News Headlines

News Headlines
Health care news from around the state and nation

 

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Overseas Operations
HealthZette

Got your beach towel and sunglasses? Check. Novel you’ve been dying to dive into? Check. Passport? Check. Cane or walker, doctor’s number, and cash for surgery? (What?)

That’s right: If you’ve been busy collecting this stuff, you may be a patient who is part of a growing trend called medical tourism — Americans traveling abroad for surgeries, treatments and procedures instead of having them done here at home.

“I drove right up to Canada to get my Lasik eye surgery several years ago,” Mary Anne Donaghey, a wife and mom who lives in a suburb of Boston, told LifeZette. “I researched the Canadian doctor and the treatment protocol, and when it came down to it I could not ignore the cost — it was over 50 percent cheaper than here in U.S. It ended up being a great experience.”

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Health Law Revision Is Approved
New York Times

The Senate passed legislation on Thursday intended to protect small and midsize businesses from increases in health insurance premiums, clearing the bill for President Obama’s expected signature.

The action by Congress was a rare example of bipartisan agreement on how to revise the Affordable Care Act.

The bill, approved this week in the House and the Senate by voice vote, eliminates a provision of the law that would have imposed tough, potentially costly new requirements on businesses with 51 to 100 employees.

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Senate sends ObamaCare tweak to president’s desk
The Hill

The Senate on Thursday passed a bipartisan change to ObamaCare’s definition of a small employer by unanimous consent, sending the measure to President Obama’s desk.

The bill, called the Protecting Affordable Coverage for Employees (PACE) Act, deals with an obscure provision in ObamaCare that changed the definition of a small employer from one with 50 employees or fewer to one with 100 employees or fewer, beginning in 2016.

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Health insurers to receive a fraction of what they’re owed under ACA program
Washington Post

Health insurers in the marketplaces created by the Affordable Care Act will be reimbursed this year only 13 percent of the money they are owed under a program designed to help cushion the burden of covering large numbers of people who need expensive medical treatment.

Federal health officials said Thursday that insurers owed money through the three-year program are entitled to nearly $2.9 billion for coverage they provided in 2014. The government will pay them $362 million.

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Will nation follow California on healthcare for immigrants here illegally?
Los Angeles Times

Like many blue states, California enthusiastically embraced Obamacare, signing up millions for health insurance. Now, it’s venturing into a potentially costly and controversial new frontier of health policy: offering medical coverage to hundreds of thousands of people living in the country illegally.

In a matter of months, the number of California counties committed to providing low-cost, government-run medical care to such residents jumped from 11 to 48. And in June, Gov. Jerry Brown signed a state budget that for the first time funds healthcare for such children.

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Congress Passes Bill Easing Small Business Health Law Rules
New York Times

Congress approved bipartisan legislation Thursday aimed at preventing premium increases that some smaller businesses were expecting next year under President Barack Obama’s health care law.

The measure, which Obama is expected to sign, represents an uncommon instance in which both parties have rallied behind an effort to revamp part of Obama’s signature health care overhaul. Most congressional efforts to retool the statute have been Republican drives to repeal it or scale it back that Democrats have blocked.

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Don’t Repeal the Cadillac Tax
New York Times

Surprisingly, there appears to be one small area of bipartisanship in Washington: the desire to repeal the so-called Cadillac tax. It is a tax on super-expensive health insurance plans provided by some private companies to their employees. The tax would be paid by employers who sponsor these high-cost plans.

In 2018, it is scheduled to be the final aspect of the Affordable Care Act to go into effect. Republicans desperately want to show they can repeal some aspect of the health care law. Under pressure from unions, some Democrats, now including Hillary Rodham Clinton, want to eliminate or postpone the Cadillac tax, too.

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Why your doctor might start asking a lot more questions
Los Angeles Times

Many residents of Los Angeles County might soon find they are getting more attention and questions from their doctors.

That’s because L.A. Care Health Plan — a public health plan in L.A. County with more than 1.8 million members — received a $15.8-million federal grant this week to help change the way physicians interact with patients and deliver care.

The funding, part of the Transforming Clinical Practice Initiative, is supposed to help achieve a key goal of Obamacare: improve primary and preventative care and thereby reduce healthcare costs. The Affordable Care Act promotes the idea that keeping people healthy — both by providing quality care to patients and catching diseases early — prevents the need for expensive medical care, saving money in the long run.

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Hospital Care Unaffected By Quality Payments, GAO Finds
Kaiser Health News

Medicare’s quality incentive program for hospitals, which provides bonuses and penalties based on performance, has not led to demonstrated improvements in its first three years, according to a federal report released Thursday.

The Government Accountability Office examined the Hospital Value-Based Purchasing Program, one of the federal health law’s initiatives to tie payment to quality of care. Earlier this year Medicare gave bonuses to 1,700 hospitals and reduced payments to 1,360 hospitals based on their mortality rates, patient reviews, degree of improvement and other measurements.

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Insurers Face Health Overhaul Losses for 2014
ABC News

Health insurers will lose about $2.5 billion because patients covered through President Barack Obama’s health law last year were sicker than expected, according to government figures released late Thursday.

The Department of Health and Human Services released updated numbers for a program that helps stabilize premiums in the health care law’s insurance markets, which offer taxpayer-subsidized private plans.

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Insurers Find Out-Of-Network Bills As Much As 1,400 Percent Higher
Kaiser Health News

It’s common knowledge that consumers have to pay more money if they choose doctors or hospitals outside of their insurance plan’s network. But a new analysis prepared by the insurance industry seeks to show just how much more in each of the 50 states.

Out-of-network providers charged patients on average 300 percent more than the Medicare rate for certain treatments or procedures, according to the analysis of 2013 and 2014 claims data released Thursday by the America’s Health Insurance Plans. The industry group, which supports limiting out-of-network charges, found that some treatments were even more exorbitant — with out-of-network providers charging nearly 1,400 percent more than what is reimbursed by Medicare.

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Don’t put children’s program in Medi-Cal
Sacramento Bee

The California Children’s Services program is small but successful, helping 180,000 medically fragile children and young people obtain specialized care for the treatment of severe or chronic illnesses such as cerebral palsy, hemophilia, sickle cell anemia and cancer.

Serving about 30,000 families in the Central Valley, the program links them to physicians, therapists and clinics. It also indirectly helps people and families outside the program by encouraging the creation of centers of excellence that support anyone needing similar specialized care.

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Many Former Foster Youths Don’t Know They Have Health Care
National Public Radio

Laticia Aossey was flat on her back in an Iowa hospital bed with a tube up her nose, a needle for a peripheral IV stuck in one arm and monitors pasted to her body. It was early June 2014, a week after her 18th birthday, when a friend brought Aossey’s mail from home — including one ominous letter. Aossey’s health insurance was about to be discontinued.

“My heart dropped. I just wondered to myself, ‘Are they going to pull this tube out, unhook me from everything and roll me down to the street?’ ” Aossey said. “Could I get the medicine I needed?”

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Newly Insured Treasure Medicaid, But Growing Pains Felt
Kaiser Health News

The Affordable Care Act unleashed a building boom of community health centers across the country. At a cost of $11 billion, more than 950 health centers have opened and thousands have expanded or modernized.

In San Diego, new clinics have popped up on school campuses and busy street corners. Cramped storefront clinics have been replaced with gleaming, three-story medical centers with family medicine, radiology and physical therapy on site. They are outfitted to care for new immigrants in dozens of languages from Spanish to Somali.

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Adults With Insurance Often Still Have Unmet Dental Needs, Survey Finds
Kaiser Health News

Dental care ranked number one among health care services that people with insurance say they’re skimping on because of cost, a new survey found.

One in five adults reported that they had unmet dental care needs because they couldn’t afford necessary care, according to the brief by researchers at the Urban Institute’s Health Policy Center. People said they were more likely to go without dental care than prescription drugs, medical care, doctor or specialist care, and medical tests.

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Five things women should know about breast cancer
University of California

Dr. Laura Esserman is filled with hope this Breast Cancer Awareness Month. The UC San Francisco surgeon is gearing up for a five-year study that will tap into technology to improve breast cancer screening and patient outcomes.

Esserman leads the Athena Breast Health Network, a collaboration of the five University of California medical centers and partners that will soon launch the WISDOM study.

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With $100 million, a different kind of startup tackles brain diseases
San Francisco Business Times

UCSF will house one of three new neuroscience institutes aimed at creating new collaborations among neuroscientists, physicists, engineers and computer scientists to develop new technologies aimed at traumatic brain injury, Parkinson’s, Alzheimer’s disease and other brain conditions. Johns Hopkins University in Baltimore and Rockefeller University in New York will host the other two institutes, splitting more than $100 million from the Kavli Foundation and universities with the UCSF institute and four existing centers.

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Hot cancer immunotherapy field brings Xoma a potential half-billion dollar deal
San Francisco Business Times

Xoma Corp., whose stock crashed in July on the failure of its lead drug against an eye disease, said today it signed a potential $530 million licensing deal with Swiss drug developer Novartis AG for an experimental cancer immunotherapy treatment.

Xoma stock shot up 43 percent, or 32 cents per share to $1.07 in late trading Thursday. Initially, the deal disclosed earlier Thursday would give the Berkeley company (NASDAQ: XOMA) $37 million upfront from Novartis (NYSE: NVS). That would be a financial shot in the arm for a company with an accumulated deficit of $1.16 billion over its 31-year history and cash and equivalents of $51 million as of June 30.

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Court Rules Blue Cross, Blue Shield May Need To Pay State Health Premiums Tax
California Healthline

A state court ruled last week that two health care service plans may need to pay the state’s gross premiums tax because they may qualify as health insurers.

The health care service plans -– Blue Shield of California and Anthem Blue Cross — argued that they were regulated by the Department of Managed Health Care, not the California Department of Insurance, and were not insurers subject to the gross premiums tax.

But California’s Second District Court of Appeals ruled on Sept. 25 in Myers v. State Board of Equalization that those service plans’ business seems to be built on selling and administering indemnity-based insurance policies, so the gross premium tax may apply to them.

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UCI gets $19 million grant to speed up practical use of scientific discoveries
Orange County Register

UC Irvine’s Institute for Clinical & Transitional Science will receive $19 million over four years from the National Institutes of Health to continue efforts to speed up the process of bringing ground-breaking scientific discoveries into the real world.

The grant will allow the university to continue work it started with a $20 million award received in 2010.

According to a statement issued by UC Irvine, it is the only medical research institution in Orange County to have earned this competitive award.

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Work begins on Loma Linda University Health’s new children’s hospital tower
San Bernardino Sun

Work has begun on the new Loma Linda University Health medical center and children’s hospital tower here.

The new hospital structure will be 267 feet tall, making it the second highest building in the Inland Empire, after Morongo Casino, which is 330 feet, officials said.

The groundbreaking for this project will occur in spring, although some demolition and earth moving has begun.

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