infections during their stay.

                The San Francisco-based Consumers Union reported on the matter earlier this week, asserting that the CDPH's internal structure made aggressive policing of infec-tions in hospital settings nearly impossible.

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