News Headlines

News Headlines
Health care news from around the state and nation

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Online doctor visits can be easy, but Congress thinks they increase costs
Washington Post

Donna Miles didn’t feel like getting dressed and driving to her physician’s office or to a retailer’s health clinic near her Cincinnati home.

For several days, she had thought she had thrush, a mouth infection that made her tongue sore and discolored with raised white spots. When Miles, 68, awoke on a wintry February morning and the pain had not subsided, she decided to see a doctor.  So she turned on her computer and logged on to www.livehealth.com, a service offered by her Medicare Advantage plan, Anthem Blue Cross Blue Shield of Ohio. She spoke to a physician, who used the camera on Miles’s computer to peer into her mouth and who then sent a prescription to her pharmacy.

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Fraud Still Plagues Medicare’s Prescription Drug Program
National Public Radio

Fraud and abuse continue to dog Medicare’s popular prescription drug program, despite a bevy of initiatives launched to prevent them, according to two new reports by the inspector general of Health and Human Services.

Their release follows the arrests of 44 pharmacy owners, doctors and others, who last week were accused of bilking the program, known as Part D.

The two reports issued Tuesday provide more insight into the extent of the fraud, as well as steps federal regulators should take to stop it. The first report, which covers data from last year, found:

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Cancer Doctors Offer Way to Compare Medicines, Including by Cost
New York Times

Alarmed by the rapid escalation in the price of cancer drugs, the nation’s leading oncology society unveiled on Monday a new way for doctors and patients to evaluate different treatments — one that pointedly includes a medicine’s cost as well as its effectiveness and side effects.

The release by the American Society of Clinical Oncology of what it calls its “value framework,” is part of a change in thinking among doctors, who once largely chose drugs based on their medical attributes alone. The major cardiology societies, for instance, are also now starting to factor cost into their evaluation of drugs.

“The reality is that many patients don’t get this information from their doctors and many doctors don’t have the information they need to talk with their patients about costs,” Dr. Richard Schilsky, chief medical officer of the oncology society, said in a news conference on Monday.

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Implementing Health Reform: The Congressional Budget Office On Repealing The ACA
HealthAffairs

The Congressional Budget Office report on the Budgetary and Economic Effects of Repealing the Affordable Care Act has been widely reported and by now its themes are well known. I add just a few observations.

The report was the first since 2012 analyzing the likely results of a repeal of the law. Indeed, in 2013 the CBO declined a request that it again estimate the results of a repeal as too difficult and unnecessary.  The report was also the first time the CBO applied “dynamic scoring,” to its repeal estimate, a change that had been required by the new Republican majorities in the House and Senate. The CBO, that is, for the first time looked not only at the direct effects of repeal on changes in revenues and expenditures in the federal budget, it also considered the broader macroeconomic consequences of repeal on the economy, and the indirect effects of these consequences on the federal budget.

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Achieving Balance After Another ACA Decision
The Health Care Blog

As the health care community waits for the outcome of King v. Burwell, the latest Affordable Care Act (ACA) challenge, the focus has been on a key question: What happens if the Supreme Court doesn’t allow the federal healthcare marketplace to continue to offer premium tax subsidies? But how such a decision would affect the rate of insurance is just the tip of the iceberg. Eliminating federal subsidies impacts a whole range of ACA policies that were carefully navigated during the legislative process. As we wait for legal decision, we have an opportunity to examine whether the choices made in 2010 remain on solid ground if a significant portion of subsidized coverage disappears.

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Covered California’s Plan To Collect Health Info Raises Concerns
KPBS

Covered California wants to tap into the health data of its 1.4 million enrollees. But privacy rights experts are raising some questions.

Exchange officials say they’re planning to create a large database with information on patients’ doctor and hospital visits, and prescription drugs. The information could be used to determine whether patients are getting appropriate care.

Pam Dixon, executive director of the San Diego-based World Privacy Forum, said people should have been given the option to keep their records out of the database.

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Company seeking extended contract with Covered California says 1,000 jobs at risk
Sacramento Business Journal

As many as 1,000 employees of a call center in south Sacramento face an uncertain future when their employer’s contract with Covered California expires next week.

The agency that runs the state health-insurance exchange signed a $14 million contract last fall to help with heavy call volume during open enrollment at the state health benefit exchange. In-Sync Consulting Services in Roseville joined with Virginia-based call-center operator Faneuil on the deal to provide temporary staff to answer questions and enroll customers from a new call center on Greenhaven Drive.

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Covered California raises pay for two top executives
Sacramento Business Journal

The Covered California board has voted to increase pay for two top executives in recognition of the work they’ve done — and their commitments to stay on the job. Executive director Peter Lee will get a 2.5 percent pay increase that will up his annual salary to $333,120, plus a $65,000 bonus. Deputy director Yolanda Richardson will get a 11.3 percent pay hike to $265,668. The changes take effect July 1.

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California’s Medicaid Program Fails To Ensure Access To Doctors
National Public Radio

Terri Anderson signed up for California’s Medicaid program earlier this year, hoping she’d finally get treatment for her high blood pressure. But the insurer operating her Medicaid plan assigned the 57-year-old to a doctor across town from her Riverside, Calif., home and she couldn’t get there.

“It was just too far away,” says Anderson, adding that she cares for her 90-year-old ill father and can’t leave him alone to make an hour round-trip drive to the doctor.

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Targeting Heavy Users of Medi-Cal, Program Aims to Lower Costs, Increase Quality
KQED Radio

Bertha Swan is wrestling with a taped-up package she calls a “bubble pack,” containing dozens of packets of pills that are different shapes, sizes and colors. On the table is a plastic box with dividers to organize them.

“You just put the medicine in there, morning, noon, evening and night,” she says. For two years now Swan has been organizing these pills for her 70-year-old mother, whom she gives insulin shots and helps with home dialysis.

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Medi-Cal’s Autism Therapy Benefit Doesn’t Mean Access to Care
KQED Radio

When Tatiana Ciudac found out in January that Medi-Cal benefits included childhood autism therapy, she was ecstatic.

Ciudac, originally from Moldova (near Ukraine) and now living in San Francisco, is the mother of a six-year-old boy with autism spectrum disorder. Her son had been getting a type of autism treatment called applied behavior analysis — known as ABA therapy — through a program at her child’s school. The ABA therapy ran out once he hit age five, though.

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Ambulance companies urge Medi-Cal fix; costs far exceed pay
Sacramento Business Journal

The cost to provide ambulance services has climbed to almost $600 per transport, but Medi-Cal pays an average of just over $100. W

hen people think “Medi-Cal provider,” doctors and dentists, hospitals, pharmacists and clinics come to mind. That’s a problem, say six large California ambulance companies that formed an alliance to get the word out that they, too, are hurting.

Medi-Cal rates have not increased since 1999 and provider rates were rolled back 10 percent during California’s fiscal crisis. Meanwhile, costs continue to rise. With a rosier state budget — but ongoing disagreement with lawmakers over spending — Gov. Jerry Brown has called a special session on Medi-Cal financing.

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Bill Aims To Reduce Prescription Drug Overdose Deaths
KPBS

Prescription drug overdoses are the leading cause of accidental death in California.

A bill in the state legislature, SB 482 (Lara), aims to reduce the problem.

It would require doctors to check a state database before prescribing schedule II and schedule III drugs to a patient for the first time. Drugs included in these categories include OxyContin, morphine and Vicodin.

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Bill helps medical marijuana users access organ transplants
San Diego Union-Tribune

California lawmakers have passed a bill that prevents medical marijuana users from being denied organ transplants just because they use pot.

The state Senate on Monday passed AB258 by Democratic Assemblyman Marc Levine of San Rafael on a 33-1 vote.

Supporters say some patients who use medical marijuana have been denied life-saving organ transplants because they are treated by doctors as drug abusers.

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America’s getting even fatter: Startling growth in obesity over past 20 years
Washington Post

New obesity statistics are out for the United States, and they show that nearly two-thirds of adults are at an unhealthy weight.

An analysis published in JAMA Internal Medicine on Monday found that 75 percent of men and 67 percent of women ages 25 and older are now overweight or obese. That’s a startling shift from 20 years ago when 63 percent of men and 55 percent of women were overweight or obese and a depressing sign that campaigns to get Americans to eat healthier and exercise more may be failing.

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Medical group targets unnecessary tests
Modern Healthcare

Sharp Rees-Stealy Medical Group is among a handful of providers nationwide selected to participate in an ongoing effort to reduce the use of unnecessary and ineffective medical treatments.

Working under guidelines from the American Board of Internal Medicine Foundation, Rees-Stealy will spend the next three years monitoring usage of five tests and procedures shown to be regularly overused in health care today. The health provider’s project will encompass 160,000 patients.

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Controversies Made Preventive Services Panel Stronger, Says Retired Leader
Kaiser Health News

For its first 25 years, the U.S. Preventive Services Task Force toiled in relative obscurity. Created by the federal government in 1984, the task force published books and articles in scientific journals that aimed to inform primary care practitioners about which preventive services were effective based on scientific evidence. It assigns preventive services such as screenings, medication and counseling grades from A to D, or an I for insufficient evidence.

In 2010, everything changed. The massive health care bill that came to be called Obamacare included language requiring that preventive services scoring a grade of A or B from the task force had to be covered by health plans without charging consumers anything out of pocket. In one stroke, this volunteer group of nonpartisan medical experts found themselves thrust into the political hurly burly. Their recommendations, including a controversial 2009 recommendation regarding breast cancer screening, came under intense scrutiny.

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U.S. suffering from prescription drug shortage
San Francisco Chronicle

Drug shortages have turned into a nationwide chronic condition.

Disruptions in production, safety recalls, difficulties finding key raw ingredients, shifts in demand and decisions to discontinue certain products are just some of the reasons pharmaceutical makers give for not having enough supply. Nearly half the time, research shows, the reason is not disclosed, but the problem has escalated over the past five years.

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Anthem continues $47B Cigna takeover battle
USA Today

Health insurance giant Anthem (ANTM) on Monday reiterated support for its $47.4 billion cash and stock takeover bid for Cigna (CI), undeterred by the smaller rival’s rejection of the latest offer.

Indianapolis-based Anthem also tried to build Cigna shareholder support for the proposed transaction, webcasting a conference call with Wall Street analysts to discuss the deal terms.

The latest jockeying in what could be the largest-ever U.S. health insurance merger came as rating agency Standard & Poor’s placed the credit rating of both firms on its CreditWatch with negative implications. S&P cited concerns the transaction would be complex, lengthy and involve a “potentially high degree of integration risk.”

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Anthem reaffirms commitment to its $47-billion bid for Cigna
San Francisco Chronicle

Anthem sees its more than $47 billion bid to buy rival Cigna as a way to muscle up on technology that helps consumers and to strengthen its rapidly growing Medicare Advantage business. Leaders of the Blue Cross-Blue Shield insurer reaffirmed on Monday their commitment to getting a deal done a day after Cigna shot down the idea in a letter delivered to Anthem’s board. “We think we’ve put forward a very compelling offer,” Anthem Chief Financial Officer Wayne DeVeydt said when asked by an analyst during a conference call whether his company would consider raising its price.

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Grand jury: Natividad’s IT security a model for others
The Californian - Salinas

Natividad Medical Center is doing an exemplary job in protecting the personal health information of patients.

That’s the conclusion of a report by the Monterey County grand jury issued Monday. The grand jury looked into how well the county hospital was complying with HIPAA, the Health Insurance Portability and Accountability Act of 1996. The grand jury wanted to make sure Natividad wasn’t exposing the county to any exorbitant penalties with respect to breaches in patient health information.

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Children’s Hospital Oakland Will Pay You To Take This Home
ABC News

Are you interested in a free home? One sitting on the property of Children’s Hospital Oakland is up for grabs. The cute little white house has a couple bedrooms and even has a lemon tree out front. But if it sounds too good to be true, well, in this case it is. The free house will still cost you a lot of money. That’s because if you want it, you have to be willing to move it. We mean literally lift it from its foundation and then haul it off the property.

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Palomar Health’s Downtown Escondido Campus May Close
NBC SanDiego.com

A North County hospital that is losing more than $20 million a year may soon close its doors after six decades of treating patients. The board of directors for Palomar Health’s Downtown Escondido campus is expected to vote Wednesday on shutting down the facility, which has been on E. Valley Parkway since 1950. However, residents got a chance to weigh in on the decision Monday night at a public forum.

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Long Beach Memorial Medical Center names John Bishop new CEO
Long Beach Press-Telegram

Long Beach Memorial Medical Center announced a new chief executive officer Monday.

John Bishop will immediately assume CEO responsibilities for Long Beach Memorial, Miller Children’s & Women’s Hospital Long Beach, and Community Hospital Long Beach, succeeding former CEO Diana Hendel, who announced her resignation in March to focus on her health.

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