News Headlines

News Headlines
Health care news from around the state and nation

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Jerry Brown asks for changes to state’s Medi-Cal expansion plan
Los Angeles Times

As an Assembly panel holds its first hearing on a proposal to authorize massive expansion of the state’s public insurance program for the poor, it has a few changes to consider from Gov. Jerry Brown’s administration.

Sixty-three pages worth, to be exact.

The administration submitted a laundry list of proposed changes to Speaker John A. Perez’s bill to expand eligibility for Medi-Cal, the state’s public insurance program for the poor.

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Can VBP Put Healthcare on Right Track?
Health Leaders Media

The overall state of the healthcare industry continues to confound and captivate healthcare leaders. Despite several years of preparing for healthcare reform standards such as care coordination, meaningful use, and value-based purchasing, leaders are still in a quandary: unhappy about the healthcare industry as a whole but convinced that their own organizations are moving in the right direction. For the third consecutive year healthcare leaders view the industry as being on the wrong track, according to the 2013 HealthLeaders Media Industry Survey.

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Health insurance rate-setting map would raise costs, official says
Los Angeles Times

A proposal to split California into six zones for setting health insurance rates would drive premiums up as much as 23% for some policyholders next year as part of the federal healthcare overhaul, the state insurance commissioner is warning.

These rating boundaries for the individual insurance market are among several items that state lawmakers are debating during a healthcare special session in Sacramento aimed at implementing the federal Affordable Care Act.

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Healthcare CIOs see even bigger challenges beyond meaningful use
Modern Healthcare

Chief information officers in healthcare are caught between their immediate concerns and the unknown challenges of future healthcare payment reforms, but without all the information they’ll need to steer their course. Consultants with the Deloitte Center for Healthcare Solutions summarize the findings of interviews with a dozen CIOs of major healthcare systems in a just-released, 11-page white paper, “Health System Chief Information Officers: Juggling Responsibilities, Managing Expectations, Building the Future.”

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Cost to expand Medi-Cal a mystery
Los Angeles Times

Gov. Jerry Brown’s administration has warned repeatedly that California is venturing into unknown territory with the expansion of healthcare under the new federal law. The exact cost of implementation is unknown.

A report issued Tuesday by the Legislative Analyst’s Office shows how big a range of potential bills California taxpayers are confronted with when it comes to a central component of the healthcare law: growing the Medi-Cal insurance program for the poor by about 1 million people.

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Analyst says California should expand Medicaid
Fresno Bee

The benefits of expanding health care for California’s poor under the Affordable Care Act far outweigh the costs to the state, according to a report released Tuesday by the nonpartisan Legislative Analyst’s Office.

Legislative analyst Mac Taylor urged lawmakers to adopt an optional Medicaid expansion that features an enhanced cost match from the federal government, meaning Uncle Sam will pick up most of the tab and send billions of dollars flowing into the state.

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Insurers see proposed Medicare Advantage rates hitting revenue
Modern Healthcare

Health insurance companies are expecting reduced Medicare Advantage payments to unfavorably impact revenue next year. The CMS on Friday released its proposed 2014 rates for Medicare Advantage plans, prompting negative reaction from payers and investors. Shares of health insurance plans such as Humana, Universal American Corp. and Health Net took a dive on the news when they opened for trading this morning. The CMS proposal calls for a 2.2% decline in Medicare Advantage benchmark payment rates.

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The Effort health program gets new name, new clinic
Sacramento Bee

Back in the flower-powered 1960s, Sacramento’s free clinic called itself the Aquarian Effort, fitting for a period when “Hair” was the top-selling LP and hippies were often medically indigent.

Eventually, the clinic expanded and shed “Aquarian,” becoming The Effort.

Simple enough, it seems. “But there’s confusion about the name and what we do,” CEO Jonathan Porteus admitted Tuesday. “Some say The Effort means we are making an effort, but we are doing more than trying.”

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20% health insurance hike for some in Bay Area?
San Francisco Chronicle

Bay Area consumers could see health insurance rates rise by more than 20 percent under proposals being considered by state lawmakers to carry out the new federal health legislation, according to the state Insurance Department. The federal health law requires most Americans to have health insurance by Jan. 1, 2014, and many people will be purchasing coverage through state- or federal-run insurance exchanges, or virtual marketplaces.

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State Legislature Votes On Healthcare Reform Measures This Week
Long Beach Business Journal

Facing a federal deadline, California State Legislature meets today through Thursday for a special session to pass measures on healthcare reform as mandated by President Barack Obama’s Affordable Care Act (ACA). The healthcare law requires an overhaul of the state’s insurance market by January 2014. The legislative items voted on this week would extend coverage to millions of uninsured Californians next year.

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Federal Government to Run 26 State Health Exchanges
Insurance Journal

The Obama administration said on Tuesday that it will operate federal online health insurance marketplaces in 26 of the 50 U.S. states with little or no input from local state officials.

The U.S. Department of Health and Human Services announced that a total of 24 states, including six with Republican governors, plus the District of Columbia, are on track to run their own marketplaces, known as healthcare exchanges, or to do so in partnership with the federal government.

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New deficit-reduction plan seeks $600B in healthcare cuts
Modern Healthcare

The former co-chairmen of the president’s bipartisan fiscal commission have introduced a deficit-reduction proposal that calls for an additional $2.4 trillion in savings over 10 years, with roughly a quarter of those savings—or about $600 billion—coming from Medicare and Medicaid.

Erskine Bowles, former White House chief of staff in the Clinton administration, and former Sen. Alan Simpson (R-Wyo.) unveiled the framework as a way to show lawmakers that a so-called grand bargain to lower the nation’s ballooning deficit is still within reach.

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Robotic Surgery Hikes Hysterectomy Costs
Health Leaders Media

Hospitals considering buying another surgical robot might think twice in light of study findings showing that for its primary use—hysterectomies for benign disease like fibroids—the robot offers no better outcomes compared with traditional laparoscopy, but costs $2,189 more per patient. That’s according to research by Jason D. Wright, MD, of Columbia University College of Physicians and Surgeons and colleagues, which is published in the Journal of the American Medical Association.

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Some autistic children recover, study shows
Contra Costa Times

When doctors diagnosed Kieran Rege with autism at age 4, they painted a bleak portrait of his future. “We were told he’s not going to get married. He will probably not have friends. He will always need additional support,” said Kieran’s mother, Jill Rege, of Palo Alto. Undaunted, she and her husband tried every treatment they could find. Today, at age 15, Kieran has friends, is active in theater at Menlo Park’s Mid-Peninsula High School and takes Caltrain by himself to school. And he no longer is diagnosed with a disorder once thought to last a lifetime.

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Medical professionals concerned antibiotics creating ’super’ bacteria
ABC News

Diverticulitis, or infection in the colon, occurs in half of Americans over the age of 60. It’s a condition often treated with antibiotics. But in more and more cases the medication doesn’t work. Now there are growing concerns that antibiotic resistance is leading to more “super” bugs that can’t easily be treated. In December 2009, emergency room doctors told 52-year-old Tom Dukes he was on the verge of death.

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State Patches Hole In Nutrition Funding Left By Fiscal Cliff Deal
KPBS

More federal budget cuts loom in the form of sequestration. But local anti-obesity programs are only now discovering how they fared in the last round of cuts – January’s fiscal cliff deal. Federal lawmakers cut more than $100 million from SNAP-Ed (Supplemental Nutrition Assistance Program Education) in that deal. The program aims to help food stamp recipients develop healthy eating habits.

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Charting out a path for revising state’s health care laws
Daily Democrat

California will decide in the next 10 days if it really wants to be the national leader in health care reform. It has a golden opportunity to improve its health care system by so much for so little state money. The Legislature started debating Tuesday two crucial bills to expand Medi-Cal eligibility to as many as 1.4 million low-income residents. Assembly Speaker John Perez’s AB1X-1 is the best plan. It would insure as many people as possible in the cheapest, most efficient manner.

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Young immigrants shut out of health reform
San Francisco Chronicle

California’s young immigrants who have been granted reprieves to stay in the country stand to gain little from the federal health reform law that the state Legislature is working to implement. The Affordable Care Act excludes illegal immigrants from accessing the law’s benefits, but some immigrant and health advocates are angry that the young people known as Dreamers have been left out, saying the policy contradicts the law’s intent of expanding coverage to more people.

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Four more states apply to run partnership exchanges as deadline passes
Modern Healthcare

Seven states in total have applied to run insurance exchanges in tandem with the federal government after four more applied, leaving the feds to operate the marketplaces in at least 26 states in 2014, according to HHS. The latest applications for partnership exchanges from Iowa, Michigan, New Hampshire and West Virginia came before a delayed Feb. 15 deadline for state applications. That final deadline for states seeking a role next year in operating the insurance marketplaces mandated by the Patient Protection and Affordable Care Act was originally scheduled for Nov. 16.

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Premium surcharge on smokers makes strange bedfellows
Daily Democrat

For all the political division over the nation’s health-care law, one provision has managed to put two longtime rivals on the same side. Big tobacco companies and anti-cancer activists are standing in opposition to a part of the Affordable Care Act that allows insurance companies to charge smokers 50 percent more than patients who do not use tobacco.

Cigarette makers such as Altria say the policy amounts to discrimination against smokers.

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Anthem Blue Cross backs off mail-order pharmacy requirement
Los Angeles Times

Anthem Blue Cross is backing off a decision to require some policyholders to buy their prescription drugs from a single mail-order pharmacy — a requirement that the California attorney general’s office said may be illegal.

Anthem, California’s largest for-profit health insurer, said in November that it was imposing the new requirement for so-called specialty medications used to treat major illnesses. The company said the limitation would help keep costs down for patients and businesses.

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Blue Cross Suspends Mail Order Program for HIV/AIDS Patients
NBC SanDiego.com

Weeks after a lawsuit was filed in San Diego over a program barring HIV/AIDS patients from using local pharmacies, Blue Cross of California will suspend the program. The group Consumer Watchdog sued the insurer in San Diego on behalf of a patient, claiming the program discriminates against those with HIV. The program, which was slated to take effect in March, would have required patients using certain drugs to buy them from a mail order pharmacy chosen by Blue Cross.

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Insurance commissioner touts new plan for CA health-care regions
Sacramento Bee

Saying the Legislature’s existing proposal could exacerbate rate shock, state Insurance Commissioner Dave Jones unveiled his own proposal Tuesday for dividing California into geographic regions for implementing federal health-care reform. Jones vowed to appear Wednesday before Senate and Assembly health committees to push his 18-region plan instead of existing legislative proposals for six regions in 2014 and 13 regions in 2015.

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