News Headlines

News Headlines
Health care news from around the state and nation

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Covered California backs dental plans for 2014, eyes future changes
Los Angeles Times

Amid criticism from the state insurance commissioner and some children’s advocates, California’s health insurance exchange is moving ahead with a controversial approach to children’s dental coverage for next year while vowing to pursue changes for 2015.

At issue has been whether pediatric dental care should be part of the basic health insurance package sold through the exchange or be sold separately. The exchange, called Covered California, will be offering it on a stand-alone basis to parents next year.

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Physicians’ Medicare Pay Data May be Next to be Made Public
Health Leaders Media

Now that Medicare payment data for individual physicians is no longer sealed from public view, the Centers for Medicare & Medicaid Services wants help building appropriate policies that balance transparency and access to the data with privacy protections for physicians.

A federal judge in May lifted an injunction in place since 1979 that prohibited CMS from disclosing Medicare payments to physicians. The ruling overturns a policy to protect physicians’ privacy, which federal officials had installed at the behest of the American Medical Association.

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Scope of practice bills still alive for pharmacists, optometrists
Sacramento Business Journal

While the fate of one of the hotly debated scope-of-practice bills pending in the state of California Legislature is iffy, two others remain in play as the end of session looms. Senate Bill 491, which would allow nurse practitioners to practice without physician supervision, failed to get out of the Assembly Business, Professions and Consumer Protection Committee Aug. 6, but will get another hearing Tuesday.

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Scripps institute examines effectiveness of mobile devices in cutting costs
Modern Healthcare

The Scripps Translational Science Institute in San Diego has launched a six-month “Wired for Health” study to evaluate the effectiveness of using mobile health devices to reduce healthcare costs.

STSI is currently enrolling 200 participants with at least one of three chronic health conditions—diabetes, high blood pressure or heart arrhythmias—selected from Scripps Health’s 13,500 employees and their family members.

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What obesity means for workers’ comp claims
Sacramento Business Journal

California’s system for injured workers could wind up paying out a heck of a lot more now that the American Medical Association has reclassified obesity as a treatable disease. The reclassification could have far-reaching implications for the workers’ compensation system, according to a report released this week.

“The operational and economic consequences could be significant for medical providers and health care delivery systems that must now reconcile implementation of the new disease category, an evolving standard of care for obese patients, managed care issues concerning medical efficacy and cost/benefit considerations, as well as coordination of care challenges between workers’ compensation, group health and federal programs and requirements. …” the California Workers’ Compensation Institute wrote in a summary of its report.

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How health systems are prepping for the big Covered California rollout
Silicon Valley Business Journal

Implementing federal healthcare reform is now more than just talk. The January 2014 kickoff date for California’s state exchange — known as Covered California — is looming large. Insurance providers and healthcare providers are creating new systems built to scale and increasing staff sizes. The question now is whether the Affordable Care Act (best known as Obamacare) can achieve its dual objectives: expanding access to care and lowering healthcare costs.

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Covered California delays kids’ dental care “embedded” in medical plans
Sacramento Bee

Board members of the California Health Benefit Exchange voted Thursday to delay soliciting bids for medical plans that include pediatric dental care until next year.

Covered California, the state’s health insurance exchange, has said it will offer five stand-alone pediatric dental plans for 2014 as well as what’s called a “bundled” plan in which insurers pair a stand-alone dental plan with a medical plan.

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Concerns surface over Covered California small-biz health program
Sacramento Business Journal

The timing looked suspicious: Michael Lujan, the man responsible for marketing California’s new health care exchange to individuals and small businesses, submitted his resignation the day before Covered California announced its health plan lineup and rates for the small employer program. But Lujan had signed on for one year, decided it was time to go and submitted his resignation July 15.

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Covered California hopes to have embedded pediatric dental plans by 2015
Sacramento Business Journal

The board at Covered California directed staff Thursday to work with “deliberate speed” to draft a recommendation by the end of the year for how to make embedded pediatric dental benefits available no later than 2015. But the board did not direct staff to solicit bids for embedded plans for 2014. This action makes it unlikely consumers will be able to buy coverage for pediatric dental care as part of their health plan when the new state health benefits exchange kicks off next year.

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Covered California backers gather in San Francisco
Sacramento Bee

California is now less than two months away from the open enrollment date for the federally mandated health insurance exchange taking shape. Lawmakers and community leaders are gathering in San Francisco this morning for an update. Participants in the Covered California forum include Rep. Nancy Pelosi, D-San Francisco, state Sens. Leland Yee and Mark Leno, Assemblymen Phil Ting and Tom Ammiano, and Covered California executive director Peter V. Lee. The event starting at 10 a.m. at the University of California, San Francisco’s Mission Bay conference center.

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Sebelius touts healthcare law in Texas
Modern Healthcare

HHS Secretary Kathleen Sebelius said the Obama administration is open to talks with Texas about expanded healthcare for the poor.

Sebelius said her office is open to crafting a uniquely Texan plan to make sure everyone has health insurance. On Thursday she met with officials in Austin and San Antonio to talk about how local communities can take advantage of the Patient Protection and Affordable Care Act.

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Broker’s advice: Let Covered California rates firm up before committing
Sacramento Business Journal

The rates released last week for the small employer insurance program at Covered California are “pretty good,” brokers say. So is the degree of choice, which goes beyond what most small employers can get on the market now. The problem is that health care insurance is complicated, and rates vary by region and age so the sample average rates released by Covered California last week are just ballpark figures.

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ObamaCare’s effects difficult to measure
USA Today

When California announced that individual premiums in its health insurance exchange could be 29% lower than expected, President Obama cheered. When Indiana announced premiums might be 72% higher than before, state officials predicted doom. So who is right? Are health insurance premiums going up or down? We don’t know, at least in part, because both sides are playing with the numbers.

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HHS to award $54 million for navigator training
Modern Healthcare

HHS is preparing to award $54 million in grants to navigators—organizations that will provide impartial information to the public about signing up for coverage on the state health insurance exchanges. Navigators are not allowed to recommend particular health plans. These grants will go to navigator organizations in states where the federal government will operate the exchanges. The states operating their own exchanges are choosing navigator groups on their own.

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Hip replacements show why health costs are so high
Sacramento Bee

No matter where they stand on the Affordable Care Act, members of Congress should be alarmed at the costs that U.S. patients are charged for common medical procedures that are far cheaper in other countries.

They should be alarmed, but they should also be held to account for their refusal to intervene. The costs that hospitals, doctors and device makers are imposing on consumers, employers and their insurance companies have become a drag on the U.S. economy. Some $2.7 trillion is spent each year on health care in the United States, and the price keeps rising.

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California political clash brews over malpractice cap
News10.net

Section 3333.2 of California’s civil code offers a level of specificity not seen in many parts of the state’s laws, a fact that’s been debated for months behind closed doors in the Capitol… and now poised to spark an expensive political war in 2014.

The law in question, the Medical Injury Compensation Reform Act of 1975 (MICRA), limits malpractice lawsuit awards for pain and suffering to $250,000.

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Employers plan changes in retiree coverage
Modern Healthcare

More than 40% of employers offering healthcare coverage to Medicare-eligible retirees have decided to change how they provide coverage, according to a new survey.

The most popular approach, planned by 32% of employers, is one in which employers will direct retirees to the individual market, according to the Aon Hewitt survey released Tuesday. In many cases, employers will partially subsidize coverage by making a fixed contribution, which a retiree could use to help pay premiums, such as for coverage offered through a private insurance exchange.

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Insurers pressed to send patient coverage information to providers
Modern Healthcare

Health insurers face a new requirement to rapidly communicate electronically with healthcare providers whether a patient has insurance coverage, plus what his or her co-payment split will be for a given visit or procedure, and how much that patient will have to pay under his or her deductibles and out-of-pocket limits.

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UCSF, Children’s Oakland sign affiliation agreement set to close by early 2014
San Francisco Business Times

UCSF Medical Center and Children’s Hospital & Research Center Oakland have signed an affiliation agreement, set to close in early 2014, that would link the two but leave them as largely separate entities. That’s according to a letter to employees, faculty and physicians Thursday from UCSF Medical Center CEO Mark Laret, Children’s Oakland CEO Bert Lubin, M.D., and Sam Hawgood, dean of the UCSF School of Medicine.

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Community Hospital of the Monterey Peninsula celebrates cancer survivors Saturday
Monterey Herald

Patients at Community Hospital of the Monterey Peninsula’s Comprehensive Cancer Center are considered survivors at the moment of their diagnosis. It’s not to delude the patients, but to bring them into a community where everyone wishes to overcome similar struggles.

That community will come together Saturday for the hospital’s 18th annual cancer survivors celebration, from 11 a.m. to 3 p.m. at Monterey Peninsula College.

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