Archived California Healthcare News

Although 119-bed Sacred Heart Hospital closed last July and is now being auctioned off piecemeal, its legacy is living on in the form of fresh indictments of former employees and associates of the Chicago-based facility. Former Sacred Heart Chief Operating Officer Anthony Puorro, 57, and marketing and recruitment chief Noemi Velgara, 64, were indicted by a federal grand jury in Chicago last week. Rajiv Kandala, M.D., 41, who practiced at the hospital, was also indicted.

Thanks to government subsidies, many St. Louis-area residents will be able to afford health insurance for the first time, beginning in 2014. But the insurance they’ll be able to buy will offer a limited range of options. This trend toward less value is happening not only on the new health insurance marketplaces, also known as health exchanges, in Missouri, Illinois and other states, but also on the “open market,” where health policies have traditionally been sold.

A large majority of low-income Californians believe they are not receiving enough information about their healthcare options, hampering their ability to make informed decisions. That\'s the conclusion of a voluminous new study by the Blue Shield of California Foundation, entitled “Building Better Healthcare For Low-Income Californians.” Low-income is considered less than 200% of the federal poverty level, or $47,000 a year for a family of four.

The Department of Managed Health Care has levied a six-figure fine against the Contra Costa County Health Plan for a variety of ongoing fiscal irregularities. The DMHC noted that the plan, which is the Medi-Cal managed care plan for Contra Costa County, had failed to meet tangible net equity requirements multiple times dating back more than a decade, and for failing to file financial reports in a timely manner after the agency asked it to do so.

They\'ve got a few weeks. But if federal officials can’t get the new online insurance marketplace running smoothly by mid-November, the problems plaguing the three-week-old website could become a far bigger threat to the success of the health law, hampering enrollment and fueling opponents’ calls to delay implementation, say analysts. \"The system needs to be operating reasonably efficiently – I’m not saying flawlessly – before the middle of November,” said Kansas Insurance Commissioner Sandy Praeger, one of the 36 states relying on the federal marketplace because legislators opted not to do their own state-based market.

Minnesota AG Wants Humana Investigated

Minnesota Attorney General Lori Swanson has asked the Centers for Medicare & Medicaid Services to investigate insurer Humana, Inc. for alleged improper handling of Medicare claims.

A state appellate court has provided a key ruling in a privacy case that raises the bar on liability for providers when patient medical records are breached. The court ruled that providers do not necessarily have liability to patients when medical records are stolen or misappropriated unless they are accessed by a third party.

Bariatric surgery has been one of the leading methods to fight the nation\'s obesity epidemic in recent years, but there has been scant evidence regarding the long-term results and effects of the invasive procedure, which extensively restructures the digestive tract. A new study by Kaiser Permanente researchers suggests there is a significant difference in outcomes between white, black and Latino patients.

A 58-year-old Maryland woman breaks her ankle, develops a blood clot and, unable to find a doctor to monitor her blood-thinning drug, winds up in an emergency room 30 times in six months. A 55-year-old Mississippi man with severe hypertension and kidney disease is repeatedly hospitalized for worsening heart and kidney failure; doctors don\'t know that his utilities have been disconnected, leaving him without air conditioning or a refrigerator in the sweltering summer heat. A 42-year-old morbidly obese woman with severe cardiovascular problems and bipolar disorder spends more than 300 days in a Michigan hospital and nursing home because she can\'t afford a special bed or arrange services that would enable her to live at home. These patients are among the 1% whose ranks no one wants to join: the costly cohort battling multiple chronic illnesses who consumed 21 percent of the nearly $1.3 trillion Americans spent on healthcare in 2010, at a cost of nearly $88,000 per person. Five percent of patients accounted for 50 percent of all health-care expenditures. By contrast, the bottom 50 percent of patients accounted for just 2.8 percent of spending that year, according to a recent report by the federal Agency for Healthcare Research and Quality.