Archived California Healthcare News

The Covered California health insurance exchange is making one final push to boost enrollment by trying to get more Latinos and Asian-Americans to obtain health insurance coverage.

State officials have not decided whether to seek federal recertification of the Osawatomie State Hospital for Kansans with mental illness. The Centers for Medicare & Medicaid Services decertified the hospital earlier this month because of the state’s failure to address security and safety issues cited by federal inspectors, who concluded the sexual assault of a hospital worker by a patient in October was due in part to lax security.

When East Cleveland’s emergency medical squad gets called to treat a man with a severe nosebleed, it’s a pretty run-of-the-mill case. The patient walks woozily out to the ambulance from a tan house on a tree-lined street. Anthony Savoy, the head medic, calls ahead to University Hospitals, which has the closest emergency room. Savoy wants to make sure the ER has space for the patient.

About 2,000 elderly patients who underwent surgery at California hospitals for hip fractures died in 2012 and 2013 within 30 days of their admission, according to new data released by the Office of Statewide Health Planning and Development.

Two leaders of Montana’s successful Medicaid expansion movement told Kansas expansion advocates Monday that persistence, organization and discretion were keys to getting it done in their state. Dozens of people who represent Kansas groups that favor Medicaid expansion gathered in Topeka to hear from Kim Abbott of the Montana Human Rights Network and Tara Jensen of the Montana Budget and Policy Center

When it comes to licensing, the nursing profession works almost exactly the way it does with driving a car — at least in half the states. A nurse with a license from one of those 25 states can practice in any other state that has signed on to a reciprocal licensing compact. Contrast that with doctors. A doctor licensed in one state who wants to practice in another still needs a license from the other state.

Cal MediConnect has so far failed to connect with enrollees. UCLA researchers will soon delve into the reasons why. The university\'s Center for Health Policy Research recently received a $400,000 grant from the Robert Wood Johnson Foundation to research to investigate why so many enrollees in the program intended to streamline care for dual-eligible Medicare/Medi-Cal beneficiaries have decided to opt out.

Long Beach-based Molina Healthcare has been fined $500,000 by the Department of Managed Health Care for what the agency said was the mishandling of appeals and grievances by enrollees on a significant scale.

Citing the flexibility they offer, many consumers choose health plans that provide some coverage outside the insurer’s network. Traditionally, such plans not only paid a portion of the bill, but also set an annual cap on how much policy holders paid toward out-of-network care. Not anymore. An increasing number of preferred provider plans (PPOs) offered under the federal health law have no ceiling at all for out-of-network costs, leaving policyholders facing unlimited financial exposure, similar to what more restrictive and often less expensive types of coverage, such as health maintenance organizations (HMOs), offer.