News Headlines

News Headlines
Health care news from around the state and nation

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Medicaid, CHIP could gain 18 million more enrollees if all states expanded programs, study says
Modern Healthcare

While a new report estimates millions of people could be added to Medicaid and the Children’s Health Insurance Program if all states expanded these programs as allowed under the Patient Protection and Affordable Care Act, a number of states have refused to expand their programs or cut their existing programs, leaving thousands of their residents without coverage. The study conducted by the Kaiser Foundation and the Urban Institute estimated 18 million people could be added to the programs, and that the rate of uninsured in each state would fall below 15% if the ACA’s Medicaid were fully implemented in all states.

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California Measure to Lift Restrictions on Advanced Nurses Stalls In Assembly
capital public radio

The Assembly Committee on Business, Professions and Consumer Protection voted down the measure, but the bill’s author says he wants it reconsidered. Democratic State Senator Ed Hernandez says lifting restrictions on nurses would help meet a new demand for primary care under the Affordable Care Act, especially in areas without enough doctors.

“Nurse practitioners understand when it is appropriate to refer, just like an optometrist, just like a dentist, just like a general practicing physician,” said Hernandez.

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CMS Overpaid Hospitals $38.2M for Short-Stay Claims
Health Leaders Media

Payments to hospitals were made when elective surgeries failed to take place and inpatient claims did not meet Medicare’s admission requirements, says a report from the Office of Inspector General. Over a two-year period, the Centers for Medicare & Medicaid Services paid an estimated $38.2 million to hospitals for unnecessary short-stay inpatient claims related to canceled elective surgery procedures.

According to a report issued Tuesday by the Office of Inspector General in the Department of Health and Human Services, no clinical conditions existed to justify the admissions. So when the elective surgery failed to take place for one reason or another, the inpatient claim did not meet Medicare’s requirement that the admission be reasonable and necessary.

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The Growing Popularity of Having Surgery Overseas
New York Times

As health care costs in the United States rise, an increasing number of Americans are going overseas for elective procedures, or are at least considering that possibility. In response to an article in The New York Times on Sunday about an American who went to Belgium to have his hip replaced because his insurer in the United States would not cover the procedure, hundreds of readers said they would be willing to follow that path. Michael Shopenn’s surgery in 2007 would have cost close to $100,000 in the United States.

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Childhood obesity sees decline in 19 states
San Francisco Chronicle

After decades on the rise, obesity rates declined slightly among low-income preschoolers in California and 18 other states and U.S. territories between 2008 and 2011, according to a report released Tuesday by the Centers for Disease Control and Prevention. The percentage of low-income obese children ages 2 to 4 dipped from 17.3 percent to 16.8 percent in the state.

That percentage was still well above the 12 percent of preschoolers considered obese nationally. The study is only the latest to signify that California is making some progress in its efforts to combat childhood obesity, though that progress is certainly slow.

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Senators build ‘grassroots army’ to pressure McConnell on ObamaCare
The Hill

Senate conservatives are increasing pressure on Republican Leader Mitch McConnell (Ky.) to use the threat of a government shutdown to defund ObamaCare. Sens. Ted Cruz (R-Texas) and Marco Rubio (R-Fla.) are spearheading the effort to build a “grassroots army” to influence GOP leadership after entreaties to their colleagues fell short. So far, only 13 Senate Republicans have signed onto a plan to block any stopgap spending measure funding the government beyond Sept. 30 unless it cuts funding for the healthcare law.

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Covered California meeting to include dental policy
Sacramento Business Journal

Covered California will hold a special board meeting Thursday to address contract matters, personnel issues and take action on policy related to dental coverage in the new state health benefits exchange.

The meeting will be held from 9:30 to noon at the California Fair Political Practices Commission office on the 8th floor at 428 J St. The open session is expected to begin at 10:30 a.m.

The public part of the meeting will include a status report by executive director Peter Lee and the item on dental policy issues.

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California lawmakers defeat measure to increase medical duties of nurse practitioners
Sacramento Bee

A medical turf war played out in the Capitol on Tuesday as lawmakers defeated a bill increasing the scope of practice for nurse practitioners while approving another for pharmacists.

The bills are part of a slew of proposed legislation, including three measures by Democratic Sen. Ed Hernandez of West Covina that aim to increase the medical duties of optometrists, nurse practitioners, pharmacists and other medical professionals. At issue is how to best increase access to care once federal law requires nearly everyone to have health insurance.

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Legislature deals nurse practitioner bill a blow
San Diego Union-Tribune

A bill that seeks to grant nurse practitioners authority to see patients without doctor supervision fell two votes shy of moving forward in the state assembly Tuesday, though a similar bill aimed at expanding the role of pharmacists won unanimous support from legislators during a hearing in Sacramento.

Members of the Assembly Committee on Business, Professions and Consumer Protection voted 6-3 in support of the nurse practitioner bill (SB-491) with five abstentions; eight yes votes were needed for passage.

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Obesity rates decline among low-income preschoolers after rising for decades
Washington Post

After decades of rising, obesity rates among low-income U.S. preschoolers declined broadly from 2008 to 2011, according to a federal report released Tuesday that offered the first glimpse of good news for children considered among the most vulnerable to the disease’s health risks. While other, smaller studies have cited drops among school-age children, the data released by the Centers for Disease Control and Prevention represent by far the largest and most comprehensive report of declining obesity rates in poor children, officials said.

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Poor Children Show a Decline in Obesity Rate
New York Times

After years of growing concern about obesity among children, federal researchers have found the clearest evidence yet that the epidemic may be turning a corner in young children from low-income families. The obesity rate among preschool-age children from poor families fell in 19 states and United States territories between 2008 and 2011, federal health officials said Tuesday — the first time a major government report has shown a consistent pattern of decline for low-income children after decades of rising rates.

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Hospital continues switch to electronic records
Needles Desert Star

Colorado River Medical Center is joining the many hospitals and physicians who are switching to electronic health records, often referred to as meaningful use. Based on a press release from the U.S. Department of Health and Human Services, the department has met and exceeded its goal for 50 percent of doctor offices and 80 percent of eligible hospitals to have electronic health records by the end of 2013. A survey conducted by the Centers for Disease Control in 2012 showed that only 17 percent of health professionals were using an advanced electronic health record systems. That’s increased to more than 50 percent in 2013.

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How IPPS Final Rule Affects Medical Coding
Health Leaders Media

CMS offered hospitals some additional guidelines for inpatient admissions and finalized requirements for the Part A to Part B rebilling in the 2014 IPPS Final Rule, released August 2.

CMS also finalized a negative 0.8% recoupment adjustment as part of the documentation and coding adjustment mandated by the American Taxpayer Relief Act of 2012.

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CalPERS sued over long-term care insurance rate hikes
Sacramento Bee

CalPERS was sued Tuesday over the big rate hikes it imposed on its long-term care insurance program, which covers stays in nursing homes.

The class-action suit was filed by a Los Angeles law firm on behalf of more than 100,000 CalPERS members who have purchased the coverage and now face big rate increases.

The lawsuit, filed in Los Angeles Superior Court, says policyholders were duped into thinking the rates would be fixed and “reasonably priced.”

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Suit alleges CalPERS misled customers about long-term care insurance
Sacramento Bee

When CalPERS imposed an 85 percent rate hike on its long-term care insurance program, it caused a fuss among customers and some legislators.

Now it’s sparked a lawsuit.

A trio of law firms filed suit against CalPERS on Tuesday, saying the pension fund misled public employees and retirees into buying the coverage by promising their premiums would be stable. The firms are seeking to have the suit certified as a class action on behalf of more than 125,000 affected policyholders.

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Tulare hospital gets ‘Improvement Champion’ recognition
Visialia Times-Delta

Tulare Regional Medical Center was identified as an “Improvement Champion” by the California Hospital Engagement Network, reaching infection reduction goals six months ahead of time.

Tulare regional achieved a 40-percent improvement on catheter associated urinary tract infections, central line associated blood stream infections and ventilator associated pneumonia.

The hospital also achieved a 20-percent improvement in elective readmissions.

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Solta Medical CEO steps down as company revamps sales strategy
East Bay Business Times

Solta Medical Inc.’s top executive is leaving — with two years’ salary and a consulting deal — after a disappointing second quarter and as the acquisitive cosmetic medical devices developer adjusts its sales strategy. Stephen Fanning stepped down Tuesday as president and CEO of Solta (NASDAQ: SLTM) and left the Hayward company’s board of directors. He will be replaced on an interim basis by Mark Sieczkarek, who has been on Solta’s board since 2006 and chairman since June.

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Drexel medical students get clinical experience through Kaiser
Sacramento Business Journal

Kaiser Permanente has launched a new program with Drexel University to help develop the next generation of doctors. Sixteen third-year students at Drexel University’s College of Medicine in Philadelphia started clinical rotations last month at Kaiser hospitals in the Sacramento region and Vallejo. The program gives Drexel students a close look at Kaiser’s integrated model of care and offers Kaiser the opportunity to train new doctors — and maybe hire them later on.

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Health care companies need to focus on driving down costs
Sacramento Bee

Health care in this nation is at a critical inflection point. All across the country, people are asking three important questions about their health care and the industry that provides it: Why does it cost so much? Why does the price keep going up so fast? And why haven’t we been able to rein in the costs? These are critical questions, and they also are entirely fair. In fact, 18 percent of all spending in this country goes toward health care – a level of spending that, despite slowing growth, remains unsustainable.

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