News Headlines

News Headlines
Health care news from around the state and nation

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Feds lose $80M looking for Medicaid fraud
San Francisco Chronicle

Private contractors received $102 million to review Medicaid fraud data, yet had only found about $20 million in overpayments since 2008, according to a new report by the federal government. “Significant federal and state resources are being poured in but only limited results are coming out,” said Ann Maxwell, a regional inspector general for the U.S. Department of Health and Human Services.

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Bill seeks to bring down patient costs for cancer pills
The Bay Citizen

Robert Adler was shocked at 50 when what seemed like pneumonia was actually multiple myeloma, a cancer of the blood and bone marrow. He was in for another shock when he found out that his first monthly prescription for an oral anti-cancer drug would cost $3,200. Adler, of Laguna Hills, said friends and family helped him come up with more than $42,000 for the Revlimid pills he needed for a course of treatment.

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Health reform forces insurers to issue $59M in refunds
Sacramento Business Journal

Individuals and businesses in California will get almost $59 million in refunds from five major health plans by Aug. 1, thanks to new rules imposed by federal health reform. The Affordable Care Act requires health plans that cover individuals and small businesses to spend at least 80 cents of every premium dollar on direct medical services and other programs that improve care. The requirement goes up to 85 cents on the dollar for large business clients.

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Access, costs, quality vary widely by area, analysis finds
Modern Healthcare

A Commonwealth Fund analysis of more than 40 measures of healthcare access, quality and cost found major differences across 306 U.S. communities. The analysis, which looked at avoidable hospital visits, infant mortality, routine checkups and more than three dozen other measures, also found an association between greater access and better quality and outcomes, according to a newly released report by the health policy not-for-profit.

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News media ask court to air health care ruling
San Francisco Chronicle

News organizations are asking the Supreme Court to allow cameras in the courtroom for the first time for its eagerly awaited decision on President Barack Obama’s health care overhaul. Reporters Committee for Freedom of the Press executive director Lucy Dalglish says the court should allow live audio and video coverage of the decision, expected in the next two weeks.

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Pelosi confident court will back health care law
San Francisco Chronicle

House Democratic leader Nancy Pelosi is predicting the Supreme Court will uphold the constitutionality of the health care law by a 6-3 vote. Pelosi didn’t say how she thought individual justices would vote in her appearance Friday on “CBS This Morning.” But the California Democrat said her party is “prepared for any eventuality,” including the possibility the high court may overturn some or all of the law that critics have labeled “Obamacare.”

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Health Reform: What’s At Stake For Small Business
CNN

The health reform law is chock full of new rules and benefits for small businesses — and all are now on the line at the Supreme Court.

The 2010 Affordable Care Act includes everything from a different way to shop for insurance to a tax credit that rewards employers for insuring workers.

The Supreme Court’s decision on the law’s constitutionality is due out later this month, even as soon as Monday.  Generally speaking, there are three main possible outcomes: Health care reform could be upheld entirely or struck down entirely, or the court could do away with only some provisions.

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Hospital CPI rises 0.6% in May; doc-office prices up 0.2%
Modern Healthcare

Consumer prices for hospital services increased 0.6% for the second straight month in May, according to seasonally adjusted Consumer Price Index figures from the U.S. Bureau of Labor Statistics. That compares with the 0.7% increase in May 2011. For the year ended last month, hospital consumer prices climbed 5.1%, a deceleration from the prior year’s increase of 6.2%.

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Health insurance survey shows most policyholders don’t know about premium rebates
Live Insurance News

According to the results from an eHealthInsurance survey, most people who purchase individual health insurance are unaware of the fact that the Affordable Care Act of 2010 may mean that they will be receiving a partial refund of the premiums that they paid last year for their coverage.

The healthcare reform law requires that insurers send rebates to policyholders if they failed to spend at least 80 percent of their income from premiums on actual medical care. August 1, 2012 represents the deadline by which the first rebates must be sent out.

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Class Claims Blue Shield Prices Out the Sick
Courthouse News Service

Blue Shield of California forces older, sicker policyholders into low-benefit coverage with high deductibles, and excludes some from coverage completely, customers claim in a federal class action. Lead plaintiffs Robert Martin and Deborah Goodwin claim Blue Shield has been manipulating California’s “dual-regulator” health insurance system by closing blocks of health plans under one agency and opening up new ones under the other.

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Lawmakers rip waste in anti-fraud programs
Modern Healthcare

Senators criticized the “mind-boggling” waste in Medicaid anti-fraud programs that cost $80 million more than they recovered, as the Obama administration identified five steps to address the problem.

At a Thursday hearing, members of the Senate Homeland Security and Government Affairs Federal Financial Management Subcommittee criticized the recently revealed finding of the Government Accountability Office that from June 2007 through February 2012 the CMS paid fraud contractors at least $102 million but they found less than $20 million.

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Hospitalists ID Unprofessional Physician Behaviors
Health Leaders Media

Ridiculing coworkers, clumsy and callous patient transfers, texting during meetings, and leaving work early were among a handful of rare, but unprofessional behaviors attributed by some hospitalists to themselves and more so to their peers, a survey published in the in the Journal of Hospital Medicine shows.

The survey and study asked 77 Illinois hospitalists to identify what they considered unprofessional behavior in themselves and their colleagues.

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Half of U.S. adults getting preventive care: CDC
Modern Healthcare

About half of U.S. adults received selected preventive services such as screenings, consultations and prescriptions, according to a study by the Centers for Disease Control and Prevention.

The study, called Use of Selected Clinical Preventive Services Among Adults—United States, 2007-2010 (PDF), aims to serve as a baseline for changes that occur with the implementation of the Patient Protection and Affordable Care Act, according to the report.

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UCSF Mission Bay Med Center finally tops $400M fund-raising mark
San Francisco Business Times

Fund raising efforts for the new UCSF Medical Center at Mission Bay finally hit the $400 million milestone. That’s the good news. But it’s taken the academic medical center since October 2010 to raise the additional $25 million to hit that mark. And it still has about $200 million to go to reach its stated philanthropic goal of $600 million for the $1.52 billion, 289-bed hospital complex that’s taking shape at Mission Bay, along with a bevy of UCSF research centers.

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