News Headlines

News Headlines
Health care news from around the state and nation

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Calif. Democrats at odds over Medicaid expansion
Modern Healthcare

California was an early booster of President Barack Obama’s healthcare reform law and was the first state to authorize a health insurance exchange in 2010. It also was quick to commit to the optional Medicaid expansion that has been rejected by some Republican states.

Turns out, saying yes was the easy part.

It’s been months since Gov. Jerry Brown agreed to expand Medi-Cal, as Medicaid is known in the state, to some 1.4 million Californians, but he and his Democratic colleagues in the Legislature are still wrangling over details of the expansion.

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Medi-Cal can limit mental health visits
San Francisco Chronicle

California can limit Medi-Cal patients to two visits per month to clinics providing psychological services, a state appeals court has ruled, rejecting a judge’s decision that the restrictions violated federal law. The federal government, which helps fund the health care program for low-income people, requires states to cover all additional costs of outpatient treatment at government-certified psychology clinics. A Sacramento County judge ruled in January 2011 that the state’s two-visit-per-month rule conflicted with that federal mandate.

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Legal loophole hurts chronically ill patients
Capitol Weekly

Health care cost containment is a critical issue facing every participant in the health care system. Efforts to contain costs, however, appear to have given rise to dangerous financial arrangements between health insurers and pharmacists that may be jeopardizing the health of California patients. A loophole in California law allows your health insurer to give a financial kickback to your pharmacist every time the pharmacist switches your medication to older, cheaper, non-chemically equivalent drugs from those originally prescribed by your doctor, even without your knowledge.

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Medical School Enrollment Forecast Tempered by Residency Concerns
Health Leaders Media

Medical schools will boost enrollment 30% by 2017 to ease the nation’s physician shortage, but that won’t do much good if the federal government won’t provide funding to expand residency slots, a new survey of the nation’s medical school deans finds.

“Our medical schools have fulfilled their commitment toward taking the first step in addressing the physician shortage,” says Christiane Mitchell, director of federal affairs for the Association of American Medical Schools.

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San Diego County Supervisors, Hospitals Urge Support for Legislation Protecting Patients from Medi-Cal Cuts to Skilled-Nursing Facilities
PR Newswire

Citing the real impact cutting the safety net would have on the most vulnerable residents, San Diego County Supervisors Greg Cox and Dianne Jacob joined with local hospital leaders today to call on the California Legislature and Governor Brown to spare hospital-based skilled-nursing facilities and other health care providers from devastating Medi-Cal cuts. Both Assembly Bill 900 by Assemblymember Luis Alejo (D-Salinas) and Senate Bill 640 by Senator Ricardo Lara (D-Long Beach) would reverse the Medi-Cal cuts that were enacted in 2011.

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Covered California meeting on model contract for health plans
Sacramento Business Journal

The board for Covered California will hold a special meeting Tuesday in Sacramento to approve a model contract for health plans that will participate in the state’s new insurance program for individuals and small employers. The meeting will be held from 9 to noon at the Fair Political Practices Commission, 428 J Street in Sacramento. The closed session portion of the meeting is expected to end at 10:30 a.m.

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Funds to help uninsured choose health-care options could affect how many get coverage
Washington Post

Florida is on course to spend $6 million to reach out to nearly 4 million uninsured people and help them sign up for coverage in the federal health law’s online marketplace this fall. Maryland will spend more than four times as much, or about $24.8 million, to help about 730,000 uninsured. The District of Columbia expects to spend about $9 million assisting 42,000 without insurance.

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Appellate court backs limits on Medi-Cal payments
Sacramento Bee

California has the legal right to limit Medi-Cal payments to federally qualified health clinics for psychological services to two visits a month per patient, a Sacramento-based appellate court ruled Thursday.

The opinion by a three-justice panel of the 3rd District Court of Appeal reversed Sacramento Superior Court Judge Michael P. Kenny, who had granted the petition of three Northern California clinics seeking payment beyond the two-visit limit.

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Reform Update: CMS’ plan for DSH payments gets close review
Modern Healthcare

As healthcare providers and analysts continue to digest more than 1,400 pages of the CMS‘ recent inpatient prospective payment proposed rule, they are analyzing how the agency would implement a new payment methodology for Medicare disproportionate-share hospital (DSH) payments next year.

The 2010 Patient Protection and Affordable Care Act decreases Medicaid and Medicare DSH payments—which community and safety net hospitals use to provide uncompensated care—starting in 2014, based on the belief that the law’s coverage expansions will lower the number of uninsured and underinsured Americans.

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Med schools on pace with enrollment target: AAMC
Modern Physician

As the U.S. faces a shortage of physicians—potentially more than 90,000 by 2020—medical schools are seeking to counteract the deficiency with higher enrollments. In 2006, the Association of American Medical Colleges issued a recommendation to expand medical school enrollment 30% over its 2002 level of 16,488 students by 2015. In 2017-18, first-year medical school enrollment is anticipated to meet that metric with 21,434 expected enrollees. That’s according to the Medical School Enrollment Survey, as conducted by the AAMC’s Center for Workforce Studies, and released during the center’s annual Physician Workforce Research Conference this week in Alexandria, Va.

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Drexel offers lectures on health care changes ahead
Sacramento Bee

With massive health care changes on the horizon, consumers are voicing angst and frustration over a scarcity of information on what to expect.

In just six months, California’s health insurance exchange, where people can sign up for subsidized health plans and compare policies, is scheduled to open.

Then, in January 2014, the most broad-based changes of the federal health care overhaul are set to begin, with an expansion of subsidized health programs and new requirements on insurers and employers designed to reduce the number of uninsured.

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Debate rages after FDA ruling on morning-after pill
Modern Healthcare

Allison Guarino understands the controversy over new rules allowing 15-year-olds to buy the morning-after pill without a prescription. But as someone who teaches pregnancy prevention to ninth-graders in Boston, she thinks lowering the age will “help the girls who need the help the most.”

“Some girls might not have a good relationship with their parents,” she said, “or they had unprotected sex and they don’t know what to do.”

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Cal. hospital bans elective abortions
Modern Healthcare

Hoag Memorial Hospital Presbyterian, Newport Beach, Calif., told its Orange County doctors this week that they’ll no longer be allowed to perform elective abortions after finalizing its partnership with a Catholic hospital group. Hoag’s CEO Robert Braithwaite told the Orange County Register the new rule wasn’t imposed by St. Joseph Health System, and was based on medical reasons, not religion. Contraception and abortions are prohibited at St. Joseph’s.

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SB 646 and the little EPHC that could
Plumas County News

On April 24, the little hospital that could chugged its way up to Capitol Hill to plead its case to the legislators in Sacramento. Eastern Plumas Health Care CEO Tom Hayes and Plumas County Supervisor Jon Kennedy testified to the Senate Health Committee on behalf of Senate Bill 646. SB 646 is a bill that was influenced directly by EPHC to counteract the impending cuts from Assembly Bill 97. It was authored by Sen. Jim Nielsen, and co-authored by Assemblyman Wes Chesbro.

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How a ‘million-dollar patient’ got off a medical merry-go-round
Los Angeles Times

For more than two decades, Wanda Remo has battled one illness after another. Asthma, chronic lung disease, heart disease, high blood pressure, arthritis, depression, chronic pain, strokes. Specialists treat her lungs, her heart and her joints.

Her litany of ailments brought her to emergency rooms six times last year, between numerous additional visits to a federally subsidized health clinic in South Los Angeles.

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States fear loss of aid for high-risk pools
Modern Healthcare

Thousands of people with serious medical problems are in danger of losing coverage under President Barack Obama’s healthcare overhaul because of cost overruns, state officials say.

At risk is the Pre-Existing Condition Insurance Plan, a transition program that’s become a lifeline for the so-called “uninsurables” — people with serious medical conditions who can’t get coverage elsewhere. The program helps bridge the gap for those patients until next year, when under the new law insurance companies will be required to accept people regardless of their medical problems.

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Docs’ EHR shortcuts are not fraud: AMA chairman
Modern Healthcare

Dr. Steven Stack, American Medical Association board chairman, gave a spirited defense of physicians and a sharp, but balanced critique of electronic health-record systems at a federal “listening” session Friday on EHRs and their potential for use in billing fraud.

The scheduled four-hour session was sponsored by the CMS and the Office of the National Coordinator for Health Information Technology at HHS.

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A chronic disease that targets women
HealthyCal.org

Imagine being unable to do the things you love to do, like playing sports, writing, or holding hands with someone you love. For most of us, that seems unimaginable, but for those suffering from rheumatoid arthritis (RA) it’s a painful reality. That’s because RA systematically attacks the body joint by joint causing inflammation so bad, it’s often tough to even walk.

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Solta Medical’s acquisition of Sound Surgical faces troubles
San Francisco Chronicle

Cosmetic treatment business Solta Medical Inc. told regulators it may face problems with its acquisition of Sound Surgical and that the merger, completed in late February for about $30.5 million, may not succeed. Among problems listed by Hayward-based Solta (NASDAQ: SLTM) over the merger are difficulty incorporating and selling Sound Surgical’s products, which use ultrasound for non-surgical cosmetic treatments, and also potential settlement of product liability lawsuits that could exceed the insurance coverage available to pay them.

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4 Strategies for Managing Hospitalists
Health Leaders Media

Years ago, doctors would make rounds to supervise care for dozens of hospitalized patients. Now physicians often want to orchestrate care from their office, so they’ll make fewer trips to the hospital—or none at all. Many especially don’t want to be called at 3 a.m. to report to the hospital for one of their patients, or even get involved in certain procedures beyond their specialties. Increasingly, hospitalists are gaining more responsibilities in areas such as monitoring patients day to day, ordering tests, performing surgeries, handling specialized care, or taking on leadership roles.

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Many opt for high-deductible health plans despite risks
Los Angeles Times

Alice Marie Francis believes it’s important to have health insurance, but finding a plan that fit her budget was no easy task. “Money is tight,” says the 50-year-old Burbank mother of two, whose children are insured by their father’s work-based policy.

To make sure she had coverage that didn’t break the bank, she opted for a high-deductible health plan — an increasingly popular option with lower monthly premiums but high upfront costs before most insurance payments kick in.

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What Health Insurance Doesn’t Do
New York Times

In one of the most famous studies of health insurance, conducted across the 1970s, thousands of participants were divided into five groups, with each receiving a different amount of insurance coverage. The study, run by the RAND Corporation, tracked the medical care each group sought out, and not surprisingly found that people with more comprehensive coverage tended to make use of it, visiting the doctor and checking into the hospital more often than people with less generous insurance.

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Will public turn against Obamacare
Sacramento Bee

Rep. Ami Bera, one of two Democratic physicians in the House, doesn’t want Obamacare to fail.

But the freshman member of Congress is worried about President Barack Obama’s signature domestic achievement.

“I have been consistently concerned about the cost of care going up,” said Bera, a former chief medical officer for Sacramento County and an assistant dean at UC Davis medical school.

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Could Opening Up the Doors to the World’s Medical Research Save Healthcare?
The Health Care Blog

What if you had access to all of the medical research in the world? Or better yet, what if the physician treating your particularly complex or rare condition had access to the latest research? Or what if a public health organization in your community could access that research to inform policymakers of measures to advance public health? “Wait,” you may think, “can’t they already access that research? Doesn’t the Internet make that possible?” While unfortunately the answer to the first question is “No,” fortunately the Internet can make such access possible.

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Diabetes drug developer NGM Biopharma, led by Genentech vets Levinson and Goeddel, raises $13.5 million
San Francisco Business Times

Drug developer NGM Biopharmaceuticals Inc., which counts big-time Genentech Inc. names like Art Levinson and Dave Goeddel among its leadership, raised nearly $13.5 million toward a $50 million goal. The South San Francisco company, which in January inked a diabetes drug deal with Janssen Pharmaceuticals Inc., said in a Securities and Exchange Commission filing Thursday that 14 investors have stepped up since the equity offering began April 9.

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