News Headlines

News Headlines
Health care news from around the state and nation

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CalPERS panel recommends 3 new HMO plans alongside Blue Shield
Los Angeles Times

A key committee of the California Public Employees’ Retirement System backed its staff’s recommendation to break up Blue Shield of California’s statewide HMO contract. The agency’s pension and health benefits committee voted Tuesday in favor of awarding health maintenance organization contracts to both Anthem Blue Cross and Blue Shield to cover most of the state. The committee also supported giving an HMO contract to UnitedHealth Group Inc. in portions of Northern and Southern California and enlisting Sharp Health Plan in San Diego County.

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Health care coverage uneven among U.S. cities
LifeHealthPRO

As far as health care coverage goes, it’s all about location, location, location.

Large discrepancies in health insurance coverage across U.S. metro areas continued in 2012, Gallup reported Tuesday.

Nearly half of adult residents living in the McAllen-Edinburg-Mission, Texas, metro area continue to be uninsured — about three times the national average of 16.9 percent.

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Doctors lobby to reduce health care labor shortage, leaving out nurses, others
Sacramento Business Journal

The doctors lobby rolled out a package of five bills Tuesday to address the physician shortage in California without allowing optometrists, pharmacists, nurse practitioners and physician assistants to expand the services they can offer patients. So-called “scope of practice” bills already introduced are expected to be among the most hotly contested this year, as doctors fight to hold onto their role as gatekeepers to medical care.

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GOP lawmakers balk at giving FDA more authority over compounding pharmacies
Modern Healthcare

House Republicans signaled they are not convinced the Food and Drug Administration needs more statutory authority to police the activities of compounding pharmacies like the one blamed for a meningitis outbreak last year that killed 53 people.

“Ten years of warning signs, alarm bells and flashing red lights were deliberately ignored,” Rep. Tom Murphy (R-Pa.), chairman of the committee’s Subcommittee on Oversight and Investigation, told FDA Commissioner Margaret Hamburg at a House Energy and Commerce subcommittee hearing today.

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Hospital profits higher with patient complications: study
Modern Healthcare

Hospitals earn higher profit margins when their patients experience surgical complications, according to a study in the Journal of the American Medical Association. The authors claim the study is the first to quantify how complications impact a hospital’s bottom line and illustrate the challenge of pushing hospitals to improve outcomes when the current system still rewards more care over better care. After looking at more than 34,000 inpatient surgical procedures, the study authors found that profit margins were 330% higher when privately insured patients suffered at least one complication.

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CalPERS vote stings Blue Shield
Sacramento Business Journal

In a stunning reversal for Blue Shield of California, a CalPERS committee voted Tuesday to add three other HMO plans to its health benefits offering next year if contracts can be negotiated successfully. Members of the Pension and Health Benefits Committee voted to recommend statewide non-exclusive contracts with Blue Shield and Anthem Blue Cross. The committee also recommended adding UnitedHealthcare in both Northern and Southern California, and Sharp in the San Diego region.

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New California bills focus on doctor shortage
The Desert Sun

State lawmakers introduced a package of bills Tuesday aimed at addressing a physician shortage in the Coachella Valley and throughout California.

One would provide $15 million annually for the UC Riverside School of Medicine, which plans to open in August. The others would add more residency slots to medically underserved areas, expand a medical school loan repayment program for those practicing in shortage areas for three years, and prioritize licensing applications from doctors serving in these areas.

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Hospital CPI growth eases in March
Modern Healthcare

Hospital consumer prices increased 0.4% last month following the 0.8% gain in February, newly released figures from the U.S. Bureau of Labor Statistics show. By comparison, the March rise in hospital consumer prices a year ago was 0.3%, the agency’s Consumer Price Index shows. Outpatient hospital consumer prices increased last month slightly faster, at 0.4%, than the 0.3% gain for inpatient prices.

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Health law expands treatment for addicts in Calif.
San Francisco Chronicle

More than twice as many drug and alcohol addicts in California will be eligible for health insurance covering substance abuse treatment when federal health care reforms kick in next year. Throughout the state, and particularly in Los Angeles County where the largest share of people get treated for substance abuse through the public health system, providers are scrambling for ways to serve the wave of expected patients. Officials remain uncertain how the new programs will be funded under the Affordable Care Act.

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Small businesses: Here’s how to prepare for health care reform
VentureBeat

In the past, small businesses could afford a certain lack of sophistication in their human resources processes. It was common practice to rely on Excel and labor-intensive reporting, but health care reform is changing the game. Compliance reporting, benefits administration, and managing employee data are just a few of the back-office tasks that will become more difficult for small businesses to handle manually once further requirements of the Affordable Care Act take effect.

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Feds issue updated protocol on fraud self-disclosure
Modern Healthcare

Though it’s been an open secret for years, federal officials are today acknowledging for the first time in writing that healthcare companies that turn themselves in for certain types of Medicare fraud will probably only have to pay back one-and-a-half times the amount of money involved.

HHS‘ inspector general’s office is releasing a revamped document called the OIG Provider Self-Disclosure Protocol that describes exactly what a hospital, doctor or supplier must confide to the government in order to avoid prosecution and get a break on potential penalties.

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Circumcision study supports HIV theory
Los Angeles Times

Circumcision is known to reduce a man’s risk of HIV infection by at least half, but scientists don’t know why. A new study offers support for the theory that removing the foreskin deprives troublesome bacteria of a place to live, leaving the immune system in much better shape to keep the human immunodeficiency virus at bay.

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Fearing abuse, FDA blocks generic OxyContin
Modern Healthcare

Federal health regulators will require generic versions of the best-selling painkiller OxyContin to include recent formulation changes designed to make the pill harder to abuse.

The Food and Drug Administration said late Tuesday it would not approve any generic versions of OxyContin based on the original formulation because it “poses an increased potential for certain types of abuse.”

The FDA decision is a key victory for Purdue Pharma LP, which spent years developing a tamper-resistant version of the blockbuster pain pill.

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Amgen will pay $25M to resolve kickback case
Modern Healthcare

The U.S. Department of Justice said Tuesday that biotech drugmaker Amgen Inc. will pay $24.9 million to resolve claims it paid kickbacks to increase sales of its anemia drug Aranesp.

The Justice Department said Amgen paid kickbacks to Omnicare Inc. and PharMerica Corp., which sell drugs to long-term care providers like nursing homes and hospitals, and Kindred Healthcare Inc., which runs long-term acute care hospitals and nursing and rehabilitation centers.

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Scripps Health named top system in national survey
San Diego Union-Tribune

Scripps Health is the only hospital operator in the state to appear on a new list of the top 15 health systems in the nation.

Truven Health Analytics, formerly the health care unit of Thomson Reuters, released its fifth annual list of what it considers the top health systems in the nation Monday.

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Next on City Visions: What does federal health care reform mean for Californians?
KALW

California is required to implement federal health care reform by January 2014. We will discuss what needs to happen by then, and what this means for you. Is California ready? What will change and what has changed already? And what are health benefit exchanges and who needs to use them? Join host David Onek and a panel of Bay Area experts, on Monday April 22 at 7pm by calling (415) 841-4134 or post your comments here anytime.

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UCSF Medical Center plans integrated system with 800-doctor South Bay group
San Francisco Business Times

Watch out, Stanford Hospital & Clinics. UCSF Medical Center, Pacific Partners Management Services Inc. and the 803-doctor Individual Practice Association Medical Group of Santa Clara County have signed a letter of intent to form an integrated system that would likely compete directly with Stanford in the South Bay. The three entities said the proposed transaction “is subject to the execution of definitive agreements.”

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Autism in California: trouble in insurance-land
San Francisco Chronicle

Here’s the deal: Autism Treatment: Applied Behavioral Analysis (ABA) therapy is the most effective treatment for ASD and can produce significant improvements in communication, social relationships, play, self-care, and school success as well as dramatically reduce problem behaviors such as self-injury and aggression. It is endorsed as the clinical standard-of-care treatment for ASD by the National Institutes of Mental Health, Surgeon General, and American Academy of Pediatrics.

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Will Your Health Insurer Pay to Train Your Doctor? One Comment
The Health Care Blog

Lost in the weeds of President Obama’s budget proposal is a 10-year, $11 billion reduction in Medicare funding for graduate medical education (GME). GME is the “residency” part of medical training, in which medical school graduates (newly minted MDs and DOs) spend 3-7 years learning the ropes of their specialties in teaching hospitals across the country. Medicare currently spends almost $10 billion annually on GME.

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