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Judge blocks Medi-Cal rate cuts to providers
Sacramento Business Journal

A federal judge has blocked California’s attempt to cut Medi-Cal rates to doctors, dentists, pharmacists and other Medi-Cal providers by 10 percent. U.S. District Court Judge Christina Snyder granted a preliminary injunction Tuesday that prohibits the state from implementing the cut, which is part of a budget fix adopted by the California Legislature last March. In twin rulings in December, the same judge tossed California’s 10 percent cuts in Medi-Cal fees to pharmacies and skilled nursing units inside hospitals.

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Lawmakers urged to spare hospitals in fixing SGR
Modern Healthcare

Several hospital groups urged Congress to use savings from overseas operations as a way to solve Medicare’s sustainable growth-rate formula for physicians—as long as those funds would provide for a full fix.

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Medicare Advantage premiums fall: HHS
Modern Healthcare

Medicare Advantage premiums fell an average of 7% over the past year, according to HHS, even as enrollment rose by about 10%.

Average premiums fell to $31.54 in 2012 from $33.97 in 2011, while enrollment rose to 12.8 million from 11.7 million beneficiaries in the same timeframe, according to figures released by HHS.

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Sen. Feinstein backs health insurance rate controls
Los Angeles Times

A high-stakes ballot measure to give state regulators the power to approve health insurance rates in California has landed a heavyweight supporter: U.S. Sen. Dianne Feinstein.

One of California’s most respected politicians, Feinstein has come forward as the chief spokeswoman and No. 1 booster of a proposed initiative to regulate hikes in health premiums.

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Planned Parenthood supporters denounce Komen’s funding halt
Los Angeles Times

He won’t be sporting that pink tie anymore.

California state Sen. Alex Padilla (D-Pacoima) has volunteered for years as one of the Susan G. Komen for the Cure “Pink Tie Guys,” who wear the ties at public events to raise awareness about breast cancer.

On Wednesday, after learning that the foundation would stop funding Planned Parenthood for breast health services, Padilla announced that his pink tie days were done.

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Single-payer campaign to begin new push
The Union

The Campaign for a Healthy California on Wednesday denounced the failure of the California Senate to pass SB 810, the California Universal Care Act. The bill died when it remained two votes short of passage.

Democrats fell short of previous levels of support, which successfully passed similar bills through the legislature twice before, only to be vetoed by then Gov. Arnold Schwarzenegger.

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Primary Care Docs Weigh Advantages of PCMH
Health Leaders Media

WellPoint Inc.’s plan to increase reimbursements for primary care physicians who transition to patient-centered medical homes could signal a tipping point in the move toward the new care management model.

That’s according to Glen R. Stream, MD, a family physician from Spokane, WA, and the president of the 100,300-member American Academy of Family Physicians.

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Medicare Advantage Enrollment Grows, Premiums Shrink
Health Leaders Media

Medicare Advantage plans are having tremendous success, with reduction in premiums amounting to 7%, an expansion of choices, and a 10% increase in enrollment from a year ago, U.S. Health and Human Services Secretary Kathleen Sebelius boasted on Wednesday.

But the administration’s claims were tempered moments earlier when officials from America’s Health Insurance Plans warned that enrollment is expected to dramatically decline hereafter, from 11.7 million in 2011 to 7.5 million in 2018, and 7.8 million in 2019, according to an analysis from the Congressional Budget Office.

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House votes to repeal part of 2010 health care law
San Francisco Chronicle

The Republican-led House on Wednesday voted to repeal a financially troubled part of the 2010 health care law that was designed to provide affordable long-term care insurance. The House vote comes months after the Obama administration suspended the Community Living Assistance Services and Support program, known as the CLASS Act. Health and Human Services Secretary Kathleen Sebelius in October said she was unable to find a way to make the program financially solvent.

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Judge issues injunction blocking healthcare cuts; state to appeal
Los Angeles Times

A federal judge has agreed to block cuts in Medi-Cal payments, making her temporary ruling earlier this week permanent.

Gov. Jerry Brown’s administration said it will appeal the judge’s ruling, dated Tuesday, to the U.S. 9th Circuit Court of Appeals.

The court battle stems from the state’s effort to slash 10% from Medi-Cal reimbursements for doctors, dentists and other healthcare providers.

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Blue Shield settles autism therapy dispute
Sacramento Bee

Blue Shield will cover behavioral therapy for autism in accordance with the state’s mental health parity law in a settlement with the California Department of Insurance. The settlement, announced Tuesday, resolves a Department of Insurance enforcement action filed in July and confirms terms that Blue Shield agreed to at that time.

The agency said Blue Shield had refused to cover applied behavior analysis therapy and steered parents of autistic children into a medical review process to secure treatment.

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Employment Gains as U.S. Health Care Eclipses Manufacturing
San Francisco Chronicle

The aging of America may be good for the U.S. labor market. A growing number of older people and rising health-care spending are driving demand for workers from nursing aides to surgeons. While the economy lost 7.5 million positions during the recession, health care expanded staff. Together with social assistance, it will add more than 5.6 million employees to become the largest job gainer by 2020, according to new projections released today by the Bureau of Labor Statistics. Manufacturing is forecast to lose 73,000 jobs by then.

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Blue Shield of California agrees to cover autism treatment
ABC News

Blue Shield of California will provide coverage of an expensive autism treatment after reaching an agreement with the state. The state insurance commission said a new law about mental health coverage requires the insurer to provide certain behavioral therapies, including applied behavioral analysis therapy. Insurance Commissioner Dave Jones said his department took action against the insurer in July to get Tuesday’s settlement that promises the insurer will comply with the state’s Mental Health Parity law.

Blogs

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It Takes a CEO to Save the U.S. Health-Care System
Bloomberg

Forget Washington and the political debate over Obamacare. The real battle for the future of health care is being fought in the world of business, where tens of thousands of companies have seen their financial well-being undermined by skyrocketing employee health costs. Although few people realize it, employee health costs have now become the third-largest expenditure for U.S. businesses today, constituting a whopping 8 percent of total compensation.

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Why Hospitals Continue to Fail in ‘Connecting the Dots’ With Their Data
The Health Care Blog

The world is awash in data. It is estimated that the amount of digital information increases ten-fold every few years, with data growing at a compound annual rate of 60 percent. The big technology company Cisco has forecast that by 2013, the amount of traffic flowing over the internet annually will reach 667 exabytes. Just to put that in perspective, one exabyte of data is the equivalent of more than 4,000 times the information stored in the US Library of Congress.

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