As more expensive specialty drugs come on the market to treat some of the most serious chronic diseases, more states are stepping in to cushion the financial pain for patients who need medicine that can cost up to hundreds of thousands of dollars a year.
At least seven states — Delaware, Louisiana, Maine, Maryland, Montana, New York and Vermont — limit the out-of-pocket payments of patients in private health plans. Montana, for instance, caps the amount that patients pay at $250 per prescription per month. Delaware, Maryland and Louisiana set the monthly limit at $150 and Vermont at $100. Maine sets an annual limit of $3,500 per drug.
Archived California Healthcare News
Legalization Of Gay Marriage Expected To Boost Ranks Of Insured
Free
Jul 6, 2015
The right to marry in any state won’t be the only gain for gay couples from the recent U.S. Supreme Court ruling. The decision will probably boost health insurance among gay couples as same-sex spouses get access to employer plans, say analysts and benefits consultants.
How much is unclear, but “it’s going to increase coverage†in a community that has often had trouble getting access to medical services, said Jennifer Kates, a vice president at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)
Obama Asks Republicans For Cooperation In Fixing ACA
Free
Jul 6, 2015
President Barack Obama called on Republicans last week to find a bipartisan way to fix problems in the nation’s health care system rather than continue to fight over the health law.
“Part of what I’m hoping is with the Supreme Court case now behind us what we can do is … focus on how we can make it even better because it’s not as if we’ve solved all the problems in our health care system,†Obama said in remarks at an elementary school in Nashville, Tenn. “America still spends more on health care than any other advanced nation and our outcomes aren’t particularly better.â€
ACA\'s Premium Subsidies Upheld By Supreme Court
Free
Jun 24, 2015
The United States Supreme Court on Thursday upheld tax-based premium subsidies for individuals purchasing coverage through the federal insurance exchange.
The 6-3 decision likely closes the books on the last major legal challenge to the Affordable Care Act, which was signed into law in 2010 and has been the subject of intense debate in the intervening years, even as it has cut the number of uninsured Americans dramatically.
Medi-Cal Card, But No Provider Access
Free
Jun 23, 2015
Terri Anderson signed up for Medi-Cal earlier this year, hoping she’d finally get treatment for her high blood pressure. But the insurer operating her Medicaid plan assigned the 57-year-old to a doctor across town from her Riverside home and she couldn’t get there.
“It was just too far away,†said Anderson, adding that she cares for her 90-year-old ill father and can’t leave him alone to make an hour round-trip drive to the doctor. Now she’s crossing her fingers that a health clinic near her house will accept her new insurance.
DMHC Fines Kaiser, Anthem $350,000
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Jun 23, 2015
The Department of Managed Health Care has levied fines this month totaling $350,000 against Kaiser Foundation Health Plan and Anthem Blue Cross of California.
The agency fined Kaiser $250,000 to settle alleged mishandling of a business associate contract with Sure File, an Indio-based firm that stored some 336,000 of the health plan’s patient records under contract, according to a DMHC spokesperson.
Obesity Surgery As Incontinence Cure?
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Jun 23, 2015
A new study by researchers at UC San Francisco has concluded that morbidly obese individuals who undergo bariatric surgery can greatly curb urinary incontinence as a result.
Nation’s Uninsured Rate Drops Significantly; Fitbit Raises $841.2 Million In IPO
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Jun 23, 2015
Nation’s Uninsured Rate Drops Significantly
The rate of uninsured in the United States dropped by nearly 9 million, according to new data released by the Centers for Disease Control and Prevention.
CBO Says ACA Repeal Would Uninsure 19 Million
Free
Jun 22, 2015
Repealing the federal health law would add an additional 19 million to the ranks of the uninsured in 2016 and increase the federal deficit over the next decade, the Congressional Budget Office said last week.
Family Caregiver Legislation Moves Forward
Free
Jun 22, 2015
Iraq war veteran Doug Mercer had been home in McAlester, Oklahoma, for just four days when he was in a motorcycle accident that left him broken and brain-damaged. His wife Michelle became his caregiver after he left the hospital, but nobody there explained how to transport him safely. A few weeks later, Michelle struggled as she tried to get Doug from the car to his wheelchair, breaking his leg.
“They’re sending you home, and you’re thinking, ‘What?’ Nobody instructs you, and says, ‘This is what’s coming home with you and how to use it,’†she said.
Kansas Lawmakers Fall Way Short On Public Health Issues
Free
Jun 22, 2015
When the 2015 legislative session started in January, public health advocates had reason to be optimistic they could reach some of their most ambitious goals.
The Kansas Hospital Association was ramping up efforts to expand Medicaid coverage to about 100,000 uninsured Kansans, with the political implications of the 2014 election over.
Auditor Slams Medi-Cal Provider Access
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Jun 17, 2015
The California Auditor has released a scathing report on access to the Medi-Cal system, raising concerns that those enrolled through commercial health plans may not be able to adequately access providers.
According to the 60-page report, both the Department of Health Care Services (DHCS), which administers the Medi-Cal program, and the Department of Managed Health Care (DMHC), which ensures the integrity of the provider networks of health plans, both stumbled on the job.
Kaiser’s New Colonoscopy Protocol
Premium Content
Jun 17, 2015
A new study undertaken by researchers at Kaiser Permanente has concluded that focusing on a particular type of polyp during colonoscopies could potentially reduce the rate of colon cancers dramatically.
Long-Term Care Demand Will Skyrocket
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Jun 17, 2015
The United States will need at least 2.5 million new workers to provide long-term care services by 2030.
That’s the assessment of researchers at the University of California at San Francisco, which published its conclusion in the most recent issue of the journal Health Affairs.
In Brief: CDPH Reports Another Big Drop In Teen Births; Nurse Practitioner Pay On The Rise
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Jun 17, 2015
CDPH Reports Another Big Drop In Teen Births
The California Department of Public Health has reported another steep drop in the rate of births among mothers between the ages of 15 and 19.
Kansas Pondering Changes In Medical Marijuana Laws
Free
Jun 15, 2015
For years Garden City resident Shona Banda has been self-medicating her Crohn’s disease with cannabis oil and making no secret of it, touting her homemade vaporizer on YouTube and in a self-published book.
Now Banda could face up to 17 years in prison for doing so, in a case that has medical marijuana advocates enraged and legislators from both parties saying it is past time to re-examine the state’s drug laws.
Most Americans Say Drugs Are Too Expensive
Free
Jun 15, 2015
Nearly three in four Americans say the costs of prescription drugs are “unreasonable†— and most blame drugmakers for those prices, according to a poll released Tuesday.
St. Louis Tackles Lack Of Dental Care
Free
Jun 15, 2015
The city of St. Louis hasn’t had a general dental school in nearly 25 years, and it shows. Too few dentists and lack of access have contributed to a measurable decline in dental health for many of the region’s residents.
Organizers of a $23 million dental clinic near Lafayette Square, which opened last week, hope to reverse that trend.
Chain Boosts SF Kidney Transplants
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Jun 10, 2015
Two San Francisco hospitals collaborated to create an elaborate “chain†of organ donors last week, resulting in nine separate kidney transplants being performed between the facilities in a 36-hour period.
The surgeries were performed at UC San Francisco Medical Center and California Pacific Medical Center on June 4 and 5, officials for the two hospitals said earlier this week, with 18 surgeries being performed to accommodate the nine donors and recipients.
DMHC Fines Delta Dental $250,000
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Jun 10, 2015
The California Department of Managed Health Care has fined Delta Dental $250,000 for failing to resolve claims in an appropriate manner.
