California Healthcare News

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AHCA Would Lead To Premium Sticker Shock Premium Content
Mar 16, 2017

The state's health insurance exchange has crunched the numbers on what the American Health Care Act – the bill intend-ed to replace current healthcare reform would create. And the picture is not pretty.

Bill Would Require Extensive Pricing Disclosures From Drug Companies Premium Content
Mar 16, 2017

State Sen. Ed Hernandez, D-West Covina, has introduced legislation that would compel a significant level of price transparency and cost disclosures on the part of drug manufacturers. The bill has gained the support of California's health insurers despite extensive reporting burdens placed on them as well.

Hernandez has been a highly vocal critic of the recent business practices of drug manufacturers, which include huge increases for the prices of medications that have often been on the market for decades.

CBO Releases Estimates Of Repeal And Replace's Impact Premium Content
Mar 16, 2017

The Congressional Budget Office is out with its estimate of the effect that the Republican health bill, “The American Health Care Act,” would have on the nation’s healthcare system and how much it would cost the federal government. The GOP plan is designed to partially repeal and replace the Affordable Care Act passed during the Obama administration.

Here are some of the CBO highlights:

CDPH Says Anthem Owes $525K Premium Content
Mar 16, 2017

The California Department of Public Health says that Anthem Blue Cross of California owes it approximately $525,000 for prenatal screening tests it conducted for its enrollees.

UC San Diego Collaborative Reduces Diabetic Complications, Avoidable Costs Premium Content
Mar 16, 2017

A diabetes “tune up” clinic operated by the Skaggs School of Pharmacy and Pharmaceutical Sciences at University of California San Diego for the local Veterans Affairs healthcare system has been able to cut avoidable costs for patients by a significant amount.

The model is based on collaboration between a pharmacist and endocrinologist, with the assistance of some pharmacy school students. They focus on medication therapy management and education for the patients.

GOP Replacement Plan Revealed – And Condemned Premium Content
Mar 8, 2017

The Republican-controlled House of Representatives revealed this week its plan to overhaul the Affordable Care Act, the crux of their proposals in two committee bills that would vastly revise the financing of Medicaid enrollments for the poor and premium support for middle-income Americans to purchase health insurance.

            The changes were roundly criticized by healthcare and public officials in California as sharply curtailing some of the most critical provisions of the ACA, and fearing that it would lead to millions losing their healthcare insurance in the future.

Telehealth May Not Be As Cost Effective As Once Thought Premium Content
Mar 8, 2017

The convenience of “telehealth” appeals to patients, and the notion that it costs less than an in-office visit would make it attractive to employers and health plans.
            But a new study suggests that while telehealth services may boost access to a physician, they don’t necessarily reduce healthcare spending, contrary to assertions by telehealth companies.

Kaiser Creates Protocol To Reduce Antibiotics For Newborns Premium Content
Mar 8, 2017

Kaiser Permanente has created a protocol that has dramatically reduced the use of antibiotics in newborns.

Legislation Would Make It Tougher For Hospitals To Shut Down Premium Content
Mar 8, 2017

A bill in the California Senate would require hospitals to jump through additional hoops if it is decided to close down emergency services.

DMHC Fines Three Health Plans $837,500 Premium Content
Mar 2, 2017

The Department of Managed Health Care was particularly active in the waning days of February, when the agency fined three major health plans more than $800,000 combined, records show.

            The largest fine, against Anthem Blue Cross of California, was for $500,000 for its failure to cover the costs of prenatal testing for thousands of enrollees. It constituted a repeat misbehavior that led to a $1.5 million fine against the insurer in 2015.

In California, Language Remains A Big Barrier To Obtaining Care Premium Content
Mar 2, 2017

When Margarita Ruiz takes her children to the doctor’s office, she has no choice but to trust that nurses and front desk staff are translating medical orders accurately. She doesn’t speak English and her children’s pediatrician speaks very little Spanish.

Advocacy Group Expressed Skepticism About Medical Board Premium Content
Mar 1, 2017

A consumer advocacy group has claimed in front of a state Senate committee that the Medical Board of California is still not providing appropriate oversight and discipline of problem doctors.

                The Santa Monica-based Consumer Watchdog made the claim in testimony this week in front of the Senate Business and Professions Committee earlier this week. The hearing is known as a “sunset review.” Such hearings take place every four years to determine if state agencies should continue to operate moving forward.

UCSF Joins Forces To Create Tech-Related Children's Health Initiative Premium Content
Mar 1, 2017

UC San Francisco has joined forces with its affiliate Benioff Children's Hospital, the Children's Hospital Oakland Research Institute and UC Berkeley to create what is known as the Engineering for Children's Health Initiative.

Kaiser Reports 2016 Earnings Premium Content
Feb 22, 2017

Kaiser Permanente reported significantly higher earnings for calendar 2016, much of it due to the improved performance of its investments.

            The Oakland-based Kaiser, which is a not-for-profit, reported net income of $3.1 billion in calendar 2016 on revenue of $64.6 million. For 2015, it reported net income of $1.9 billion on revenue of $60.6 billion.

            The 60% boost in the bottom line is attributed primarily to the $1.2 billion reported in net non-operating income. In 2015 that total was $102 million in 2015.

CDPH Fines Nursing Home $100,000 Premium Content
Feb 22, 2017

The California Department of Public Health has fined a Los Angeles-area skilled nursing facility $100,000 in relation to neglect that led to a patient's death nearly eight years ago.

            The patient, an unidentified female, died at a hospital emergency room in November 2009, suffering from peritonitis, sepsis and a perforated colon.

Single-Payer Bill Introduced in Legislature Premium Content
Feb 22, 2017

Legislation introduced in the state Senate last week would set California on a path toward the possible creation of a single-payer health care system ― a proposal that has failed to gain traction here in the past.

California's Uninsured Rate Plummets Premium Content
Feb 22, 2017

The uninsured rate in California has dropped to its lowest level ever recorded, according to new data released by the Centers for Disease Control and Prevention.

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.