News Headlines

News Headlines
Health care news from around the state and nation

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Budget deal extends health care to undocumented children, punts Medi-Cal financing to special session
Sacramento Business Journal

The budget deal reached Tuesday between legislative leaders and Gov. Jerry Brown would expand health coverage to 170,000 undocumented immigrant children, but punts efforts to boost Medi-Cal spending to a special session.

The purpose of the special session will be to come up with a way to replace at least $1.1 billion in spending currently funded by a tax on managed care plans.

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Auditor Slams California’s Oversight Of Medi-Cal Plans Used By 9 Million
Kaiser Health News

California health officials failed to ensure that more than 9 million residents enrolled in Medi-Cal managed care plans had access to doctors when they needed them, the state auditor said in a stinging report Tuesday. Health officials might have learned about those problems from calls to an ombudsman’s office – but thousands went unanswered every month.

Among the report’s findings:

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Startling link between pregnant mother’s exposure to DDT and daughter’s risk of breast cancer
Washington Post

Banned by the United States in 1972, the insecticide DDT is best known as the impetus for the modern environmental movement. Since Rachel Carson’s bestseller “Silent Spring” sounded the alarm about the poisonous effects of the chemical on wildlife, the environment and human health, numerous studies have linked it to birth defects, miscarriage and reduced fertility.

Its role in cancer has been less clear. The Environmental Protection Agency classifies DDT as a “probable” carcinogen. Roughly three dozen studies have been published about DDT and breast cancer risk for women who lived during its peak use in the 1950s, but a 2014 meta-analysis of that research found that there was no significant association between exposure and breast cancer risk.

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San Francisco health tech startup nabs $50 million
San Francisco Business Times

Doctor On Demand, a San Francisco video telemedicine startup, has nabbed $50 million in Series B funding, giving it a total of $74 million in venture capital and seed funding.

The startup, launched in late 2012, will use its new-found cash to continue “the rapid expansion” of its video telemedicine service, officials said in a June 17 statement. Consumers can use smartphones, laptops, tablets and desktop computers to communicate via video with participating medical professionals. They can talk with doctors, psychologists and psychiatrists after downloading an app or connecting via the company’s web site.

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How Affordable Is the Affordable Care Act?
KQED Radio

For many Californians, the Affordable Care Act isn’t.

You’re not alone if you can’t afford your health insurance obligations, whether you’re struggling to pay your monthly premium or facing thousands of dollars in out-of-pocket costs.

“There are days when I can’t sleep, thinking ‘How am I going to do this?’” says Maria Chavez, a Whittier resident with a $625 monthly premium for a subsidized Covered California plan for herself, her husband and one of her children.

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How Four Words In Huge Health Law Divide The Supreme Court
Kaiser Health News

The U.S. Supreme Court is poised to issue a decision this month in a case that could again threaten a key aspect of President Barack Obama’s health law.

But this time around, unlike three years ago when the court rejected a constitutional challenge to the law’s individual mandate, the case, King v. Burwell, focuses primarily on statutory interpretation.

The issue is whether section 36B means what it seems to say if read literally and in isolation from the rest of the law: that Affordable Care Act subsidies are available only to people “enrolled … through an exchange established by the state.”

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GOP leaders to brief lawmakers on healthcare
Modern Healthcare

House and Senate Republican leaders are ready to tell GOP lawmakers about their proposals for responding to a U.S. Supreme Court decision that could abruptly halt federal healthcare subsidies for millions of people.

With justices expected to rule imminently and possibly obliterate a pillar of President Barack Obama’s healthcare overhaul, each chamber’s Republican leaders planned separate briefings Wednesday for their party’s rank-and-file.

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Medicare’s CCM Code: Extra Money or Extra Pain?
HealthLeaders Media

Medicare’s long-sought chronic care management (CCM) code 99490, which pays doctors about $42.60 a month per qualifying beneficiary, took effect Jan. 1, carrying a huge payload for primary care.

Now, physicians can be paid for the hours of non-face-to-face time they spend on behalf of beneficiaries with two or more chronic conditions — care many doctors have provided for free — if they document at least 20 minutes per month reviewing a patient’s issues and answering questions.

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Calif. budget deal grants health coverage to children in U.S. illegally
Fox News

Gov. Jerry Brown and top Democratic lawmakers on Tuesday announced a budget deal that extends public healthcare coverage to immigrant children who are in the country illegally.

The expansion of the state’s Medi-Cal program would begin in May 2016. It is expected to cost $40 million in the next budget and $132 million annually after that, Los Angeles Times reported.

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State auditor finds holes in Medi-Cal plans
San Diego Union-Tribune

A new report highlights significant shortcomings in the Medi-Cal program — from inaccurate doctor directories to an overwhelmed ombudsman program that has seen the number of rejected phone calls spike as high as 45,000 in one month.

The state auditor’s report, requested by the Legislature and released Tuesday, arrives as many medical providers, patient advocates and others question whether California’s health insurance program for low-income and disadvantaged residents has enough physicians to meet the demands of its 12.2 million beneficiaries.

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State auditor issues stinging review of Medi-Cal plans: Anthem Blue Cross in Fresno County gets worst grade
Fresno Bee

A searing review of Medi-Cal managed care provider directories released Tuesday by the California State Auditor found numerous inaccuracies ranging from incorrect phone numbers of doctors to listings of providers who no longer were participating in the health plans.

Telephone calls from thousands of frustrated consumers also have gone unanswered by the state Ombudsman Office, the audit said.

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California State Auditor blasts Medi-Cal program for inadequate provider networks
Contra Costa Times

A scathing state review of California’s strained Medi-Cal program confirms what thousands of the health plan’s exasperated enrollees have long complained about: The department tasked with overseeing health care for almost one third of the state’s residents cannot ensure it has enough doctors to serve its 12.3 million patients.

The 46-page audit released Tuesday morning by the California State Auditor revealed that the Department of Health Care Services didn’t verify the accuracy of the list of doctors available through the public health care program’s managed care plans.

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Audit: California’s Medi-Cal phone lines overwhelmed
Sacramento Bee

Thousands of calls to California’s Medi-Cal complaint lines don’t get through, and thousands more that manage to ring the call center go unanswered, according to a new state audit. For the year that ended in January 2015, the phone system to the Medi-Cal ombudsman’s office rejected up to 45,000 calls in a month, State Auditor Elaine Howle said in her report to lawmakers. Of the calls that did get through, only one-third and one-half were handled by ombudsman’s staff each month.

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Medi-Cal’s expansion hits a snag
Sacramento Bee

The Supreme Court will soon decide whether residents of states that refused to implement Obamacare are entitled to federal insurance subsidies.

Whatever it decides, the court’s decree will not affect California because no state was more eager to embrace the iconic program.

Previously, California had one of the nation’s highest proportions of medically uninsured residents, with an estimated 7 million Californians – the working poor, mostly – lacking coverage.

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New ECH study supports patients enduring pancreatic cancer chemo
Los Altos Town Crier

El Camino Hospital in Mountain View enrolled its first patient earlier this month in a new safety study of a catheter that delivers targeted chemotherapy for pancreatic cancer.

RenovoCath – manufactured in Los Altos by RenovoRx – brings fluids to targeted sites in the peripheral vascular system. The dose-escalation safety study evaluates the delivery of the anticancer drug Gemcitabine, directly infused into the arteries that supply blood flow to the area of the pancreatic tumor. The therapy is being tested in patients with cancer that cannot be surgically removed from the pancreas.

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Blaming drug costs, CalPERS considers 7% hike in HMO premiums
Sacramento Business Journal

The California Public Employees’ Retirement System is poised to raise HMO premiums for state employees an average of 7.21 percent in 2016. The move shows that rising hospital and drug costs could mean higher premiums in the private sector, too. The proposed HMO rate hike is up from a 3.9 percent hike in 2015. Premiums for state employees in less-restrictive preferred provider organization plans are slated to jump an average of 10.8 percent.

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Health insurance giants are in a frenzied search for merger partners
Los Angeles Times

The nation’s biggest health insurers are speed-dating one another, searching for a partner worthy of a multibillion-dollar merger.

Anthem Inc. and other industry giants are flush with cash and eager to swallow up competitors as they increasingly vie for individual customers on Obamacare exchanges and government business tied to Medicare and Medicaid. As a result, employers and consumers may be left with fewer choices and little relief from ever-rising medical costs, experts say.

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Desert Regional expands fields for residency program
The Desert Sun

The Coachella Valley’s newest doctor residency program is expanding before it even begins to train physicians in specialized fields such as neurosurgery and emergency medicine.

Desert Regional Medical Center in Palm Springs is taking on four residents starting this summer in each of three specialized fields: neurology, neurosurgery and emergency medicine. This is in addition to eight family medicine residents coming under a previously announced partnership with the UC Riverside School of Medicine.

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Former professor named interim president of UCLA Hospital System
UCLA Daily Bruin

Professor emeritus James B. Atkinson, who served several leadership positions in the UCLA Health System, has been serving as the interim associate vice chancellor and president of UCLA Hospital System as of May 11, officials announced Tuesday.

Atkinson temporarily assumed the position after David Feinberg stepped down from his role on May 1. The university is searching for a permanent replacement for Feinberg, a process that they predict will take up to 12 months, according to a statement.