News Headlines

News Headlines
Health care news from around the state and nation

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How Might Immigration Reform Influence Health Care Reform?
California Healthline

After decades of debate and legal challenges, national health care reform moves onward. Next up: immigration reform. The two are linked. Immigrants — both those who are documented and those who are not — are less likely to have health insurance than their U.S.-born counterparts. Almost half the documented immigrants in the U.S. do not have health coverage, according to 2011 Employee Benefit Research Institute statistics.

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More than 450 provider organizations join payment-bundling initiative
Modern Healthcare

The CMS on Thursday announced that more than 450 healthcare organizations will participate in the Bundled Payments for Care Improvement initiative, a payment model program created in the healthcare reform law to test whether bundling payments for services in a single episode of care can improve quality and lower costs. Those selected organizations represent a wide range of healthcare providers—including not-for-profit and for-profit hospitals, academic medical centers, physician-owned facilities and post-acute providers—that were chosen by the CMS either as awardees for Model 1 starting in April, or as participants for the first phase of models 2, 3 and 4 that begins with Thursday’s announcement.

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Clancy stepping down as AHRQ director
Modern Healthcare

Dr. Carolyn Clancy, who has led HHS‘ Agency for Healthcare Research and Quality for nearly a decade, will leave her post sometime “in the coming months,” according to a memo to employees from HHS Secretary Kathleen Sebelius.

Clancy, an internist, was named AHRQ’s director in February 2003 and was reappointed in October 2009. She joined AHRQ in 1990 and previously served as director of its Center for Outcomes and Effectiveness Research.

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Support for healthcare overhaul reaches all-time high in new poll
Los Angeles Times

Support for President Obama’s healthcare overhaul is at an all-time high in California, according to a new poll from the Public Policy Institute of California. The survey, released Wednesday, found that 55% of Californians back the changes to the nation’s healthcare system under the federal Affordable Care Act, up 8 percentage points since last March. The Legislature gaveled in a special session on healthcare this week, pushing forward with sweeping proposals to help California implement the law, which will require most Americans to buy health insurance or pay a penalty next year.

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AMA joins brief opposing ‘pay-for-delay’ deals
Modern Physician

The American Medical Association joined healthcare and consumer groups calling on the U.S. Supreme Court to limit the ability of drugmakers to enter agreements that keep generic competition off the market.

The Federal Trade Commission has been battling what it calls “pay-for-delay” agreements in court with limited success for several years, arguing they illegally deny consumers the benefits of competition.

The case at issue, FTC v. Watson Pharmaceuticals, is scheduled for oral arguments before the court March 25.

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Report warns of U.S. state inactivity on consumer health reforms
Yahoo! News

Only 11 of the 50 U.S. states have moved to implement new consumer safeguards under President Barack Obama’s healthcare law, raising questions about how major health insurance reforms will be enforced, a report released on Friday says. The report by the nonpartisan Commonwealth Fund found 39 states have yet to pass laws or issue regulations on seven reforms, including coverage for people with preexisting medical conditions, a ban on coverage waiting periods and limits for out-of-pocket consumer costs.

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Obama prepares Affordable Care Act mandate for 2014 rollout
ALLVOICES

President Barack Obama signed the Affordable Care Act, his signature health-care law, into law in 2010. Republicans quickly vowed to overturn it, but their hopes were dashed—first by the Supreme Court ruling that it was constitutional, and then by last year’s election results. On Wednesday, the Health and Human Services Department and the Internal Revenue Service took steps toward implementing the individual mandate in the health-care legislation.

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Many states lack authority on new insurance rules: report
Modern Healthcare

Nearly half of state insurance departments lack the power to fully enforce new insurance regulations that take effect next year under healthcare reform, raising the possibility of federal oversight of the rules when a state fails to do so, according to a newly released report.

Twenty-two states surveyed by the Commonwealth Fund have limited or no authority to uphold the new regulations, including a popular provision that prohibits insurers from denying coverage to individuals with existing medical conditions. The report did not list the states and researchers declined to release a list, saying respondents were promised confidentiality.

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Physicians’ Persistent ‘Overuse’ of Care Continues
Health Leaders Media

Clinicians are getting better at providing patients with appropriate care, such as assuring coronary disease patients receive aspirin, beta blockers and statins. But they’ve done a poor job in reducing unnecessary, overused care, such as screening men 75 and older for prostate cancer, or screening women 66 and older for cervical cancer.

Those are conclusions in a special “Less Is More” paperpublished this week in JAMA Internal Medicine by Minal Kale, MD, of Mt.Sinai School of Medicine and research colleagues at the University of California San Francisco and San Francisco Veterans Affairs Hospital.

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Report Faults High Fees for Out-of-Network Care
New York Times

Just over a year ago, Angel Gonzalez, 36, awoke with searing chest pain at 2 a.m. A friend drove him to the closest emergency room.

Though he was living on $18,000 a year as a graduate student, Mr. Gonzalez had good insurance and the hospital, St. Charles in Port Jefferson, N.Y., was in his network. But the surgeon who came in to remove Mr. Gonzalez’s gallbladder that Sunday night was not. He billed Mr. Gonzalez $30,000, and an assistant billed an additional $30,000. Mr. Gonzalez’s policy covered out-of-network providers, but at a rate it considered appropriate: $2,000. “I was on the hook for more than I made in a year,” Mr. Gonzalez said.

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CMS warned about e-reporting of quality data
Modern Healthcare

An association of hospital chief information officers is warning the CMS that reporting of complete and accurate clinical quality measures through electronic health records systems is “nearly impossible” for many healthcare organizations given the state of record-keeping workflows and technology.

The comments from the College of Healthcare Information Management Executives came in response to a CMS “request for information” from hospital and health IT system vendor leaders that asked them to assess the readiness of their organizations for electronic submissions of clinical quality measures for the CMS’ Hospital Inpatient Quality Reporting program created under the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003.

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Hospital flu masks raise questions
Chico Enterprise Record

It’s become a national trend — and a sometimes controversial one — for hospitals to require employees to wear masks if they haven’t had flu shots, said Dr. Mark Lundberg, Butte County’s health officer. Last week, Enloe Medical Center adopted a mask policy. It says staff members who haven’t been vaccinated must wear masks if they enter patients’ rooms or come within six feet of patients. Oroville Hospital officials said they were considering taking the same step.

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Judge restricts generic drug company from making, distributing drugs
Modern Healthcare

A federal judge has approved a permanent injunction restricting a generic drug company from manufacturing and distributing certain drugs until it complies with the law, the Justice Department said Thursday.

The DOJ said the company, Ben Venue Laboratories Inc., has been the subject of about 40 recalls since 2002, including 10 each in 2011 and 2012.

The Bedford, Ohio, company is a subsidiary of Ingelheim, German-based Boehringer Ingelheim.

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Dental clinic proves importance of care
San Francisco Chronicle

Jabari Kelly showed up at San Francisco General Hospital’s dental clinic last Friday looking like he was hiding a golf ball in his left cheek. He had been in pain for three weeks. The 36-year-old San Francisco man had an infected wisdom tooth, and swelling had spread into his jaw and cheek. A few more days, he was told, and the infection could have advanced below his chin, possibly restricting his breathing. “You’ve got 32 teeth – each one can kill you,” said Dr. Newton Gordon, a dentist and UCSF School of Dentistry professor.

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Intel-GE launches remote care tool for health plans
Sacramento Business Journal

Intel-GE Care Innovations LLC, a joint venture with a growing Roseville office, launched a new product Thursday to help health plans understand remote care management of chronic conditions in patient homes. A new website — called a “briefing center” — is designed to help health plans seeking to improve care and save money by helping members actively participate in managing their own care.

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Analyst: Stem cell agency reforms fall short
Sacramento Bee

With little money and time left to repair its legacy, California’s controversial stem cell agency is falling short in its response to a federal committee’s recommendations for an overhaul, the committee’s chair said Thursday.

The stem cell agency’s reform plan does not go far enough to fix all that has been chipping away at the agency’s credibility, said Harold Shapiro, chair of the Institute of Medicine committee hired to evaluate the agency.

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Anthem Blue Cross rates rise 17.5 percent today; critics call for ballot initiative to cap costs
The Mercury News

As about 730,000 California health insurance consumers’ rates rise an average 17.5 percent today, a consumer group is renewing its support for a ballot initiative to rein in costs. The group, Consumer Watchdog, called the hikes announced last year outrageous, but representatives from Anthem Blue Cross and the California Association of Health Plans said the boosts were necessary and in line with industry norms and federal health care requirements.

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CommuniCare to begin construction of Woodland health center
Sacramento Business Journal

It has been a long time coming, but CommuniCare Health Centers will start construction on a $9.3 million health center in Woodland next week. Construction is expected to take about 10 months, with move-in projected for late 2013 or early 2014. The nonprofit will consolidate its Peterson clinic with its John H. Jones Community Clinic into the new, 21,000-square-foot clinic as it prepares to offer integrated services to more low-income Woodland residents in one convenient downtown location.

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Valley Voice: Children’s Hospital seeks to expand
The Desert Sun

Grant Virgin’s remarkable comeback from a near-fatal hit-and-run accident is testimony to human resilience and the love and support of his devoted family.

During his eight-week hospitalization at Children’s Hospital’s Rehabilitation Center, I was his doctor and worked closely with his parents, JJ and John Virgin, one of whom were always at his bedside 24 hours a day, seven days a week.

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Kaiser Has Biggest Piece Of State’s $53 Billion Insurance Market
KPBS

Kaiser Permanente has 40 percent of California’s lucrative health insurance market. A new report from Citigroup reveals Kaiser received more than $23 billion in premiums in 2011. The report shows that just five health insurers control 91 percent of California’s market. Kaiser had the biggest share of the state’s $59 billion health insurance business. Second place went to Anthem Blue Cross, which had 23 percent of the pie. Blue Shield of California earned third place, followed by Health Net and UnitedHealth Group.

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Is the ACA the road to semi-single payer?
HealthyCal.org

The Wall Street Journal has an interesting, and important, story on how some unions that supported the Affordable Care Act are now wary about how it will affect them once it is fully implemented. At issue is whether workers who get their health care through unions will be eligible for the same subsidies that are available for lower-income people who will get their insurance through the new health exchanges, or Covered California here.

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In the dark on doctor perks
Los Angeles Times

Though few patients realize it, many doctors receive thousands of dollars from pharmaceutical companies for each patient enrolled in an experimental drug trial. The medication might be the best thing for the patient’s condition. The doctor’s motives might be pure. But patients should be able to find out about such payments so they can discuss them with their doctors and decide for themselves whether the doctor’s participation in an experiment might compromise his medical advice.

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Genentech sees promising results from late-stage cancer drug study
San Francisco Business Times

Genentech Inc.’s potential replacement for Rituxan as a treatment for two blood cancers helped patients live longer before their disease progressed again. Genentech, the South San Francisco-based U.S. biotech arm of Swiss drug giant Roche, said the Phase III trial tested its drug, called GA-101, in combination with the chemotherapy agent chlorambucil in previously untreated chronic lymphocytic leukemia patients.

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Could Wasteful Healthcare Spending Be Good for the Economy?
The Health Care Blog

Suppose I throw a rock through a store owner’s window. You admonish me for this act of vandalism. But I reply that I have actually done a good deed. The store owner will now have to employ someone to haul the broken glass away and someone else, perhaps, to clean up afterward. Then, the order of a new glass pane will create work and wages for the glassmaker. Plus, someone will have to install it. In short, my act of vandalism created jobs and income for others.

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Health Premiums Rise and Insurers Drop Guarantees Amidst Regulatory Uncertainty
reason.com

What happens to a highly regulated industry in which government actively changes the rules of the game on an ongoing basis? Well, matters get a bit uncertain, to say the least. And with the federal government “improving” America’s health care with a massive state intervention, details to be determined later, health insurance companies are betting that the only thing they can know for certain is that costs are going up.

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