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Anthem Blue Cross disputes order to pay back claims
Sacramento Business Journal

State regulators have identified errors in claims processed by Anthem Blue Cross and ordered the company to pay doctors and hospitals money owed for services going back to 2007. The action Thursday by the California Department of Managed Health Care follows a claims audit and Anthem’s refusal to compensate providers, department director Brent Barnhart said.

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Mercy’s new east Sac facilities latest in growing cluster trend
Sacramento Bee

Mercy’s twin cancer and imaging centers, opening officially today in east Sacramento, could change the way the health network’s Sacramento-area cancer patients receive oncology care.

The combined 35,500-square-foot, $20 million centers sit side-by-side at 3301 C St., providing outpatient cancer services such as radiation and other therapies, and diagnostic imaging including CT, ultrasound and mammography.

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Sutter Health, Aetna renew access plan
Sacramento Bee

Sacramento-based Sutter Health and Aetna have agreed on a two-year contract renewal maintaining network access for Aetna members in Northern California. Under the agreement, members of Aetna commercial plans can receive covered benefits at in-network rates from Sutter Health hospitals and ancillary facilities.

The contract also keeps the physicians and health care providers at Sutter facilities as participating network providers.

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Catholic Healthcare West gives $647,000 in grants
Sacramento Bee

Catholic Healthcare West has awarded $647,000 in funding to 21 nonprofits in Sacramento, El Dorado, Placer and Yolo counties.

The grants range from $5,000 to $50,000. Nonprofit organizations receiving the grants include those who provide primary care, mental health care and shelter.

Catholic Healthcare West wants to “help fill the gaps that exist in our region’s safety net as a result of the current economy and lack of public funding,” said Michael Taylor, a CHW senior vice president of operations.

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New rural health clinic opens in Woodlake
Visialia Times-Delta

Dr. Rocio Medina grew up in Woodlake and knew early on that she wanted to be a doctor someday. She volunteered at the Woodlake Family Health Clinic in her free time and after graduating Woodlake High School in 1998, she left for college.

Medina worked her way through the University of California, Davis, and received her bachelor’s degree in cell biology. Then she turned her attention to medical school.

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Sonoma Valley Hospital seeks parcel tax renewal
Sonoma Index-Tribune

Sonoma Valley Hospital is conducting a quiet campaign to renew the $195 parcel tax that has been in place since voters passed it in 2007. The money generated, hospital officials say, is critical for keeping the hospital and emergency room open for Sonoma Valley residents.

“The parcel tax provides 6 percent of our total revenue at the hospital, so that’s big,” said Peter Hohorst, chair of the Sonoma Valley Health Care District board, which governs Sonoma Valley Hospital.

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CVS Settles Prescription Price Case
New York Times

After more than two years of investigation, CVS Caremark agreed on Thursday to pay $5 million to settle charges by the Federal Trade Commission that the company had misrepresented the price of certain prescription drugs in one of its Medicare drug plans, causing many older consumers to pay significantly higher prices than advertised.

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Public input sought in Tulare hospital board election
Visialia Times-Delta

Pressed by a lawsuit, the Tulare Regional Medical Center is inching closer to asking residents to decide whether they want to elect board members by district or at large.

A ballot measure is in the works for the June statewide primary election.

The lawsuit, filed in 2007 by seven Hispanic citizens, claims at-large elections dilute Hispanic representation and violate the California Voting Rights Act of 2001.

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CVS agrees to pay $5 million settlement
Modern Healthcare

The Federal Trade Commission said that CVS Caremark Corp.

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Hospital workers vote to keep union
Mountain View VOICE

After a contentious vote, overshadowed by accusations of procedural lapses and questionable tactics, service workers at El Camino Hospital turned down a proposal to decertify their union, a hospital official confirmed. Members of the hospital’s branch of the Service Employees International Union-United Healthcare Workers chose not to decertify their union in a 599-357 vote, El Camino spokeswoman Chris Ernst announced on the evening of Jan. 10.

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Agency could end hospital’s tax power
Mountain View VOICE

The county’s Local Agency Formation Commission might be an obscure agency, but a new state law has empowered it to bypass voters and eliminate special districts, and the El Camino Hospital District may be its first target. “If we find that if there’s a district that isn’t needed anymore, we may move for dissolution of that district,” said Mountain View City Council member Margaret Abe-Koga, a member of the LAFCO board.

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Public hears plan for Salinas Valley Memorial Hospital
The Californian - Salinas

More than 80 people packed into the Salinas Valley Memorial Healthcare System’s board room Thursday to hear a hospital merger specialist outline the process ahead for the public district hospital as it contemplates affiliating with another health care entity.

With about 70 people in the district’s main board room and another 20 or so watching via closed circuit TV in the nearby cafeteria, Jim Moloney, a managing partner of Cain Brothers said 2012 will be divided into four phases lasting over six to nine months.

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NCQA announces six organizations seeking ACO accreditation
Modern Healthcare

The National Committee for Quality Assurance said four health systems and two multispecialty physician groups will try for accreditation as accountable care organizations this year. The half-dozen organizations include the Billings Clinic, Billings, Mont.; Children’s Hospital of Philadelphia; Essentia Health, Duluth, Minn.; HealthPartners, Bloomington, Minn.; Crystal Run Healthcare, Middletown, N.Y. and the Kelsey-Seybold Clinic, Houston. Organizations will undergo accreditation surveys by the end of December, the NCQA said in an e-mailed news release.

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U.S. diabetes prevention program might avert 885,000 cases
USA Today

A national community-based diabetes prevention program in the United States could prevent or delay 885,000 cases of type 2 diabetes over 25 years, a new federal government study says. Overall, the program would save $29.8 billion in medical costs. But, the program itself would require a $24 billion investment. Still, the researchers said, it would only take about 14 years to recoup the money spent on the program.

Opinion/Editorial

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Put us all in the same ‘risk pool’
The Union

When my husband applied for disability a few years ago, we were not surprised when Social Security denied him. What did surprise us was that several months later we received a call from a company who was hired by our insurer to fight for his disability claim.

Two years after our original request, my husband is now on Social Security disability. This is because our insurer, Blue Shield, upon learning my husband had applied for disability, realized that he may become a costly customer and they didn’t want to have to cover him any longer.

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A hospital or ‘health care facilities?’
Tehachapi News

The president of the organization formerly known as the Tehachapi Hospital Foundation — renamed “HighCountry HealthCare Foundation” — indicates in a letter to the editor this week that funds collected by that organization will be used “to further the building of new healthcare facilities.”

One might assume — but should not — that a healthcare facility is a hospital. According to a statement by the foundation on its now defunct website:

Blogs

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How Healthcare’s Embrace of Mobility has Turned Dangerous
The Health Care Blog

No industry has adopted mobility faster than healthcare. Doctors love their devices. 81% of physicians have smartphones. They also love their apps. 38% of them use medical apps daily. One-third use smartphones or tablets to access electronic medical records today, with another 20% expecting to start using them this year.

  

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