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California Hospital Association: 2012 Looks Bleak for State Hospitals
Becker's Hospital Review

Inadequate reimbursements for government-sponsored health programs, an aging population, a widening proportion of low-income residents and high-income earners and “substantial” state budget complications are some of the biggest reasons California hospitals will be facing significant downward pressures this year, according to a report from the California Hospital Association (pdf).

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Brown gets no promise of federal help for Medi-Cal
Los Angeles Times

Reporting from Washington— Health and Human Services Secretary Kathleen Sebelius on Sunday threw cold water on Gov. Jerry Brown’s plan to ask California’s poor to contribute to their federally subsidized healthcare — payments the governor has proposed to save the state more than $500 million a year.

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Romney would raise eligibility age for Medicare
San Francisco Chronicle

Four days before critical primary elections, Republican presidential contender Mitt Romney outlined a far-reaching plan Friday to gradually delay Americans’ eligibility for Medicare as well as Social Security. Romney said the shift, as people live longer, is needed to steer the giant benefit programs toward economic sustainability.

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New initiative reclaims $370 million in overpayments, CMS says
Modern Healthcare

A new effort from the CMS to reduce improper payments in Medicare Advantage plans is estimated to recover about $370 million in overpayments for the first year, the agency announced Friday.

Medicare Advantage organizations are required to submit data to the CMS to receive risk-adjustment payments, and 2010’s Improper Payments Elimination and Recovery Act requires that the CMS audit these data each year.

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Healthcare history: How the patchwork coverage came to be
Los Angeles Times

Workers swarmed through Henry J. Kaiser’s Richmond, Calif., shipyard in World War II, building 747 ships for the Navy. The war “had siphoned off the most hardy specimens,” a newspaper reported, so Kaiser was left with many workers too young, old or infirm to be drafted.

The workers needed to be in good health to be effective on the job, and Kaiser offered them care from doctors in company clinics and at company hospitals. The workers paid 50 cents a week for the benefit.

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Healthcare: Five patients, five ways to be billed
Los Angeles Times

To appreciate the complexity of the U.S. healthcare system, consider the case of five hypothetical patients in the same hospital, all with the same illness, all receiving the same treatment from doctors and nurses.

Their bills could be paid in so many ways. The patient who has insurance on the job, like 170 million other Americans, will have the bills covered by private insurance.

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Locals Oppose Hospital’s Increased Use of Helipad
Daily Nexus

The Santa Barbara Cottage Hospital’s new helipad is undergoing close scrutiny from various neighborhood associations due to the unexpectedly large volume of flights from the platform this month. The helipad opened Feb. 3 under the expectation that the facility would see an average of two landings per week. After the hospital received five flights within a week, approximately 100 people from local organizations including the Oak Park Neighborhood Association, Samarkand Neighborhood Association and Upper East Association met with hospital officials Feb.

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Cancer survivor programs taking root
San Francisco Chronicle

It’s been more than eight years since Janelle O’Malley was diagnosed at age 49 with a rare form of ovarian cancer, but she still struggles with sleep problems and other side effects from being thrust into immediate menopause. Now she has a new way of attacking those problems. O’Malley has become one of the first patients of the Stanford Cancer Institute’s new Survivorship Clinic, which opened earlier this month.

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Groups urge incentives for antibiotic research
Modern Healthcare

The Infectious Diseases Society of America and a coalition of groups representing patients, providers and others are advocating for the inclusion of economic incentives for antibiotic research and development in the reauthorization of the Prescription Drug User Fee Act. The organizations said in a news release that they are contacting members of Congress about the need for economic incentives for the research and development of antibiotics, as well as diagnostic tests.

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Health care reform signals uncertainty for insurance agents
Ventura County Star

Rising insurance costs push would-be buyers out of the market. Health care reform is being unveiled, and more is coming. State insurance marketplaces loom in the near future.

The lives of insurance agents are in flux.

“So much is changing. So much is at stake,” said lobbyist Julianne Broyles, who spoke Friday to agents and brokers at an annual gathering of the Ventura County Association of Health Underwriters.

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California insurance commissioner issues report card for PPO
Live Insurance News

The California Department of Insurance has released the quality of care report card by insurance commissioner Dave Jones, called the “2012 Preferred Provider Organization (PPO)”. According to Jones, this report is a useful resource which provides consumers with a larger amount of practical data about the quality of the care they can expect to receive, so that they are better able to make decisions that will meet their healthcare requirements.

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Lawmakers meet in LA to discuss hospital reimbursements under Obama health care plan
Southern California Public Radio

In the run-up to federal health care reform, leaders of the state Senate and Assembly health committees met Friday in Los Angeles. They discussed how hospitals bill the government and insurers, and the effects of that billing on patient care.

Health care providers, insurance company officials and patients testified at the hearing.

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Medicare Advantage Plans’ Fraud Oversight Weak, Says OIG
Health Leaders Media

Federal inspectors are calling for tighter oversight of waste, fraud, and abuse in Medicare Advantage after a first-ever system-wide audit of the program found wide disparities in vigilance and reporting among the privately run plans.

“Our findings indicate that Medicare Advantage organizations lack a common understanding of key fraud and abuse program terms and raise questions about whether all Medicare Advantage organizations are implementing their programs to detect and address potential fraud and abuse effectively,” the report said.

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Hoag Hospital opens satellite breast care center
OC Metro

Hoag Memorial Hospital Presbyterian opened a satellite breast care center in Irvine earlier this month for the convenience of patients living far from the current facility in Newport Beach.

The new location, in the Hoag Health Center Woodbridge, offers the same 3D digital breast tomosynthesis technology for breast cancer screening that was available for the first time in California at the Newport Beach center.

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Colic may be migraine precursor, UCSF team says
San Francisco Chronicle

For a few months after she was born, Ashley Chase cried inconsolably every day, for hours at a time. Her mother didn’t call it colic at the time, but now she wonders. There was never any obvious cause for Ashley’s distress, and she was an otherwise happy and healthy baby. The fussiness eventually went away without cause, as is often the case with colicky babies. And perhaps most intriguing – Ashley, now 14, suffers migraines. Just like her mom.

Opinion/Editorial

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‘Tax’ is crucial health care detail
Sacramento Bee

Two years ago, a majority of both houses of Congress passed the Affordable Care Act. Before the ink was dry on the president’s signature, opponents who lost in the political process went to court to file the first of more than two dozen lawsuits aimed at killing the new health care law.

Now its fate is up to the U.S. Supreme Court. The justices have scheduled a whopping 5 1/2 hours of oral argument to take place during the last week of March. (One hour of oral argument is the norm.) And in June, the nine justices, or at least a majority of them, will rule on the case.

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Health Improvement Partnership of Santa Cruz County: Women in county can get the health care they need
Santa Cruz Sentinel

Recent headlines about access to contraception and breast cancer screening have brought much-needed attention to the fact that many women lack basic access to health care. A recent report from the Public Health Institute reveals that in 2009 [the last year for which data were available], 24 percent of California women between the ages of 18 and 64 were uninsured for all or part of the year.

  

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