News Headlines

News Headlines
Health care news from around the state and nation

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Courts Issue Conflicting Rulings on Health Care Law
The New York Times

Two federal appeals court panels issued conflicting rulings Tuesday on whether the government could subsidize health insurance premiums for people in three dozen states that use the federal insurance exchange. The decisions are the latest in a series of legal challenges to central components of President Obama’s health care law.

The United States Court of Appeals for the Fourth Circuit, in Richmond, upheld the subsidies, saying that a rule issued by the Internal Revenue Service was “a permissible exercise of the agency’s discretion.”

The ruling came within hours of a 2-to-1 ruling by a panel of the United States Court of Appeals for the District of Columbia Circuit, which said that the government could not subsidize insurance for people in states that use the federal exchange.

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As States Regulate Provider Competition, Common Threads Emerge
HealthLeaders Media

States are taking a number of measures to regulate hospital and provider competition within their borders as healthcare sector consolidation accelerates, a new study has found.

The joint report, State Policies on Provider Market Power, from the National Academy of Social Insurance and Catalyst for Payment Reform catalogs state laws that attempt to regulate or encourage competition within healthcare markets in the face of this wave of consolidations.

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Governor signs board changes to Covered California
San Francisco Chronicle

Gov. Jerry Brown has signed a bill aimed at diversifying California’s health exchange board by expanding the eligibility criteria for members.

The governor’s office announced Monday that he signed SB972 by Democratic Sen. Norma Torres of Pomona. She said her bill responds to consumer complaints of long waits, confusing website materials and low minority enrollment on the Covered California exchange.

The bill broadens the qualifications for the five-member Covered California board, which is currently dominated with health care and insurance administrators.

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That emergency room wait? Here’s how to cut it.
Washington Post

Three times within a week, 34-year-old Michael Granillo went to the emergency room at Northridge Hospital Medical Center in Los Angeles because of intense back pain. Each time, Granillo, who didn’t have insurance, stayed for less than an hour before leaving without being seen by a doctor. “I was in so much pain I wanted to be taken care of now,” said Granillo, who runs a hot-dog-cart business. “I didn’t want to sit and wait.”

On a recent Wednesday morning, he woke up feeling even worse. This time, Granillo’s wife, Sonya, tried something different: Using a new service offered by the hospital, she was able to make an ER appointment online, using her mobile phone.

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Government’s New Year’s Resolution: Grant All Americans Affordable Health Care Coverage
The Huffington Post

Did you remember to cheers the ACA? You know that, ahem – controversial, requirement to have health insurance coverage that began January 1, 2014. Love it or hate it, most taxpayers must have minimum health insurance coverage or pay a penalty when they file their tax return in 2015. The good news is that you may qualify for a tax credit to help offset the cost of health insurance. That credit is generally paid directly to your health insurance company.

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What The Odds Fail To Capture When A Health Crisis Hits
National Public Radio

How well do we understand and act on probabilities that something will happen? A 30 percent chance of this or an 80 percent chance of that?

As it turns out, making decisions based on the odds can be an extremely difficult thing to do, even for people who study the science of how we make decisions.

Brian Zikmund-Fisher would know. He teaches about risk and probability at the University of Michigan School of Public Health.

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Narrow networks getting wide attention from regulators
MedCity News

With the proliferation of narrow networks being rolled out as a cost-containing effort on health plan costs, the Obama administration and state insurance commissioners are vowing to more closely scrutinize such networks amid consumer concerns of limited choice of doctors and hospitals and potentially surprising out-of-network costs.

The New York Times reports that federal officials are developing new standards that would work similar to how Medicare Advantage plans are overseen, and whether they have adequate physician networks.

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Providers, insurers grapple with narrow-network backlash
Modern Healthcare

Narrow networks are a reality of the new health insurance landscape. Nearly half of all insurance plans sold on the public exchanges in 2014 were narrow network plans, defined as those with less than 70% of area hospitals included, according to an analysis by the research firm McKinsey & Company.

But given that reality, insurers and providers need to do a better job of providing consumers with accessible, easily understandable information about networks when they shop for coverage.

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Slew Of Health Care Bills Await Lawmaker Consideration In August
capital public radio

California lawmakers have left Sacramento for the month of July. But when they return, they’ll consider a few health care measures supported by consumer advocates and opposed by insurance companies.

One bill would require insurance companies to track out-of-pocket expenses, and reimburse patients if they go over the limit. Another proposal would make specialty drug payments more affordable for chronic disease patients.

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Governor signs bill to diversify Covered California board
Sacramento Business Journal

Gov. Jerry Brown has signed a bill to diversify the expertise of the board that governs Covered California, the state health benefit exchange.

Senate Bill 972 by Democratic Sen. Norma Torres from Pomona seeks a board better grounded in health insurance marketing, information technology, management of information technology systems and enrollment assistance geared toward cultural and linguistic diversity.

The bill was introduced after early enrollment numbers for the state health benefit exchange showed only 5 percent of the state’s eligible Latino population had signed up for insurance through Covered California, even though Latinos represent about 38 percent of the state population — and about 58 percent of its uninsured population.

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Gov. Brown signs bill to diversify California’s health care exchange board
The Mercury News

Gov. Jerry Brown on Monday signed a bill that will diversify the expertise of the five-member board of directors of Covered California, the state’s health care exchange.

While previous state law limited the expertise of board members to only those with experience in certain health care fields, Senate Bill 972 by Sen. Norma Torres (D-Pomona) expands the criteria to allow individuals with expertise in marketing, information technology, management information systems and cultural competency in enrollment counseling.

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States Experiment With Health Savings Accounts For Medicaid
National Public Radio

If all goes according to plan, next year many Arkansas Medicaid beneficiaries will be required to make monthly contributions to so-called Health Independence Accounts. Those who don’t may have to pay more of the cost of their medical services, and in some cases may be refused services.

Supporters say it will help nudge Medicaid beneficiaries toward becoming more cost-conscious health care consumers. Patient advocates are skeptical, pointing to studies showing that such financial “skin-in-the-game” requirements discourage low-income people from getting care that they need.

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Roundtable: Life After a Healthcare Organization Acquisition
Health Leaders Media

Consolidation in healthcare has been the trend for many years, and it shows no sign of abating as provider organizations look to redesign care delivery models and prepare for the shift toward population health management and value-based purchasing.

For those institutions that have already undertaken an acquisition, many challenges exist, including merging IT infrastructures, blending different organizational cultures, and balancing local versus corporate control.

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More than half of local doctors work in health system medical groups
Sacramento Business Journal

The number of local doctors who work for medical groups associated with the four big health systems in the Sacramento region is up 65 percent from a decade ago.

A total of 3,378 doctors — 52 percent of physicians in the four-county Sacramento metropolitan area — work exclusively for Sutter Health, Dignity Health, Kaiser Permanente or the UC Davis Health System, according to Business Journal research. That’s up from 2,044 in 2004, when it was 39 percent of the total. The trend away from solo or small group practice is expected to increase as time goes on.

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Pancreatic cancer treatment that almost never was lands key FDA win
San Francisco Business Times

Aduro BioTech Inc.’s immune system-boosting treatment for fighting deadly pancreatic cancer won “breakthrough therapy” designation from regulators, the small Berkeley company said Monday. The breakthrough therapy tag can accelerate approval of badly needed drugs from years to 60 days by speeding the Food and Drug Administration review of drugs that are a “substantial improvement” over existing therapies.

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Mobile app helps health care consumers comparison shop
Sacramento Business Journal

UnitedHealthcare’s free mobile app Health4Me is now available to all consumers. Among other information, it gives users the ability to review average market prices for more than 520 medical services. The app is designed to help all consumers make more informed decisions about their care including how to locate providers and facilities, review market prices and anticipate health care expenses based on local estimates.

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Amid whooping cough epidemic, LAUSD offers free vaccines
Los Angeles Times

Starting middle school comes with a whole host of worries — going to a new school, picking electives, making friends — but coming down with whooping cough doesn’t need to be one of them.

For incoming 7th grade students in the Los Angeles Unified School District, proof of a TDaP booster shot is mandatory before school starts Aug. 12. L.A. Unified will host a number clinics, listed below, to help make sure students receive a booster shot free of charge.

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CVS Ramps Up Retail Clinics with Provider Affiliations
Health Leaders Media

Relief for a common side effect of healthcare reform—increased demand for primary care services—may come from a place well known for soothing many ills.

CVS Caremark, one of the biggest retail pharmacy brands in the country is playing a major new-entrant role in healthcare delivery.

With several new provider partners announced last week, the Woonsocket, RI-based company has established clinical affiliations with more traditional healthcare providers in six states:

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Loma Linda refinancing hospital’s debt
The Press-Enterprise

One of Riverside County’s newest hospitals is preparing to sell up to $310 million in tax-exempt bonds to refinance debt and put 106-bed Loma Linda University Medical Center – Murrieta in a strong fiscal position as it moves toward expansion. The hospital received the green light last week from the Murrieta City Council, in a 5-0 vote, for a bond sale to be conducted by a state agency.

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Sutter Health privacy lawsuit dismissed
Sacramento Business Journal

A lawsuit against Sutter Health over patient data theft has been dismissed, according to the Sacramento Bee. The suit, which could have cost the Sacramento-based health system more than $4 billion, looked for $1,000 in compensation for each patient.

In late 2011, Sutter disclosed that a desktop computer with personal data from millions of patients had been stolenfrom a Sacramento medical office. At the time, Sutter said the computer was protected with a password, but that stolen records were not encrypted.

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Court halts $4 billion privacy suit against Sutter Health
Sacramento Bee

A state appellate court Monday ordered the dismissal of a lawsuit that could have cost Sutter Health more than $4 billion when it ruled that millions of the health care giant’s patients had no right to sue over the theft of a computer with their personal, medical and insurance records on its hard drive.

The court decided it has not been shown – and the patients have not alleged – that any unauthorized persons have actually viewed the contents of the hard drive, a fact that deprives the patients of grounds to seek civil damages.

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Sonoma Valley Hospital may takeover Palm Drive therapy center
Santa Rosa Press Democrat

A proposal by Sonoma Valley Hospital to take over management of West County Hand and Physical Therapy Center could mean the facility could reopen as soon as September.

Sonoma Valley’s proposal was one of two received by the Palm Drive Health Care District, which had closed the rehabilitation facility in April. The district also closed Palm Drive Hospital because of financial troubles and declining patient rates.