News Headlines

News Headlines
Health care news from around the state and nation

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Almost $12M on the way in health insurance refunds, thanks to Affordable Care Act
Sacramento Business Journal

Individuals and businesses in California will get almost $12 million in refunds from health insurers this summer because of the Affordable Care Act. The health reform law requires health plans that cover individuals and small businesses to spend at least 80 cents of every premium dollar on direct services and other programs to improve care. The requirement goes up to 85 cents on the dollar for large business clients. Federal law requires rebates to be sent by Aug. 1.

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California pharmacies resist push to translate drug labels
Sacramento Bee

When Chek Lun Wong picks up his prescription medication for hepatitis B at his local Walmart, he doesn’t understand a word. “I give them the prescription and my license and they give it to me. I don’t read the bottle,” said Wong. “I usually just ignore it if I don’t understand it.” The 63-year-old Wong, who told his story with the help of a Chinese translator at the Paul Hom Asian Clinic in East Sacramento last weekend, is one of thousands in the capital region and the state who struggle to take their medication correctly because of a language barrier – an issue that some health advocates want rectified at a California State Board of Pharmacy meeting later this month.

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Drug Pricing ‘Tantamount to Greed’ Lawmaker Says
HealthLeaders Media

Calling Sovaldi, a high-priced drug for hepatitis C, “the poster child for high Medicare Part D drug prices,” Rep. Henry Waxman (D-CA) Wednesday urged Congress to pass several bills that would ease the prescription price burden on seniors, taxpayers, and the Medicare trust fund.

Made by Gilead Sciences, Sovaldi costs $84,000 for a 12-week course of treatment. “Why are they charging that? Because they have a monopoly and they can charge whatever they want,” Waxman said.

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A Simple Way To Reduce Stroke Risk: Take Your Pulse
National Public Radio

An irregular heartbeat called atrial fibrillation is a big cause of stroke, especially for people who have recently had a stroke. But it’s not something that most people can feel.

Doctors test for atrial fibrillation by hooking people up to an electrocardiogram machine at the office, or having them wear a Holter monitor for a day or a week. There are also implantable monitors to check for afib, but they aren’t widely used.

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Obamacare ruling could affect employer mandate, local broker says
Sacramento Business Journal

A federal court decision Tuesday that throws into question government subsidies provided through the federal insurance exchange doesn’t affect California directly, but it could have an impact on Affordable Care Act funding through employer fines, a local insurance broker says.

If the subsidy no longer exists, the trigger for fines on employers whose workers qualify for those subsidies is gutted, said Carolyn Lewis, a spokeswoman for the Sacramento Association of Health Underwriters.

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Preliminary Results of Undercover Testing of Enrollment Controls for Health Care Coverage and Consumer Subsidies Provided Under the Act
insurance newsnet

The Government Accountability Office released the following report highlight: What GAO Found Centers for Medicare & Medicaid Services (CMS) officials told us they have internal controls for health care coverage eligibility determinations. GAO’s undercover testing addressed processes for identity- and income-verification, with preliminary results revealing questions as follows:

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Ideological justice blind on health law
Sacramento Bee

Retired Supreme Court Justice John Paul Stevens captured our ideal when he wrote of the judge as “an impartial guardian of the rule of law.”

By effectively gutting the Affordable Care Act on Tuesday, two members of a three-judge panel on the D.C. Circuit Court of Appeals showed how far right-leaning jurists have strayed from such impartiality. We are confronted with a conservative judiciary that will use any argument it can muster to win ideological victories that elude their side in the elected branches of our government.

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Federal Health Exchange Stays Busy After Open Enrollment Ends
National Public Radio

For months, journalists and politicians fixated on the number of people signing up for health insurance through the federal exchange created as part of the Affordable Care Act. It turned out that more than 5 million people signed up using HealthCare.gov by April 19.

But perhaps more surprising is that, according to federal data released Wednesday to ProPublica, there have been nearly 1 million transactions on the exchange since then. People are allowed to sign up and switch plans after certain life events, such as job changes, moves, the birth of a baby, marriages and divorces.

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ACO Directory: 268 ACOs in America
Becker's Hospital Review

Accountable care organizations have become increasingly popular with the switch from fee for service to pay for performance, and the number of commercial and government ACOs continues to grow.

Seeking to improve the quality of healthcare and reduce costs, Pioneer ACOs were created for the more advanced health systems that had already achieved a high level of integration. CMS named the original 32 Pioneer ACOs in December 2011. Upon the release of first year performance data in July 2013, nine Pioneers announced their departure from the program.

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Eligible California immigrants not receiving healthcare, Pan says
Sacramento Bee

California immigrants who are newly eligible for government health care are being rebuffed because of inadequate communication between public agencies, Assemblyman Richard Pan, D-Sacramento, and advocates warned on Wednesday.

Enacted by President Obama amid a record number of deportations and pleas from advocates to help young immigrants, the Deferred Action for Childhood Arrivals program extends temporary deportation immunity to immigrants who are in the country illegally but have established roots. Many of them arrived in the United States as young children.

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Gilead hepatitis C pill reaches $3.48 billion in quarterly sales
San Francisco Chronicle

Despite criticism from insurers and lawmakers, Gilead Sciences said Wednesday its $1,000-a-day hepatitis C pill had improved on its record-setting debut as it reached $3.48 billion in sales last quarter.

The drug, Sovaldi, can cure more than 90 percent of patients with the most common form of hepatitis C, which afflicts 3 million Americans. The therapy was celebrated as the most successful drug launch ever when it brought in $2.3 billion in sales in the first quarter, and it once again surprised analysts who had predicted sales of $2.6 billion in the second quarter.

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States Help New Mothers Get Birth Control Through Medicaid
National Public Radio

A woman is about to give birth. It will be her second child, and she’s not looking to have a third anytime soon. She doesn’t want to take birth control pills while she’s breast-feeding. And condoms aren’t as error-proof as she’d like.

There are a couple of alternatives that are safe, effective and could work for years: an IUD or an implant. She’ll need a doctor to get those.

Here’s the catch: Her Medicaid plan won’t pay for contraception if she tries to get it while she’s still at the hospital.

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New law enhances residents’ rights in residential care facilities for elderly
The Mercury News

Residential care facilities for the elderly will soon have greater representation among their residents, thanks to a bill Gov. Jerry Brown signed into law Wednesday.

AB1572, authored by Assemblywoman Susan Eggman, D-Stockton, requires a residential care facility for the elderly to help residents establish and maintain a resident council when two or more residents request it. The original requirement stated that a council would only be created if a majority of residents requested it.

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Santa Rosa company to add air ambulance base in Rancho Cordova
Sacramento Bee

Santa Rosa-based REACH Air Medical Services said it plans to expand its Northern California operations with a new air ambulance base in Rancho Cordova, possibly by October.

REACH officials did not disclose the exact location of the emergency-medical air base, saying a final agreement had not yet been signed.

In the region, REACH currently oversees bases at Sacramento Executive Airport and at sites in Marysville and Stockton.

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Dignity Health, Anthem Blue Cross continue talks beyond contract termination deadline
Sacramento Bee

San Francisco-based Dignity Health and Anthem Blue Cross have gone into overtime on negotiations for a new contract, but both sides appeared confident of an eventual agreement.

Anthem spokesman Darrel Ng said Wednesday that the existing contract between Dignity and Anthem expired July 15, but the termination deadline has been extended on a daily basis by mutual agreement of both parties.

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With three retirements, Memorial Hospital will get new leaders – after a competitive election.
Monterey County Weekly

When Pat Egan’s term on the Salinas Valley Memorial Healthcare System board of directors ended in 2012, he wanted to run again, but he had no district to run in. Until that year, Memorial’s board of directors was elected at-large.

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Sutter Health data breach case dismissal has precedent
Sacramento Business Journal

The appeals court ruling Monday that dismissed a data breach class action against Sutter Health was not the first to contend no damages are due when it appears nobody actually looked at or used the stolen information.

Another appeals court ruling in a University of California Regents case last year came to the same conclusion. As data breaches become more common, courts are beginning to look at the actual toll from the incidents and question whether a theft that doesn’t hurt anybody should bring multimillion-dollar damage awards.

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