Archived California Healthcare News

Although the public option for healthcare coverage died in Congress before the Affordable Care Act was signed into law three years ago, it appears to have been partially resurrected via Covered California\'s healthcare exchange. Of the 13 plans Covered California officials said last week would offer benefits to individual and family applicants, six operate for the most part in the public realm. Four specialize in Medi-Cal managed care – L.A. Care Health Plan, Molina Health Care, Alameda Alliance for Health and Contra Costa Health Care. Ventura County Health Care Plan and Valley Health Plan in Santa Clara County offer benefits to government employees in their respective counties.

John Muir Health was able to reduce complications in its hip and knee replacement patients by nearly a third by employing a straightforward perioperative patient evaluation. The two-hospital system in Walnut Creek examined the post-surgical experiences of about 700 patients who underwent hip and knee replacement procedures. They had been evaluated by a nurse practitioner for potential surgical risk factors at a pre-operation clinic. Such factors include reactions to medications and other potentially ovelooked pre-existing physical conditions prior to the surgery.

The Obama administration is making it easier for states to sign up the poor for health coverage – and to help those people stay covered. Last Friday, it informed state officials that they could simplify enrollment in Medicaid to handle the onslaught of millions of anticipated enrollees next year when the health care law expands coverage. The administration said the changes are geared to states that are expanding their programs, but they may also be adopted by others.

Centene Wins Imperial County Medi-Cal Contract

A subsidiary of St. Louis-based Centene Corp. has been awarded a pact to manage 55,000 Medi-Cal managed care beneficiaries in Imperial County.

Covered California, the government entity that operates the state health insurance exchange, announced on Wednesday it was granting $37 million to a variety of community organization to encourage outreach and education in order to boost enrollment in health insurance plans. As many as 5.3 million Californians are eligible to purchase healthcare benefits from the insurance exchange, officials say, with half or more receiving federal income tax subsidies in order to do so.

That sigh of relief you heard Monday was from hospital administrators in nearly two dozen states, including Michigan, Indiana, Nebraska and others in the Midwest. That’s because the Obama administration announced that for the next two years, it doesn’t plan to penalize states that have yet to expand Medicaid coverage under the federal health law by targeting them for reduced Medicaid funding, according to a proposed rule unveiled Monday. That money goes to hospitals that treat large numbers of poor people.

The struggles to expand Medicaid under the Affordable Care Act in Michigan are continuing, with Republican lawmakers suggesting that enrollees should receive coverage for only a limited time. The proposal was put in a bill late last week that would require Michigan to obtain a waiver from the Centers for Medicare and Medicaid Services that would allow a lifetime enrollment cap of 48 months per individual. Children, the disabled and those over the age of 65 would be excluded from the restriction.

Adventist Health has agreed to pay $14.1 million to state and federal agencies to settle allegations that one of its Southern California hospitals paid kickbacks to two medical groups. The allegations surfaced as part of a recently unsealed whistleblower lawsuit filed by two osteopathic doctors in 2008 in U.S. District Court in Sacramento. Both the U.S. Department of Justice and the California Department of Health Care Services joined the lawsuit last month, likely pressuring a settlement on Adventist\'s part.