News Headlines

News Headlines
Health care news from around the state and nation

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Obama urged to include healthcare in immigration end-run
Modern Healthcare

President Barack Obama is expected to issue an executive order as soon as this week that would freeze deportations for up to 5 million immigrants living in the country illegally, but they’re likely to remain ineligible for Medicaid coverage and exchange subsidies.

In 2012, the Obama administration established the Deferred Action for Childhood Arrivals program. It allows law-abiding immigrants who came to the country as children to avoid deportation. More than 500,000 undocumented immigrants have been approved for the program.

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Immigrants baffled by lapse
San Francisco Chronicle is working better, but immigrants are running into what looks like an obvious slip-up.

Call it the green card glitch: The website has no clear path to upload the government identification document that shows they are legal U.S. residents, and entitled to benefits under President Barack Obama’s health care law.

It’s a baffling omission, say consumers and counselors assisting with this year’s sign-up drive.

“It doesn’t list the green card as an option to upload,” said Elizabeth Colvin of Foundation Communities, an Austin, Texas, group that serves low-income people, including many immigrants. There’s a way to upload copies of other types of documentation, Colvin said, but not green cards.

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Native Americans Urged To Sign Up For Private Insurance
National Public Radio

The second round of buying health insurance on the Affordable Care Act exchanges has started. Health officials say Native Americans may have much to gain by buying insurance there. Open enrollment round two for health insurance on the Affordable Care Act exchanges got underway over the weekend. On the first day alone, more than 100,000 people signed up for plans. With the website now working more smoothly, health officials hope to attract people who did not buy insurance last year, including many Native Americans.

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GOP senators seek to recoup funding from failed state-run exchanges
Modern Healthcare

Three influential Republican senators are seeking answers from HHS Secretary Sylvia Mathews Burwell about whether the agency will try to get money back from states that used federal grants to build insurance exchanges that flopped.

In a letter sent Tuesday to Burwell, Sens. John Barrasso of Wyoming, Chuck Grassley of Iowa and Orrin Hatch of Utah pointed out that over $1 billion was allocated to states to build exchange websites and that several of them have been plagued by technological problems. Two states—Oregon and Nevada—have deferred to to handle enrollments for 2015 after disastrous experiences during the first open-enrollment period. “This equates to hundreds of millions of dollars in government waste, and this issue needs to be addressed swiftly,” the senators wrote.

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Outreach Workers Look For Gains In Second Year Of Obamacare
National Public Radio

With the website working for consumers much more smoothly than last year, health officials are focused on reaching out to potential customers.

For starters, they want to people who bought insurance last year to take another look at those plans. And, of course, the exchange wants to bring in new customers who didn’t need or skipped insurance last year.

Among them, are minority groups that didn’t sign up in the numbers that state officials hoped for last year. In Montana and Georgia the minorities differ but face similar challenges.

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Lawmakers eye final attempt at state-run exchange
San Francisco Chronicle

Illinois lawmakers may have one more chance to approve a state-run health insurance marketplace during the fall legislative session that starts Wednesday, and they are under pressure from an end-of-the-year deadline and a pending court decision.

Supporters of creating a state-run website say the impending deadline to receive up to $300 million in federal funding plus a U.S. Supreme Court decision on tax credits due in the spring create urgency. Currently, Illinois residents purchase insurance on the national website.

Gov. Pat Quinn, who’s set to leave office in January, supports the idea, and the Illinois Senate passed a bill last year. Sponsors are now readying a House version. “I’d like to see the House take it up and pass it,” the Democrat said at a wellness fair Saturday.

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California expected to drop hundreds of thousands from Medi-Cal rolls
Contra Costa Times

When it comes to expanding health coverage to its poorest residents, California could be taking two steps forward and one step back.

Even as the state celebrates its enrollment of more than 2.7 million low-income Californians in Medi-Cal in 2014, it may drop an unusually high number of beneficiaries from its rolls by year’s end.

That is because Medicaid eligibility standards relating to income and household size changed under the Affordable Care Act, forcing the 8.6 million people who had been on the program before Jan. 1 to apply under the new rules. Medi-Cal is California’s version of the federal Medicaid program.

Beneficiaries always have to renew their coverage annually, and there is always some churn in enrollment as people’s circumstances change. But this year, the forms asked for a host of new information, and many more people than usual haven’t responded, according to state officials, county welfare directors and advocates.

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AMA Pushes Lame Duck Congress for SGR Repeal
HealthLeaders Media

The American Medical Association wants the lame duck 113th Congress to permanently repeal the reviled Sustainable Growth Rate funding formula for Medicare before the session adjourns next month.

“It’s important that we take advantage of the momentum that was created by all the worked that was done earlier this year to create HR4015 and Senate bill 2000,” AMA President Robert M. Wah, MD, told HealthLeaders Media Tuesday, referring to the ill-fated legislation that failed to repeal the SGR last spring.

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Americans Think Ebola Is A Top Health Care Problem
National Public Radio

A new poll shows Ebola is the one of the top health concerns of Americans, below access to health care and affordable health care. Robert Siegel talks to Frank Newport, editor in chief at Gallup. Ebola is a huge health care problem for Liberia and the other countries in West Africa. But that is not the case here. What is the most urgent health care problem facing this country? That’s a question that Gallup asks Americans each year. Frank Newport is the editor in chief at Gallup, and he told me about this year’s responses.

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Heart docs say better care is slowed by bad metrics
Modern Healthcare

New penalties for hospital readmissions and other poor outcomes are drawing the attention of leading cardiac physicians and researchers to a need for better ways to measure the quality of heart care delivered in the U.S.

“We have a system that has gone out of its way to fail to produce the information needed to make the best choices,” said Dr. Robert Califf of Duke University School of Medicine during a presentation Tuesday at the American Heart Association’s 2014 Scientific Sessions in Chicago. In terms of using data in the service of public health, “The U.S. is in trouble,” Califf said, noting astronomical costs of care, decreasing life expectancy and increasing numbers of patients suffering from preventable chronic diseases like heart disease.

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More States Adopt Laws To Ease Access To Experimental Treatments
National Public Radio

On Election Day, Arizona voters approved a referendum that allows terminally ill patients to receive treatment with drugs and devices that haven’t been approved by the Food and Drug Administration. Arizona became the fifth state to approve a so-called right-to-try law this year.

Supporters say the laws give patients faster access to experimental, potentially life-saving therapies than the FDA’s existing approach, often referred to as “expanded access” or “compassionate use.”

But critics of the state laws charge that they’re feel-good measures that don’t address some of the real reasons patients don’t receive experimental treatments in the first place.

Nevertheless, legislatures in Colorado, Louisiana, Michigan and Missouri also passed right-to-try laws this year as part of a nationwide effort spearheaded by the conservative Goldwater Institute, which hopes to get right-to-try laws on the books in all 50 states.

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Quality in Ambulatory Surgical Settings Gets a Closer Look
HealthLeaders Media

Why would OSF Saint Francis Medical Center, a 616-bed hospital in Peoria, Illinois, gladly let a group of doctors take away a sizeable chunk of surgical business, performing many of the same procedures 11 miles down the road at about half the price and in less than a day?

Seven years ago, that’s exactly what happened when four independent groups consisting of 43 doctors created a freestanding ambulatory surgery center, one where they could take patients they’d otherwise have to operate on in a hospital. The Center for Health Ambulatory Surgery Center, LLC, and its 90 staff doctors, perform procedures on some 7,000 patients a year in the outpatient setting.

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State regulators slam Anthem, Blue Shield over doctor access
Sacramento Business Journal

State regulators released a scathing report Tuesday saying Anthem Blue Cross and Blue Shield of California have failed to provide accurate doctor lists to patients who sign up through Covered California. Neither plan has corrected three out of four problems identified, according to the California Department of Managed Health Care, which has referred the issues to its enforcement arm. The agency could levy fines, department spokesman Rodger Butler said.

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State: Anthem, Blue Shield Misled Customers On Number Of Doctors In Covered California Plans
CBS News

Anthem Blue Cross and Blue Shield of California, two of California’s largest health insurers, misled customers about the number of doctors in their networks under plans sold through the state’s insurance marketplace, according to a state report released Tuesday. The California Department of Managed Health Care began investigating in May after patients complained they were told that certain medical providers were included when they chose a health plan, only to find out after their appointment that their doctor was not part of their network.

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Top insurers overstated doctor networks, California regulators charge
Los Angeles Times

Bolstering a chief complaint about Obamacare coverage, California regulators said two major health insurers violated state law by overstating the number of doctors available to patients.

More than 25% of physicians listed by Anthem Blue Cross and Blue Shield of California weren’t taking Covered California patients or were no longer at the location listed by the companies, according to state reports released Tuesday.

In some cases, these errors led to big unforeseen medical bills when patients unwittingly ventured to out-of-network doctors for medical tests or a surgery.

The results of the five-month investigation come at a critical juncture as the second year of health law enrollment gets underway and more than 1.2 million Californians are shopping in the state’s insurance exchange.

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Two Covered California health insurance plans misled consumers, regulators say
The Mercury News

Two major health insurers selling policies on the Covered California insurance exchange violated state law over the last year when they listed names of doctors in online directories who were not part of their networks.

Results of a five-month-long investigation into the practices of Blue Shield of California and Anthem Blue Cross of California by the Department of Managed Health Care released Tuesday revealed that:

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Aspirin, shampoo, Humana bill: CVS accepting insurance payments
Modern Healthcare

National health insurer Humana said Tuesday that policyholders who have bought its health plans on a federal or state insurance exchange or through its website can now pay their monthly premiums at any CVS Health store.

The move can be seen as an attempt by insurers like Humana to more directly engage their growing customer base and improve consumers’ adherence to their payment obligations, observers say.

“The industry is at the beginning of a wave of really delivering retail capabilities, specifically when we talk about individuals,” said Rich Birhanzel, a healthcare group managing director at consulting firm Accenture.

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Kaiser launches clinics in Target stores
San Diego Union-Tribune

Kaiser Permanente has its clinical cross-hairs trained on a few local Target stores to test its aim at caring for patients in a retail setting.

Target and Kaiser this week announced a pilot project that involves launching primary-care clinics in four Southern California locations.

Clinics in San Diego, Vista and Fontana opened Monday, while the fourth, in Fullerton, is scheduled for a ribbon-cutting ceremony on Dec. 6.

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Study: Health sector pumps $28 billion into S.F. economy
San Francisco Business Times

The health care industry drives $28 billion in economy activity in San Francisco and is the city’s largest source of employment, accounting for about 20 percent of its workforce.

That’s according to a report released Tuesday by the Hospital Council of Northern and Central California. Health care employs 121,000 people in San Francisco — more than any other sector, the report said — and the industry’s payrolls account for $9.63 billion in direct labor income.