California Healthcare News

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In Brief: Legislature Passes Insurance Fraud Fund Bill Free
Sep 5, 2012


A bill expected to boost funding to fight healthcare fraud in California has been passed by both the Assembly and Senate and is awaiting the signature of Gov. Jerry Brown.

AB 2138, authored by Assemblyman Bob Blumenfeld, a Los Angeles Democrat, would increase the current annial surcharge on health and disability insurers from 10 cents per insured life to 20 cents, which is expected to raise an additional $4 million a year.

In Brief: Rideout Health Rebrands Free
Sep 5, 2012


ideout Health is the resulting name after a rebranding effort by the former Fremont-Rideout Health Group, which operates hospitals in the Northern California towns of Marysville and Yuba City.

Rideout, the surname of the system’s original founder more than a century ago, was the preferred choice after the system conducted several stakeholder surveys in 2011.

“We were gratified to see how important the Rideout legacy is

In Brief: Arbitrator Says Marin General Won Case Free
Sep 5, 2012


Marin General Hospital received a fraction of what it was seeking from Sutter Health to settle a years-long dispute over siphoned revenues. Nevertheless, Marin was declared the “prevailing party” earlier this week by the arbitrator who decided the case earlier this year.

SCAN Pays $323.7 Million To Settle Suit Free
Sep 5, 2012
Long Beach-based Medicare Advantage insurer SCAN Health Plan has agreed to pay $323.7 million to state and federal regulators to settle claims of overpayments for care provided to dual-eligible seniors.
Kids Medi-Cal Program Cuts Costs Premium Content
Sep 5, 2012
A program that concurrently provides curative and palliative care to children enrolled in Medi-Cal has significantly cut spending per child, according to new data from the UCLA Center for Health Policy Research.
CDPH Fines 14 Hospitals $825,000 Premium Content
Sep 5, 2012
The California Department of Public Health levied $825,000 worth of penalties against 14 hospitals late last week for serious safety breaches that led to the deaths of five patients. However, the agency had scant details about plans to speed up a painfully slow appeals process that has delayed the collection of about $1.4 million in fines.
In Brief: Premium Regulation Initiative Resurrected Free
Aug 29, 2012
An initiative that failed to quality for the November ballot that would more closely regulate insurance premium increases in California if approved by the voters will appear on the 2014 ballot instead.
Firms More Bullish On Coverage Free
Aug 29, 2012
A new survey by the benefits consulting firm Towers Watson reveals significantly more companies are likely to retain employer healthcare benefits after the primary components of the Affordable Care Act are deployed in 2014.
Regulators Win $4.6 Million ACA Grant Premium Content
Aug 29, 2012
Three California agencies that play a large role in regulating and monitoring the state’s healthcare market have received a $4.6 million federal grant to beef up consumer protections and education.
Troubled MLK Toddles Toward Rebirth Premium Content
Aug 29, 2012
As it nears the end of what will be nearly a decade-long exile from providing inpatient care, Martin Luther King Medical Center has appointed the top physician at the nation’s largest public health plan to oversee its reemergence as a full-fledged hospital in 2014. Elaine Batchlor, M.D., chief medical officer at L.A. Care Health Plan, was named as MLK’s new chief executive officer earlier this week. She will begin work on Oct. 15. Although Batchlor has not had any prior experience as a hospital administrator – most of her career has been on the payer side of the equation – she has long been a fixture in local and regional public health circles. She has overseen the treatment of nearly 1 million Medi-Cal and Healthy Family enrollees during her tenure at L.A. Care.
In Brief: IHS Self-Study Focuses On Wellness Program Free
Aug 27, 2012


A study by Chicago-based firm Interactive Health Solutions found a correlation between the use of a wellness program and reduced healthcare costs.

In Brief: Minnesota Blues, Innovalon Renew Pact Premium Content
Aug 27, 2012


Blue Cross Blue Shield of Minnesota has renewed its contract with Inovalon to improve patient outcomes.

The Eagan-based health plan and Bowie, Md.-based Inovalon, which was formerly known as MedAssurant, reached terms on what Inovalon called a “multi-year engagement.”

In Brief: Case Western Links Insomnia To More Aggressive Breast Cancers Free
Aug 27, 2012


Researchers at Case Western University and its affiliated hospital in Cleveland have linked lack of sleep to more aggressive tumors in breast cancer victims.

The research team examined more than 400 post-menopausal breast cancer victims and queried about their sleep habits. Those women who had reported less than six hours of sleep a night on average were more likely to have tumors with a genetic makeup more likely to make them recur.

Anthem Ohio In CPC Initiative Free
Aug 27, 2012


Anthem Blue Cross Blue Shield of Ohio will begin working with 75 physician practices in the Cincinnati and Dayton regions as part of a Medicare pilot project.

Ohio Awards SPD HMO Contracts Free
Aug 27, 2012


The State of Ohio has awarded contracts to five insurers to provider care to 114,000 Medicare-Medicaid seniors and persons with disabilities under a pilot program that begins in 2013.

Health Care REIT Acquires Sunrise Free
Aug 27, 2012
A May 2012 study in the journal Health Services Research found a 10% increase in assisted living capacity between 1993 and 2007. At the same time there was a 1.4% decline in private pay occupancy in nursing homes.
In Brief: UnitedHealthcare Drops Out of BadgerCare Program Free
Aug 20, 2012



UnitedHealthcare has opted to end its Medicaid managed care contract with BadgerCare, citing continued cuts in reimbursement by Wisconsin regulators.

UnitedHealth cares for 174,000 Medicaid lives in Wisconsin and was paid $284 million for its service in the last fiscal year, which ended on June 30. Its contract terminates on Oct. 31.

In Brief: Minnesota Auditors Drop Thousands From State Insurance Roles Free
Aug 20, 2012


The state of Minnesota has dropped health insurance coverage for more than 3,000 dependents of state employees after an eligibility audit was conducted by the state’s Management and Budget Agency.

However, there have been complaints that more than half of those dropped lost their coverage peremptorily without any prior notification or request for clarification, or they may have thrown out paperwork necessary to maintain their coverage because the thought it was junk mail.

In Brief: HCCA Says Not-For-Profits Much More Likely To Be Audited Free
Aug 20, 2012


Not-for-profit healthcare institutions experience audits from outside entities at a rate more than 50% higher for-profits, according to a new study by the Minneapolis-based Health Care Compliance Association.

Not-for-profits experienced an average of six audits per calendar year, compared to fewer than four audits per calendar year among for-profits.

Upton Queries CMS On Exchanges Free
Aug 20, 2012
Rep. Fred Upton, R-Mich. sent a letter on Monday to the Centers for Medicare and Medicaid Services seeking more information on regulations regarding insurance exchanges and Medicaid.