News Headlines

News Headlines
Health care news from around the state and nation

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GAO: Standardizing Medicare prepayment audits could save millions
Modern Healthcare

The Government Accountability Office says the CMS could potentially save tens of millions of dollars a year by standardizing how Medicare payments to hospitals and physicians are audited before the bills are paid—a recommendation likely to irk healthcare providers. Medicare administrative contractors are already supposed to be using a form of auditing known as “prepayment review,” and the more controversial recovery audit contractors were slated to begin a long-stalled prepayment review demonstration project on Aug. 27.

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Sutter Health consolidating records, billing systems
Sacramento Business Journal

Sutter Health is consolidating separate computer systems for medical records and billing this month that will improve administrative efficiency and boost what patients can do online. This means there may be longer wait times than usual at the doctor’s office during December, Sutter cautions patients in a memo about new features in My Sutter Online. Patients have been able to view most test results, renew prescriptions and get health reminders online for a while.

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Program cuts health costs by housing the homeless
HealthyCal.org

Sixteen months after a coalition of San Diego nonprofit groups took the county’s most costly homeless people – highest consumers of ambulance rides, emergency room and police resources – and put them into permanent housing, the cost savings are adding up. Early calculations suggest that costs are down by nearly $1 million. But it’s more than money saved. “Project 25 saved my life,” says Paige, 46. “I’d be dead if they hadn’t got me off the streets.”

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Healthcare Exec Compensation Models Play Catch-up
Health Leaders Media

With the Patient Protection and Affordable Care Act ushering in the pay-for-value era, healthcare organization compensation committees are scrutinizing executive compensation models to stay in step with new objectives. Though few external benchmark resources are available to help create the guiding metrics, boards continue to try to shift away from rewarding solely on organization-wide financial performance and move toward incentivizing for quality and patient satisfaction.

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Obama Approves Health Insurance Marketplaces in 6 States
New York Times

The Obama administration gave conditional approval on Monday to health insurance marketplaces being set up by six states led by Democratic governors eager to carry out President Obama’s health care overhaul. The six are Colorado, Connecticut, Maryland, Massachusetts, Oregon and Washington.

At the same time, the administration rejected pleas from other states that want to carry out a partial expansion of Medicaid, to cover fewer people than the president and Congress originally intended.

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Insured to see $63 annual fee increase to cover pre-existing conditions
Contra Costa Times

Your medical plan is facing an unexpected expense, so you probably are, too. It’s a new, $63-per-head fee to cushion the cost of covering people with pre-existing conditions under President Barack Obama’s health care overhaul. The charge, buried in a recent regulation, works out to tens of millions of dollars for the largest companies, employers say. Most of that is likely to be passed on to workers.

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Feds rule on health care law’s Medicaid expansion
San Francisco Chronicle

States must commit to fully expanding their Medicaid programs to take advantage of generous funding in the federal health care law, the Obama administration said Monday. The ruling affects a federal-state program that covers nearly 60 million low-income and severely disabled people, caught in a tug-of-war between Republican governors and the Democratic administration. President Barack Obama’s health care law expanded Medicaid to cover people up to 138 percent of the federal poverty line, or about $15,400 for an individual.

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HHS Details Limits to Medicaid Expansion
Health Leaders Media

States that don’t expand their Medicaid rolls to include residents at 133% of the federal poverty level won’t get 100% of the matching federal funds made available under the Patient Protection and Affordable Care Act, the nation’s governors were told Monday.

“Congress directed that the enhanced matching rate be used to expand coverage to 133% of FPL. The law does not provide for a phased-in or partial expansion.

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Partial Medicaid expansions won’t get full funding: HHS
Modern Healthcare

States choosing to expand their Medicaid programs must broaden Medicaid eligibility to the full extent laid out in the healthcare reform law in order to get full federal matching funds to help pay for the new coverage, HHS announced Monday.

That directive came during a call with reporters when acting CMS Administrator Marilyn Tavenner said “there is not an option for enhanced match” for a partial or phased-in expansion.

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Beware ‘Medicare’ scams
Marin Independent Journal

You receive a phone call from a person who states he is a representative of the National Medicare Department. He then states that he needs to send you a new Medicare card and that under new health care reform legislation you will receive $3,000 toward medical expenses. He just needs your bank account information to transfer the funds to your account.

Don’t do it. Scam artists have found yet another way to steal your money, this time from your checking account.

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Frailty is a medical condition, not an inevitable result of aging
Washington Post

As a medical resident 30 years ago, Ava Kaufman remembers puzzling over some of the elderly patients who came to the primary-care practice at George Washington University Hospital. They weren’t really ill, at least not with any identifiable diseases. But they weren’t well, either. They were thin and weak. They had no energy. They tired easily. Their walking speed was agonizingly slow. “We couldn’t put our finger on a specific diagnosis or problem,’’ Kaufman says. “We didn’t have a word for it then.’’ Today we do. It’s called frailty.

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Progress seen in child obesity
Sacramento Bee

After decades of rising childhood obesity rates, several U.S. cities are reporting their first declines.

The trend has emerged in big cities like New York and Los Angeles, as well as smaller places like Anchorage, Alaska, and Kearney, Neb. The state of Mississippi has also registered a drop, but only among white students.

“It’s been nothing but bad news for 30 years, so the fact that we have any good news is a big story,” said Dr. Thomas Farley, the health commissioner in New York City, which reported a 5.5 percent decline in the number of obese schoolchildren from 2007 to 2011.

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Desert Regional Medical Center skilled nursing facility to close
The Desert Sun

Desert Regional Medical Center is looking to close its skilled nursing facility in the first quarter after operating at a loss for at least a year.

The 34-bed unit on the fourth floor of the Palm Springs hospital currently houses 15 patients and employs 30 full-time and four part-time employees, said Rich Ramhoff, a hospital spokesman.

Desert Regional is the only one of the valley’s three hospitals that offers a skilled nursing facility.

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As doctors grow older, hospitals begin requiring them to prove they’re still fit
Washington Post

A distinguished vascular specialist in his 80s performs surgery, then goes on vacation, forgetting he has patients in the hospital; one subsequently dies because no doctor was overseeing his care. An internist who suffered a stroke gets lost going from one exam room to another in his own office. A beloved general surgeon with Alzheimer’s disease continues to assist in operations because hospital officials don’t have the heart to tell him to retire.

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Kaiser Permanente to hire 500 IT staffers in Colorado to support national and California projects
San Francisco Business Times

Kaiser Permanente is opening a new information technology campus in Colorado that will support national, California and Bay Area operations, and employ about 500 staffers by 2015. The Oakland-based health care giant announced its plans late last week to Colorado news outlets, noting that the decision to locate the new IT site in the Denver suburb of Greenwood Village, Colo., came after a national search.

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