A rapidly growing Los Angeles hospitalist firm has been accused by the U.S. Justice Department of systematically overbilling the Medicare and Medicaid programs by millions of dollars and training its staff to do so.
IPC The Hospitalist Co. was named in a whistleblower lawsuit unsealed in Chicago earlier this week, accusing it of violating the federal False Claims Act and a variety of state civil statutes.
Archived California Healthcare News
California Faces Tough Tobacco Reality
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Dec 11, 2013
A new report urges California to increase its tobacco tax for fear the state is falling behind in smoking prevention and cessation efforts.
That\'s the conclusion of the Campaign for Tobacco-Free Kids, which ranks the Golden State 23rd overall among the 50 states in terms of protecting children from using tobacco.
In Brief: Kaiser Discloses Patient Breach; Many Plan Not To Purchase Insurance
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Dec 11, 2013
Kaiser Discloses Breach Involving 49,000 Patients
Kaiser Permanente's Southern California division has notified approximately 49,000 patients of a potential breach of their personal data that occurred at its Anaheim hospital, the organization has disclosed.
Surprise For MNSure Enrollees: They May Not Have Coverage
Free
Dec 9, 2013
In the most vivid detail yet, Minnesota\'s top insurers have laid out a list of technological problems that they say may keep people who\'ve enrolled in a health plan from being covered on Jan. 1.
Insurance carriers selling plans on the state\'s insurance marketplace say enrollment information they\'re getting from MNsure, is inaccurate and incomplete - and that time is running out to fix these problems.
Michigan\'s Medicaid Expansion Has Unexpected Beneficiaries: Inmates
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Dec 9, 2013
When Medicaid expands next year under the federal health law to include all adults living close to the poverty line, one group of eligible beneficiaries will be several million men and women who have spent time in state and federal prisons and jails.
The Department of Justice estimates former inmates and detainees will comprise about 35 percent of the people who will qualify for Medicaid coverage in the states expanding their programs to anyone earning less than 138 percent of the federal poverty level, or about $15,000 for an individual in 2013. The Congressional Budget Office estimated earlier this year that 9 million people will get that new coverage next year.
UnitedHealthcare\'s Plan To Drop Medicare Advantage Docs Thwarted For Now
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Dec 9, 2013
In a decision that could have national implications, a federal judge in Connecticut late last week temporarily blocked Minnesota-based UnitedHealthcare late Thursday from dropping an estimated 2,200 physicians from its Medicare Advantage plan in that state.
While the judge’s decision affects only the physicians in Fairfield and Hartford Counties who brought suit, several other medical groups are considering filing similar actions.
In Brief: Allegiance To Affiliate With UM Health; Cardinal Foundation Grants $350,000
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Dec 9, 2013
University of Michigan Health, Allegiance Plan To Affiliate
The University of Michigan Health System and Allegiance Health have signed a letter of intent to affiliate, with the latter joining the UMHS network.
Hospital Infection Rates Continue To Dip
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Dec 4, 2013
The number of central line blood stream and MRSA infections acquired in California hospitals dropped slightly in 2012 compared to the prior year, and is down considerably from less than a decade ago, according to data released last week by the state Department of Public Health.
Methicillin-resistant Staphylococcus aureus, or MRSA, is an often deadly infection when acquired in hospitals. It kills about 19,000 people a year, according to data from the Centers for Disease Control and Prevention. Hospitals have been more vigilant in recent years in compelling staff to wash their hands between patient contacts to reduce infections. At UCLA Medical Center, a group of graduate and undergraduate students keep tabs on the hand-washing of medical staff.
Obsolete Phone Number Costly to Cigna
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Dec 4, 2013
The toll-free number 877-562-0975 is non-functional. Call it and you\'ll be connected to a computerized voice asking for a PIN. It had once been a pager number, but its carrier dropped support of the number years ago as communications morphed from pagers to cellphones.
But as late as 2011, it was the number Cigna California provided to the Department of Managed Health Care to lodge after-hours appeals regarding delivery of care issues – appeals that apparently couldn’t reach the insurer, an administrative law judge recently concluded.
Cedars, UCLA To Open Rehab Hospital
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Dec 4, 2013
Two of Los Angeles\' most prestigious hospital operators have joined forces with a for-profit rehabilitation services firm to open a rehab hospital on the city\'s Westside.
UCLA Health Services, which operates Ronald Reagan UCLA Medical Center and UCLA Santa Monica Hospital, has formed a joined venture with Cedars-Sinai Medical Center and Select Medical, a provider of rehab services, to open a standalone facility by 2015. Select operates facilities in 42 states.
In Brief: Blue Shield Foundation Grants $10.7 Million; NHF Receives Money To Expand Homeless Project
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Dec 4, 2013
Blue Shield Foundation Grants $10.7 Million For The Quarter
The Blue Shield of California Foundation has awarded $10.7 million in grants for the fourth quarter of 2013 to promote access to healthcare services and insurance coverage, and the prevention of domestic and other forms of violence.
Narrow Network Health Plans In Exchanges Draw Criticism
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Dec 2, 2013
Officials in at least a half dozen states are pushing back against health plans in the new insurance markets that limit choice of doctors and hospitals in a bid to control medical costs.
The plans don’t start offering coverage until January but they’re facing regulatory action, possible legislation, and in at least one case involving a high-profile children’s hospital, litigation.
Kansas Hospitals Launch Medicaid Expansion Campaign
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Dec 2, 2013
The Kansas Hospital Association recently completed an advertising campaign aimed at building support for expanding state’s Medicaid program.
“We’re just wanting to raise the public’s awareness about there being a lot of people who would benefit from expanding Medicaid,†said Cindy Samuelson, a KHA spokesperson.
Rural Outreach A Challenge For Iowa\'s ACA Efforts
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Dec 2, 2013
Broadlawns Medical Center has been serving low-income residents in Des Moines and the surrounding countryside for decades. And now, there’s a new aspect to its public hospital mission – offering people help to sign up for insurance under the Affordable Care Act.
On a recent Saturday morning, Jerrine Sanford came half an hour from the small town of Runnells, Iowa to get her Obamacare questions answered at a hospital event.
In Brief: Nebraska Auditor Calls For Reform Of State\'s Health Agency
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Dec 2, 2013
Nebraska Auditor Mike Foley has called for reforming the state's Department of Health and Human Services, saying it bungled its programs for aged, blind and disabled healthcare.
Benefits Report Makes Hospitals Fume
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Nov 20, 2013
A new report on the community benefits spending of some of California\'s largest healthcare systems has raised questions as to the transparency of their efforts in this arena, and has prompted a surprisingly strong backlash from the state\'s powerful hospital lobby.
The report, issued by the Berkeley-based Greenlining Institute, questioned the community benefits provided by the state\'s most prominent hospital systems, including Kaiser Permanente, Sutter Health, Dignity Health, Adventist Health, and Scripps Health. It used data the systems furnish to the Office of Statewide Health Planning and Development.
DMHC Fines Health Net $300,000
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Nov 20, 2013
The Department of Managed Health Care has levied a $300,000 fine against Health Net and issued cease and desist orders against Anthem Blue Cross and Blue Shield of California for denying speech and occupational therapy coverage to its members.
According to the DMHC, the health plans had been regularly denying coverage of such therapies to members with autism, developmental disabilities and other medical conditions.
In Brief: Ensign Settles Whistleblower Suit; First 5 L.A. Approves Initiatives
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Nov 20, 2013
Ensign Group Settles Whistleblower Suit
The Ensign Group, the Mission Viejo-based operator of nursing homes and rehabilitation services, has agreed to settle civil federal charges of overbilling the Medicare program for $48 million.
Counties Urged To Lead On Safety Net
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Nov 19, 2013
Although California will greatly expand Medi-Cal and commercial coverage as a result of the Affordable Care Act, the state\'s safety net will remain fragmented in many ways, according to a new study by the advocacy group Health Access.
The Sacramento-based organization projected that 3.4 million Californians will remained uninsured at the end of the decade, and their access to care is likely to remain fragmented.
Uncertainties Facing Big Insurers In Midwest
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Nov 18, 2013
WellPoint Inc., the parent of Anthem Blue Cross and Blue Shield in Missouri, took a huge gamble when it dove headfirst into many of the new health insurance marketplaces around the country.
Aetna Inc. hedged its bets by entering a patchwork of federal- and state-run health exchanges, but skipped California and New York, two of the most populous markets.
