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California Barred by Judge From Cutting Medi-Cal Rates
Bloomberg.com

California can’t cut reimbursements hospitals receive for the skilled-nursing services they provide to low-income people, a federal judge ruled. U.S. District Judge Christina Snyder in Los Angeles yesterday granted the request from the California Hospital Association for an order to stop California from imposing the reductions, saying the hospitals had shown there would be irreparable harm if she didn’t halt the cuts temporarily.

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CMS’s Proposed Hospital Staffing Revisions Gets Cool Reception
Health Leaders Media

A rule proposed by the Centers for Medicare & Medicaid Services to allow changes in the governance structure and medical staffing at hospitals has little support among the more than 100 public comments submitted.

The rule is part of an extensive CMS review of the entire set of conditions for participation (CoP) that hospitals must meet to participate as deemed hospitals in the Medicare and Medicaid programs.

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California adds patients to health insurance rolls
Los Angeles Times

Despite a slow start, California’s push to extend health coverage to those with preexisting medical conditions — a three-year stopgap effort until federal healthcare reform fully kicks in — has enrolled more than 6,000 patients.

California now ranks second only to Pennsylvania with the highest number of enrollees in the temporary federally funded insurance plan. The interim coverage helps people with cancer, heart disease and other long-term disorders pay for doctor visits, hospital stays and medications.

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Encinitas doctor heads California Medical Association
San Diego Union-Tribune

Since founding North Coast Family Medical Group in 1978, physician James Hay has treated thousands of patients, but his influence has reached far beyond his Encinitas office.

Hay, 65, has been a longtime activist in the local health care community, serving on the boards of the San Diego County Medical Society, the local American Red Cross chapter and 211 San Diego.

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Jerry Brown builds political operation to win tax vote, re-election
Sacramento Bee

For 11 months Gov. Jerry Brown raised almost no money and conducted few political exercises outside the Capitol.But in a spate of private meetings and fundraisers in recent weeks, his political apparatus stirred. Brown quietly raised more than $1.2 million in two weeks for his campaign to raise taxes.He is also raising money for his re-election bid, and his administration is positioned to engage in legislative races next year.

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2012 Medicare debate is all about the baby boomers
Santa Rosa Press Democrat

Baby boomers take note: Medicare as your parents have known it is headed for big changes no matter who wins the White House in 2012. You may not like it, but you might have to accept it.

Dial down the partisan rhetoric and surprising similarities emerge from competing policy prescriptions by President Barack Obama and leading Republicans such as Wisconsin Rep. Paul Ryan.

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Trouble looms ahead for Medicare
Chico Enterprise Record

Where Medicare and doctors are concerned, there’s a little problem and a big problem. Seeing that Medicare pays doctors adequately is a problem, but the larger issue is how to make Medicare itself workable and affordable, said Dr. Richard Thorp, a Paradise physician. Fixing Medicare relates directly to fixing the nation’s entire health care system, since private insurers often use Medicare as a model for coverage and payments, he said in a phone interview.

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Employers urged to prepare in 2012 for health care reform
North Bay Business Journal

Nearly two years after its passage, health care reform and much of its measures hang in the balance of what promises to be a politically charged U.S. Supreme Court decision on the constitutionality of the individual mandate requiring individuals to purchase health insurance.

But while politicos and pundits await the decision and its implications, health insurance experts in the North Bay said most of the reforms are here to stay, even in the event that the mandate is struck down.

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Judge’s decision favors small hospitals
Chico Enterprise Record

A judge’s decision has let a number of California’s small hospitals off the budget-cut hook — at least for now. Biggs-Gridley Memorial Hospital is among the facilities the budget cut would snag. Last week, U.S. District Court Judge Christina Snyder ruled that the state could not cut Medi-Cal payments to a number of hospitals that have nursing-home beds as well as acute-care beds. Most of these hospitals are small and in rural areas.

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Latino Health Access is a charity built on moxie and masa
Los Angeles Times

Soon after America Bracho started a health nonprofit in Santa Ana 18 years ago, a student in her diabetes self-management class needed eye screening. He didn’t have enough money to pay for it, so Bracho and the class decided to raise the funds — by selling tamales.

The man had the screening, and Bracho had a new motto: We will build a healthy community, even if we have to sell tamales.

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Top 12 Healthcare Buzzwords for 2012
Health Leaders Media

This year’s crop of healthcare buzzwords and catchphrases includes a handful of terms that are really oxymorons. By oxymoron, of course, we mean one of the words or phrases in the expression contradicts the rest. But if you think about it, that’s the very theme of health reform today.

Innovators are looking at their systems and turning them upside down, contradicting old assumptions and turning volume-based care and payment systems into long-term wellness programs.

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Uninsured turn to daily deal sites for health care
Sacramento Bee

The last time Mark Stella went to the dentist he didn’t need an insurance card. Instead, he pulled out a Groupon.Stella, a small business owner, canceled his health insurance plan more than three years ago when his premium rose to more than $400 a month. He considered himself healthy and decided that he was wasting money on something that he rarely used.

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Hospice Turns Months-to-Live Patient Into Years of Abusing Drugs
San Francisco Chronicle

Suffering from painful nerve damage in his feet, Charles Groomes was prescribed a daily dose of 205 milligrams of Oxycontin and oxycodone in 2007. His doctor wrote that it was the most he was comfortable prescribing — more, he said, than anyone without cancer should take. After he was admitted to hospice care 11 months later, his painkillers were eventually increased to 2,880 milligrams, 14 times the pre-hospice levels. The hospice doctor forecast he had six months to live at most. He was wrong.

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Kaweah Delta Hospital to save on Medi-Cal
Fresno Bee

Taking care of low-income nursing home patients will be a little less costly at Kaweah Delta Hospital since hospitals in the state were successful in blocking — at least temporarily — a cut in Medi-Cal rates for skilled nursing services.Kaweah was set to lose $400,000 this yearfrom the Medi-Cal cut, but a federal judge’s preliminary injunction Thursday put the 10% rate reduction on hold.

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How One Health System Has Improved Perinatal Care
Health Leaders Media

The Geisinger Health System in Danbury, PA, which prides itself on innovative healthcare delivery programs, looked deeply into its women’s care, particularly for perinatal care. It didn’t like what it saw. Hospital leadership thought the programs were not as encompassing as they should have been. When they looked for ways to improve, though, they didn’t have to look far.

They looked inside Geisinger.

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What Medicare covers in the hospital
Red Bluff Daily News

One of Medicare’s most important benefits is helping to cover your expenses if you need to be hospitalized.

But what exactly is covered, and how much do you pay?

Medicare helps cover certain medical services and supplies in hospitals. To get the full range of benefits, you must have both Medicare Part A, which is hospital insurance, and Part B, which is medical insurance.

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AHRQ wants more feedback on pediatric care
Modern Healthcare

HHS‘ Agency for Healthcare Research and Quality seeks tools to help the government more accurately measure families’ experiences with inpatient pediatric care. According to a notice published in the Federal Register, accepted submissions, such as survey items and measurement domains, will eventually be compiled into a standardized instrument to be used in pediatric quality reporting.

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Senators call for task force on adverse drug events
Modern Healthcare

Sens. Michael Bennett (D-Colo.) and Olympia Snowe (R-Maine) are asking for a new federal task force in reaction to a study that found that common drug medications cause two-thirds of drug reaction-related hospitalizations. In a study published in the Nov. 24 edition of the New England Journal of Medicine, researchers from the Centers for Disease Control and Prevention identified four high-risk blood thinners and diabetes medications—warfarin, insulin, oral anti-platelet agents and oral hypoglycemic agents—that account for a disproportionate share of serious events such as overdoses.

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Hospitals are making room for alternative therapies
Los Angeles Times

As hospitals elbow one another to attract patients, increasingly they’re hoping to tap into Americans’ interest in — and willingness to spend money on — complementary and alternative therapies such as acupuncture and massage.

According to a recent survey by the American Hospital Assn. and the Samueli Institute, a nonprofit research group focusing on complementary medicine, 42% of the 714 hospitals that responded offered at least one such therapy in 2010; five years earlier, only 27% of hospitals offered such treatments.

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CMS holds off on two anti-fraud projects
Modern Healthcare

The CMS delayed two anti-fraud demonstration projects that drew heavy provider opposition after they were announced in November. The delay in implementing anti-fraud programs for power wheelchairs and an expansion of Recovery Audit Contractor authority stemmed from the large number of comments and suggestions the agency received regarding two of the programs, the CMS said in a notice on its website.

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UC Davis Health partners with Mexico on telehealth
Modern Healthcare

The UC Davis Health System, Sacramento, Calif., recently signed a telehealth research collaboration agreement with the Mexican state of Sinaloa. The memorandum of understanding commits the two to sharing ideas and research data on telehealth, scientific and technical development, and neurodevelopmental disorders, according to a news release.

      

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