Archived California Healthcare News

Some influential conservatives are now saying the healthcare law is too entrenched to repeal. Take the U.S. Chamber of Commerce, the powerful business lobbying group. When the Affordable Care Act Passed in 2010, the Chamber got behind a major business lawsuit to fight it at the U.S. Supreme Court. And in January, 2011 during his annual State of American Business address, Chamber President Tom Donohue said, \"It\'s time, in my opinion, to go back to the drawing board...and thus we support legislation in the House to repeal it.\"

Despite having some of the best health indicators in the country, there remain some troubling gaps in outcomes in Minnesota, with most clearly delineated by race and income. That\'s the conclusion of a new report by the Minnesota Department of Health submitted to the Legislature earlier this week. Lawmakers had requested the report to obtain more data about health inequities in the state. Department officials conducted interviews with more than 1,000 individuals at 180 different healthcare organizations statewide.

The California Endowment has granted $23 million to help 36 counties in California with outreach in order to increase enrollment in Medi-Cal. The money will be used for outreach to Californians who may be eligible to enroll in the program but have not yet done so. Specific groups will be targeted for Medi-Cal enrollment, including those mental health needs; the homeless, those who are incarcerated or on parole, those with limited English proficiency and young men of color.

A new report has criticized the utility of Minnesota\'s health insurance exchange, saying it will fall short of enrollment goals and satisfying consumers trying to purchase coverage. The MNSure exchange was built with $155 million in federal funds dispersed under the Affordable Care Act. It is one of 16 exchanges operated at the state level.

Medicare beneficiaries who have been waiting months and even years for a hearing on their appeals for coverage may soon get a break as their cases take top priority in an effort to remedy a massive backlog. Nancy Griswold, the chief judge of the Office of Medicare Hearings and Appeals (OMHA), announced in a memo sent last month to more than 900 appellants and health care associations that her office has a backlog of nearly 357,000 claims. In response, she said, the agency has suspended acting on new requests for hearings filed by hospitals, doctors, nursing homes and other health care providers, which make up nearly 90 percent of the cases. She said that she expected the suspension would last about two years.

The director of performance improvement at Alvarado Hospital in San Diego has filed a whistleblower suit against its owner, Prime Healthcare Services, claiming the Ontario-based hospital chain systematically overbilled the Medicare program. The suit claims Prime violated the federal False Claims Act by disregarding guidelines for keeping patients under observation care, admitting them as inpatients and them not discharging them to post-acute care facilities.

Health Net Wins Dual-Eligibles Contract

A subsidiary of the Woodland Hills-based insurer Health Net has received a contract from the Centers for Medicare & Medicaid Services and the California Department of Health Care Services to provide services to the dual-eligible populations in Los Angeles and San Diego Counties.

Nationally, Republican party leaders say their number one campaign issue for the midterm elections is opposition to the Affordable Care Act. But at the same time, a growing number of Republican states are now embracing a major provision of the law – expanding Medicaid, the government-funded health benefit program for the poor. The Supreme Court made doing that optional for states in 2012 and most Republican-led states said “no”. But now, some states like Ohio, Iowa and Michigan are forging compromises with the White House on Medicaid. To understand why this happened in Michigan, drop in on the cavernous, busy emergency room at Henry Ford Hospital in the heart of Detroit. About one in three patients being treated by the blue-scrubbed swarm of doctors, nurses and techs is uninsured. It\'s a much higher rate than in Michigan or the rest of the country, and that means hospitals like this one had been providing a lot of health care for free.

The state of emergency healthcare services varies widely in the Midwest, but a new study by the American College of Emergency Physicians concludes it is mostly subpar all around.