News Headlines

News Headlines
Health care news from around the state and nation

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Two California insurers probed for allegedly misleading Obamacare enrollees
Market Watch

A report in Friday’s Los Angeles Times says that two major insurers — Anthem Blue Cross and Blue Shield of California — are under investigation for allegedly misleading consumers about what doctors would be available in Obamacare networks in the state. The California Department of Managed Care is examining the two insurers for offering inaccurate provider lists, leaving many consumers without the doctor and/or hospital they hoped to retain while buying a plan under the Affordable Care Act.

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Health Insurers Pressing Down on Drug Prices
New York Times

In dealing with health plans, drug companies are facing a new imperative — bargain or be banned.

Determined to slow the rapid rise in drug prices, more health plans are refusing to cover certain drugs unless the companies charge less for them.

The strategy appears to be getting pharmaceutical makers to compete on price. Some big-selling products, like the respiratory medicine Advair and the diabetes drug Victoza, have suffered precipitous declines in market share because Express Scripts, the biggest pharmacy benefits manager, recently stopped paying for them for many patients.

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Covered California expands choice in small-employer program
Sacramento Business Journal

Starting Oct. 1, Covered California will expand choice in its Small Employer Health Options Program by allowing employers to offer a choice of plans in two contiguous benefit levels. Currently, business owners can offer only one benefit level, although workers can choose from a variety of plans at that level. Other states generally don’t allow even that much choice. “We are on the cutting edge of offering even more choice,” Covered California executive director Peter Lee said at a Sacramento board meeting Thursday.

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UC Davis study finds link between pesticides, autism
Sacramento Bee

Pregnant women who live near areas where agricultural pesticides are applied experience a higher risk of delivering children with autism or other developmental delays, a UC Davis study has found.

The study, published today in the periodical Environmental Health Perspectives, found that mothers who lived within roughly one mile of where pesticides were applied were found to have a 60 percent higher risk of having children with any of the spectrum of autism disorders, such as Asperger’s syndrome.

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What a GOP Senate Would Mean for Obamacare
National Journal Magazine

A Republican Senate majority wouldn’t be able to fully repeal Obamacare, but it could force some pretty significant changes to the health care law.

For now, the GOP isn’t talking much about what would come after Election Day. Its candidates are falling over themselves to pledge their support for full repeal—which may well be a winning message in a campaign but will be politically impossible even with the Senate majority. After all, President Obama will still be in the White House.

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Can we finally agree that Obamacare is working?
Los Angeles Times

At the end of a war, some people will remain holed up in the trees, thinking they can still turn the tide of a lost cause. Increasingly, that’s the best description of the anti-Obamacare dead-enders, including congressional Republicans, who continue to depict the Affordable Care Act as a failure despite facts like these:

–Nearly 60% of enrollees in ACA-compliant exchange health plans this year were previously uninsured–most of them for two years or more. (Source: Kaiser Family Foundation.)

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Anthem, Blue Shield under scrutiny over narrow Obamacare networks
San Francisco Business Times

State officials are checking to see if Anthem Blue Cross and Blue Shield of California violated state law by creating overly narrow, hard-to-use Obamacare networks on the Covered California exchange and elsewhere in the individual health insurance marketplace. The Department of Managed Health Care has started “non-routine surveys” of provider networks that Anthem and Blue Shield offer to the individual market, Shelley Rouillard, the agency’s director, said in a Friday afternoon statement to the Business Times, “due to (a) pattern of consumer complaints regard

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California probes Obamacare doctor networks at Anthem and Blue Shield
Los Angeles Times

California regulators are investigating whether Anthem Blue Cross and Blue Shield of California have violated state law in connection to patients struggling to find doctors under Obamacare.

Officials at the California Department of Managed Health Care said they are looking into whether consumers were misled by inaccurate provider lists and the difficulty some patients are still having at locating a physician in narrower networks statewide.

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Blue Cross, Blue Shield investigated by California
Orange County Register

State health regulators are investigating Anthem Blue Cross and Blue Shield of California for possible violations of the law after complaints from consumers attempting to use their Obamacare insurance plans. Shelley Rouillard, director of the Department of Managed Health, said Friday that many consumers picked plans that would allow them to see a certain doctor – only to discover their doctor wasn’t included in the network when they called for an appointment. Other consumers struggled to find doctors accepting new patients.

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State launches probe of Anthem Blue Cross, Blue Shield

California regulators are investigating whether Anthem Blue Cross and Blue Shield of California misled consumers about which doctors they covered under federal health care reform packages. The California Department of Managed Care is trying to determine whether state laws were violated in the way the medical insurance giants enacted new, limited health coverage networks under the Affordable Care Act, the Los Angeles Times.

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Hiker wants break on health insurance
San Francisco Chronicle

A hiker on the Pacific Crest Trail has a proposal for the health care industry that would save a fortune for Bay Area hikers, bikers and other outdoor athletes on their health insurance costs.

Just as the banking industry gives you a credit score to assess your financial risk, the health industry should give you a medical score to assess your health risk, she said.

“You would then pay for insurance according to your number,” she said. “People who hike or bike, like so many in the Bay Area, who don’t smoke, are in good shape and have good genetics would get a very high score.

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California expands Medi-Cal while continuing cuts
Modern Healthcare

California has been praised by health advocates for its early embrace of the federal healthcare expansion, but the new state budget has raised questions about its commitment to getting the poorest residents into doctors’ offices and dentists’ chairs.

Gov. Jerry Brown on Friday signed a budget for the 2014-15 fiscal year that accommodates an influx of uninsured residents into Medi-Cal, the state’s Medicaid program.

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KQED Launches ‘PriceCheck’ to Make Health Costs Transparent
KQED Radio

Say you’re shopping for a new computer or a new car, and you want to get the best price. Within a matter of minutes on Google, you would have a pretty good idea of the price range for the product you want.

But in health care? Forget it.

It’s well known to health policy types, but less so to consumers, that health care prices are utterly lacking in transparency and wildly variable.

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Cost of prostate cancer surgery varies widely in U.S.
Visialia Times-Delta

For an uninsured man with prostate cancer, the price of surgery could range from $10,000 to $135,000, depending on the hospital, a U.S. study finds.

What’s more, that wide range in charges — a 13-fold difference — has nothing to do with quality, researchers said.

“Consumers are used to higher prices meaning higher quality. But that’s not true in medicine,” said Dr. Bradley Erickson, the senior researcher on the study. “Prices are not attached to any kind of quality information.”

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Hospital program coaches parents to help alleviate ‘toxic stress’ in babies and toddlers
Southern California Public Radio

An innovative program run by Children’s Hospital of Los Angeles is trying to head off mental health issues in older children by improving their home lives when they’re babies and toddlers.

Through its “early childhood mental health program,” the hospital sends therapists into the homes of hundreds of kids who are showing signs of anxiety, trauma and stress that can pile up causing what experts call “toxic stress.”

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Aging in California: Who will support our seniors?
Sacramento Bee

Winifred Hertzen raised her five kids in a world that seemed overrun by children: California of the 1950s and 1960s, during the height of the baby boom years. New suburbs seemed to pop up overnight to accommodate growing families. Businesses flourished. School districts added schools and more schools. The world seemed young and noisy, and filled with promise.

“So many of my friends back then had three, four or five kids,” said Hertzen, 89, a retired business manager and grandmother of nine who lives at Sacramento’s Eskaton Monroe Lodge.

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Time for doctors and nurses to help solve West Contra Costa hospital crisis
Contra Costa Times

After West Contra Costa voters said they didn’t want to pay more to keep Doctors Medical Center afloat, the hospital district board and county supervisors last week extracted some extra money from property owners anyway.

The latest financing scheme should stave off closure at least through September. It was a necessary, one-time stopgap move. The question remains whether labor leaders and executives from other hospitals will make good use of limited time to devise a sustainable plan for preserving critical care.

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Kaiser’s new Oakland hospital opens July 1
The Mercury News

Kaiser’s new 12-story hospital in Oakland stretches the length of a football field and has private rooms for every patient with room service and Wi-Fi.

Employees preparing for the hospital’s July 1 opening say their Fitbits are easily hitting 10,000 steps a day in the 1-million-square-foot building.

Although the hospital is equipped with new state-of-the-art facilities, the same staff will provide care.