California Healthcare News Nov 24, 2014

California Healthcare News

  • In Brief: Cal-OSHA/CDPH Issues Workplace Guidelines on Ebola; Kaiser, Target Team On Retail Clinica

    Nov 20, 2014 By Payers & Providers Staff


  • Paid news articlePrime, Union Trade Barbs Yet Again

    Rhetoric Heats Up Over Daughters of Charity Deal

    Nov 20, 2014 By Ron Shinkman


    Prime Healthcare's often contentious relationship with California's labor unions flared anew this week, as the for-profit hospital system traded charges with the Service Employers International-United Healthcare Workers West.

    The SEIU-UHW has alleged that Prime overbilled Medicare to the tune of $93 million by admitting patients to the hospital for short hospital stays rather than keeping them in observation and not officially admitting them as inpatients.

  • Paid news articleUCSF Publishes Smoking, Driving Link

    Says Passengers Are Exposed to Toxic Chemicals

    Nov 19, 2014 By Payers & Providers Staff


    A new study by researchers at UC San Francisco has concluded that passengers in cars where someone else is puffing on a cigarette are at significant risk from toxic chemicals in secondhand smoke.

    According to the study, nonsmoking passengers sitting in a car for an hour with someone smoking demonstrated elevated levels of butadiene, acrylonitrile, benzene, methylating agents and ethylene oxide – chemicals all thought to contribute the greatest hazards to a person's health, including an elevated risk of cancer.

  • Paid news articleDMHC Faults Blues On Their Networks

    Insurers Failed to Provide Accurate Provider Information

    Nov 20, 2014 By Ron Shinkman


    A state regulator concluded that two of the state's largest health insurers misled consumers who purchased their plans through the Covered California health insurance exchange.

    In a blunt assessment of Anthem Blue Cross of California and Blue Shield of California, the Department of Managed Health Care concluded that both plans did not provide accurate rosters of physicians and other providers to those state residents who purchased coverage during the exchange's open enrollment period between last fall and early 2014.

  • In Brief: CDPH Fines Nursing Home $75,000; Hill Physicians Joins Anthem ACO

    Nov 13, 2014 By Payers & Providers Staff


  • Paid news articleKaiser NorCal Nurses Go On Strike

    Two-Day Walkout Focused Concerns on Safety

    Nov 13, 2014 By Payers & Providers Staff


    Some 20,000 nurses employed by Oakland-based Kaiser Permanente's Northern California division walked off their jobs on Tuesday, complaining of work conditions and patient safety during a two-day work stoppage.

    The strike involved nurses at 21 Kaiser hospitals and 35 clinics in 20 cities in the Bay Area, East Bay, San Jose and the San Joaquin Valley.

  • Paid news articleHealth Net Reports Quarterly Loss

    Signs Multi-Year Pact to Better Manage Enrollment Growth

    Nov 13, 2014 By Ron Shinkman


    Health Net, the Woodland Hills-based health insurer, reported robust enrollment growth during the third quarter of the year, but its confronting of mounting administrative costs pulled it into the red.

    The company reported a loss of $8.9 million for the quarter ending Sept. 30 on revenue of $3.6 billion.

  • Paid news articleUCSF Gets Granular On Sugar’s Impact

    Launches Website to Discuss The Sweetener’s Science

    Nov 13, 2014 By Ron Shinkman


    As the rates of diabetes, heart disease and other obesity-related illnesses continue to rise rapidly in the United States, the University of California at San Francisco has created an initiative intended to educate the public about an ubiquitous substance at the center of the issue: Sugar.

    The initiative, known as SugarScience, is being spearheaded by researchers at UCSF, with assistance from UC Davis and the Emory University School of Medicine.

  • In Brief: East Bay Physician Charged With Insurance Fraud; San Francisco Health Plan Begins Medication Management Program

    Nov 6, 2014 By Payers & Providers Staff


  • Paid news articleKaiser Says Type 1 Diabetes On Rise

    New Study Cannot Pinpoint a Specific Cause For Increase

    Nov 6, 2014 By Ron Shinkman


    The prevalence of type 1 diabetes has risen significantly in the U.S. between 2002 and 2009, according to a new study by researchers with Kaiser Permanente.

    The study included data on more than 2 million non-Hispanic white children and adolescents living throughout the United States, using the SEARCH for Diabetes in Youth disease registory.

  • CDPH Has Huge Nursing Home Backlog

    Audit Says Some 11,000 Complaints Not Fully Investigated

    Nov 6, 2014 By Anna Gorman


    The California Department of Public Health has failed to adequately manage investigations of nursing homes statewide, resulting in a backlog of more than 11,000 complaints – many involving serious safety risks to patients, according to an audit released last week.

    California State Auditor Elaine M. Howle found that the complaints had been open for a year on average – a time frame she called unreasonable and “very concerning.” Nearly 370 open complaints arose from situations that put patients in “immediate jeopardy,” meaning they caused or were likely to cause serious injury or death, according to the review, which looked at cases open as of April 2014.

  • Paid news articleProps. 45, 46 Lose By Wide Margins

    Supporters Blame Defeats on Low Turnout, Negative Ads

    Nov 6, 2014 By Ron Shinkman


    The two healthcare-related propositions on the election ballot were soundly defeated Tuesday after health plans and physician lobbies spent tens of millions of dollars on advertising against them.

    Proposition 45, which would have allowed the California Insurance Commissioner to veto any premium increase deemed unreasonable, lost by a 20-point margin, 60 to 40 percent. Proposition 46, which would have raised the current non-economic damages cap on medical malpractice suits from $250,000 to more than $1.1 million, was thrashed even more soundly, losing by a 66 to 34 percent margin.

  • In Brief: CDPH Adopts Ebola Quarantine Guidelines; AG Says Many Healthcare Breaches Are Avoidable

    Oct 30, 2014 By Payers & Providers Staff


  • Paid news articleDMHC Fines Arcadian Health $75,000

    Plan Failed to Tell Agency It Moved Members to Humana

    Oct 30, 2014 By Payers & Providers Staff


    In 2011, Kentucky-based managed care giant Humana Health Plan acquired Arcadian Health Plan, a small Medicare Advantage operator with just 26,000 enrollees in California.

    Arcadian's failure to inform regulators some two years after the deal closed that it was moving its members to Humana earned it a hefty fine from the Department of Managed Health Care.

  • Paid news articleCalifornia’s PAs: Well-Paid But In Debt

    OSHPD Survey On Profession First In Nearly 20 Years

    Oct 29, 2014 By Ron Shinkman


    The typical physician assistant practicing in California enjoys six-figure compensation, is juggling a significant student debt load and is more likely these days to be a woman and eyeing a career in emergency medicine or orthopedics than family practice.

    Those are among the findings of a sweeping survey of more than 3,400 physician assistants – nearly 40% of those practicing statewide – by the Office of Statewide Health Planning and Development. It's the first survey undertaken by OSHPD since 1998.

  • Paid news articleLeapfrog Grades Hospitals On Safety

    California Facilities Post Higher Than Average Scores

    Oct 30, 2014 By Ron Shinkman


    The 250 California hospitals surveyed by the Leapfrog Group for their safety have a bit of the Lake Wobegon syndrome: Most of them are above average.

    A total of 108 of the hospitals received a grade of “A” from the Leapfrog Group, the Washington, D.C.-based non-profit that measures safety and quality at inpatient facilities across the country. That's more than 40% of the total. Another 48 received “Bs,” meaning more than 60% of the hospitals statewide are above average.

  • Paid news articleIn Brief: CDPH Creates Ebola Hotline; Many Latino Children Have Issues Accessing Healthcare

    Oct 23, 2014 By Payers & Providers Staff


  • Paid news articleAnthem Partly Walks Back Rate Hike

    Reduces Small Group Increase After Jones Objects

    Oct 23, 2014 By Ron Shinkman


    A ballot proposition that would give the California Insurance Commissioner more authority to regulate health insurance rates has an uncertain future when it goes to voters next month, but Commissioner Dave Jones is apparently still able to use his office to soften payer moves to raise rates.

    Just hours after Jones’ office denounced a move by Anthem Blue Cross of California to increase premiums for 120,000 enrollees in small group plans an average of 9.8%, the insurer backed off the plan, instead saying it would raise rates only an average of 7.8%. Jones had asked for an increase of 2.1% instead.

  • Paid news article17 Facilities Cited For Privacy Breaches

    CDPH Has Issued Record Number of Penalties in 2014

    Oct 23, 2014 By Ron Shinkman


    At a time when concerns about patient privacy are regularly being raised by consumer advocates, the state’s hospital watchdog has been investigating and penalizing institutions with an approach that’s all but discreet.

    The California Department of Public Health has issued 22 citations against healthcare facilities for breaches of patient privacy so far this year -- a record since it began issuing penalties in 2009. But the agency tucked the information in a corner of its website so obscure that a CDPH public information officer asked a reporter to email him a link to the page in order to answer his questions.

  • In Brief: Betty Ford Survey Says Pain Patients Want To Give Up Drugs; UC Says Grants Have Big ROI

    Oct 16, 2014 By Payers & Providers Staff


  • Medicaid Expansion Drops ER Visits

    UCLA Study Shows Dramatic Plunge After Enrollment

    Oct 16, 2014 By Payers & Providers Staff


    A new study by UCLA researchers suggests that the overflow of patients into hospital emergency rooms as the result of Medicaid expansion quickly levels off after the new enrollees become acclimated to receiving steady access to healthcare.

  • Paid news articleOPA Releases Annual Care Report Card

    Kaiser Dominates Ratings For Care, Customer Service

    Oct 16, 2014 By Ron Shinkman


    The California Office of the Patient Advocate (OPA) issued its annual report card on the state's health plans on Wednesday, realigning the release of such data so that consumers can use it to selected plans during the open enrollment period that begins next month.

    Elizabeth Abbott, the OPA's director, said the report cards contained 2,000 different data points on the state's largest HMOs, PPOs and medical groups.

  • Paid news articleState On High Alert For Ebola Cases

    CDPH Coordinating With Hospitals For Potential Response

    Oct 16, 2014 By Ron Shinkman


    Although there have been no cases of the Ebola virus reported in California as of yet, the death of one patient in Texas and the subsequent infection of two nurses who cared for him have placed the state's healthcare providers in a state of high vigilance.

    The California Department of Public Health (CDPH) on Wednesday announced that it has activated the state's medical and healthcare coordination center and was negotiating with hospitals to act as designated facilities to treat patients in the state who might be stricken with Ebola.

  • In Brief: Workers' Comp System Could Save Millions With Drug Formulary; MemorialCare Medical Foundation Acquires Imaging Centers

    Oct 9, 2014 By Payers & Providers Staff


  • Paid news articleUCs Launch Center To Study Aging

    Will Focus Research on Age-Related Diseases, Treatments

    Oct 9, 2014 By Payers & Providers Staff


    Researchers at UC Berkeley and UC San Francisco have joined forces to create a new research center that will investigate the aging process and focus on creating new treatments to address age-related diseases.

    The center, known as the Glenn Consortium for Research in Aging, was funded by a $3 million grant from the Glenn Foundation for Medical Research in Santa Barbara.

  • Paid news articleKaiser Grants $1 Million For Ebola Care

    Money Goes to Two Relief Organizations Working in Africa

    Oct 9, 2014 By Payers & Providers Staff


    As the outbreak of Ebola has impacted the United States, Kaiser Permanente is trying to help contain the epidemic at its source.

    The Oakland-based Kaiser has donated a total of $1 million to two healthcare relief organizations working in West Africa: Doctors Without Borders and the International Medical Corps. Both received grants of $500,000 apiece.

  • Paid news articleMajority Of Hospitals Dinged By CMS

    223 Facilities Statewide to be Penalized for Readmissions

    Oct 9, 2014 By Ron Shinkman


    The Centers for Medicare & Medicaid Services plans to penalize a record number of hospitals for readmitting certain patients within 30 days of discharge. California hospitals are no exception, although they are faring better in this round than the average hospital nationwide.

    A total of 223 hospitals, or 64% in California, will be penalized under the Hospital Readmissions Reduction Program, according to CMS data. That's significantly lower than the nationwide average of 75% of hospitals being penalized.

  • Paid news articleMedical Debt Growing Patient Problem

    Healthcare Services Source of Much Bill Collection in U.S.

    Oct 9, 2014 By Ron Shinkman


    Californians and Americans as a whole may have more access to healthcare services as the result of the Affordable Care Act, but they are also slowly drowning in medical debt.

    A new study by NerdWallet concludes that Americans have been squeezed by the double whammy of the Great Recession and continually rising prices for medical services. The San Francisco-based healthcare finance research firm came to this conclusion by crunching data from the Centers for Medicare & Medicaid Services and other federal data, as well as commissioning a poll that was conducted on its behalf by Harris Interactive.

  • Paid news articleIn Brief: Catholic Bishops File Complaint Against California On Abortion Mandate

    Oct 2, 2014 By Payers & Providers Staff


  • Kaiser Grants $1.4 Million To Schools

    Districts Will Use Money to Improve Student, Staff Health

    Oct 2, 2014 By Payers & Providers Staff


    Kaiser Permanente has granted $1.4 million to 13 school districts in Southern California in attempt to make the lifestyles of both students and staff healthier.

    The grants are part of the Thriving School Partnership initiative, which Kaiser launched last year.

  • Paid news articleUCLA Gets $3 Million Federal Grant

    Focus On Limiting Smoking Exposure in L.A. Apartments

    Oct 2, 2014 By Payers & Providers Staff


    The UCLA Center for Health Policy Research has been awarded a $3 million federal grants to mitigate the effects of secondhand smoke on low-income Latino and African-American families who are living in Los Angeles.

    The grant will be used to implement a comprehensive action plan to reduce individual exposure to smoking in apartment buildings in L.A.

  • Paid news articleDMHC Fines Kaiser, Universal $150,000

    Plans Cited For Unfair Payment Patterns, Fiduciary Lapses

    Oct 2, 2014 By Ron Shinkman


    The Department of Managed Health Care levied fines last month against Universal Care and Kaiser Foundation Health Plan totaling $150,000.

    Universal, which is based in Signal Hill, was fined $100,000 for a variety of fiduciary violations, including failure to maintain a fidelity bond for all its officers and directors, engaging in unfair payment practices, failure to pay claims in a timely manner and fees and interest on late claims, and failure to maintain tangible net equity.

  • Paid news articleMedi-Cal Program Lacks Coordination

    Reports Says More “Whole-Person Care” is Required

    Oct 2, 2014 By Ron Shinkman


    A new report from a public interest research firm concludes that despite large safety net insurance expansions in California as a result of the Affordable Care Act, the provider system remains too patchwork and chaotic to provide appropriate care for the state's poorest and neediest residents.

    The report, authored by San Francisco-based John Snow, Inc. and underwritten by the Blue Shield of California Foundation, suggests the state needs to focus on what it calls “whole-person care” - an integration of health and social services that would improve outcomes and cut costs for providing services.

  • Paid news articleIn Brief: Hunn Departs Providence Health; St. Joseph Hoag Places Clinics In Apartment Complexes

    Sep 18, 2014 By Payers & Providers Staff


  • Paid news articleAnthem, So. Cal Hospitals Collaborate

    Vivity Health Expected to Offer Competitive Business Rates

    Sep 18, 2014 By Ron Shinkman


    In an apparent move to offer healthcare coverage to businesses at a lower price and with better integrated delivery of services, Anthem Blue Cross has teamed with Southern California's leading urban medical centers to create a new insurance product called Vivity.

    The managed care plan includes many of the major acute care providers in the Los Angeles area, including Cedars-Sinai Medical Center, the UCLA Health system, Good Samaritan Hospital, Huntington Memorial Hospital in Pasadena and the five-hospital MemorialCare system in Long Beach and Orange County. The participating hospitals and Anthem will divide any profits derived from Vivity.

  • UCLA Launches Telemedicine Initiative

    LiveHealth Online Aimed At Patients With Busy Schedules

    Sep 18, 2014 By Anna Gorman


    Patients looking for convenient medical appointments can now see UCLA Health System doctors using their cell phones, computers or tablets.

    It’s part of an ongoing effort at UCLA and elsewhere to extend alternatives to the in-person doctor visit to busy consumers outside rural areas.

  • Paid news articleExchange Gears Up For Enrollments

    Covered California Rolls Out Ad Campaign, New Grants

    Sep 18, 2014 By Payers & Providers Staff


    With the open enrollment period for 2015 now just weeks away, Covered California is trying to build on the success of its initial year by ramping up an $94 million outreach campaign.

  • In Brief: Employer Premiums Rise Modestly; Support For Props. 45, 46 Waning

    Sep 11, 2014 By Payers & Providers Staff


  • Paid news articleStartup Buys Citizens Choice Health

    Alignment Wants to Make Splash in Medicare Advantage

    Sep 11, 2014 By Ron Shinkman


    A well-funded Orange County startup has acquired a Medicare Advantage health plan to gain a toehold into the Southern California market.

    Irvine-based Alignment Healthcare purchased Cerritos-based Citizens Choice Health Plan for an undisclosed sum. Citizens Choice, which also goes by the name Honored Citizens Choice, had about 13,000 Medicare Advantage enrollees in Los Angeles and Orange Counties and was headquartered in Cerritos.

  • DMHC Fines Dental Plan $25,000

    Data Sent Directly to Physicians’ Smart Devices

    Sep 10, 2014 By Payers & Providers Staff


    The Department of Managed Health Care has fined United Dental Care of California $25,000 for failing to pay provider claims in a timely manner and with the appropriate interest, as well as underinsuring its corporate staff.

  • Paid news articleScripps Launches Monitoring Pilot

    Data Sent Directly to Physicians’ Smart Devices

    Sep 10, 2014 By Payers & Providers Staff


    San Diego-based hospital operator Scripps Health has launched a brief pilot project that will allow for remote monitoring of some of its most fragile patients through the smartphones and other devices carried by its medical staff.

    AirStrip, a Texas-based mobile healthcare firm, has agreed to provide its miniaturized monitoring devices to place on Scripps heart surgery, intensive care, trauma and other critically ill patients.

  • Paid news articleKaiser Acquiesces on $4 Million Fine

    Prefers Improving Mental Health Services Over Litigation

    Sep 11, 2014 By Ron Shinkman


    After months of wrangling with one of the state's health plan regulators, Kaiser Foundation Health Plan has thrown in the towel, agreeing to pay a large fine for limiting access to mental health services and improve its existing service.

    Kaiser will pay a $4 million penalty levied by the Department of Managed Health Care last year, although the Oakland-based insurer and healthcare provider said in a statement that the fine “was unwarranted and excessive, and (the DMHC) ignored the very compliance standards that they had expressly approved.”

  • In Brief: Most Anti-Prop. 45 Money Coming From Insurers; U.S. Attorney Files Suit Against Two Watsonville Nursing Homes

    Sep 4, 2014 By Payers & Providers Staff


  • DMHC Fines Safeguard Health $100,000

    Latest in Series of Penalties For Unfair Payment Patterns

    Sep 3, 2014 By Payers & Providers Staff


    The Department of Managed Health Care has fined Safeguard Health Plans $100,000 for engaging in what it determined was an “unfair” pattern of claims handling and payments.

  • Paid news articleA Preventative Care Delivery Twist

    Programs in Unconventional Settings Boost Compliance

    Sep 4, 2014 By Ron Shinkman


    A new study by UCLA researchers has concluded that the best way to provide preventative care to underserved populations may be to deliver it within their communities as opposed to waiting for them to show up and ask for it.

    An examination of 20 such preventative care outreach programs by the UCLA Center for Health Policy Research has concluded that they all provide far higher success rates in getting underserved and minority communities screened for conditions such as breast and colorectal cancers. Four of the programs are based in California, including three in San Francisco.

  • Paid news articleCDPH Says Underage Tobacco Sales Up

    First Increase Seen Since 2008; In-Store Signage Drops

    Sep 4, 2014 By Ron Shinkman


    A new report by the California Department of Public Health indicates that sales of tobacco to minors – which has generally been trending steadily downward over the past two decades – spiked upward sharply this year.

    In addition to the uptick in sales to buyers under the age of 18, there was also a significant drop in signage in stores that sell tobacco warning sales were prohbited to minors.

  • In Brief: Sharp Pulls Out of Pioneer ACO; Covered California To Add Dental Benefits

    Aug 28, 2014 By Payers & Providers Staff


  • Exchange Paying For Gender Changes

    Blue Shield Among Plans Providing Some Coverage

    Aug 28, 2014 By Anna Gorman


    Devin Payne had gone years without health insurance – having little need and not much money to pay for it.

    Then Payne, who had a wife and four children, realized she could no longer live as a man.

  • Paid news articlePrime Files RICO Suit Against Union

    Claims SEIU-UHW is Attempting to Destroy its Business

    Aug 28, 2014 By Ron Shinkman


    Prime Healthcare Services rarely hesitates to use bareknuckle tactics as part of its business operations. A lawsuit it has just filed against California's biggest healthcare labor union could be said to be "Exhibit A" of such conduct.

    The Ontario-based Prime has sued the Service Employees International Union-United Healthcare Workers, claiming the union had violated provisions of the Racketeering Influenced and Corrupt Organizations Act (RICO), a federal statute typically used to prosecute organized crime figures.


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