California Healthcare News Jan 31, 2015

California Healthcare News

  • Paid news articleIn Brief: Most Covered California Enrollees Kept Plans; CDPH Lifts WIC Mortatorium

    Jan 29, 2015 By Payers & Providers Staff


  • Paid news articleState’s Opening Salvo On E-Cigarettes

    CDPH Issues Health Advisory; Legislation on Use Pending

    Jan 29, 2015 By Ron Shinkman


    The California Department of Public Health issued a scathing report on electronic cigarettes Wednesday, calling them unsafe, overtly tempting to children and woefully underregulated.

    The agency, which also issued a formal health advisory on electronic cigarettes -- commonly known as e-cigarettes -- warned that their increasing popularity threatened to undo decades of successful smoking cessation efforts in California.

  • Paid news articleDMHC Fines Kaiser Plan $90,000

    Cited For Failure to Redact, Disclose Arbitration Cases

    Jan 29, 2015 By Payers & Providers Staff


    The California Department of Managed Care fined Kaiser Foundation Health Plan $90,000 earlier this month for failing to properly redact arbitration cases submitted to the agency.

    The DMHC makes such cases publicly available, but requires that the litigants, provider names and other portions of the case be redacted so as to respect patient privacy rights.

  • Paid news articleBarriers Posed In Cancer Screenings

    Study Says Some Chinese-American Californians Lag

    Jan 29, 2015 By Payers & Providers Staff


    Chinese-American immigrants in California with limited English language proficiency and low health literacy are much less likely to undergo crucial cancer screenings, according to a new study.

    The study focused on more than 1,400 Asian-American women and men. Although many large swaths of Asian-Americans are well assimilated into the U.S., up to 58% of immigrants from China have issues with English language proficiency, according to the study.

  • CDPH Fines Nursing Home $75K; Sutter, Blue Shield Still At Impasse

    Jan 22, 2015 By Payers & Providers Staff


  • Paid news articleCigna Enters Into 3 ACO-Like Pacts

    Care Coordinated For UCLA, Scripps And Facey Patients

    Jan 22, 2015 By Payers & Providers Staff


    Health insurer Cigna has entered into three accountable care-like arrangements with major providers in Southern California.

    The arrangements between Cigna and Scripps Health in San Diego, the UCLA Medical Group and Facey Medical Group in the San Fernando Valley were announced this week. They began on Jan. 1.

  • Paid news articleLong-Term Care Workers Have It Tough

    Despite Rising Demand, Sector Has Low Pay, Turnover

    Jan 22, 2015 By Payers & Providers Staff


    A new study by the University of California at San Francisco paints a fairly bleak picture of one of the healthcare sector's fastest-growing workforces: Long-term care employees.

  • Paid news articleNorcal’s Under-Immunization Problem

    Kaiser Study Underlines Trend During Measles Outbreak

    Jan 22, 2015 By Ron Shinkman


    A new study by Kaiser Permanente has identified clusters of underimmunized children in Northern California that took even researchers by surprise.

    The study, part of a larger look at vaccination preference undertaken by the Patient-Centered Outcomes Research Institute, was released this week as a measles outbreak in California continues to grow, prompting one Southern California county to order some households to self-quarantine their school-age children.

  • Paid news articleIn Brief: The Camden Group Acquires Illinois Consulting Firm

    Jan 15, 2015 By Payers & Providers Staff


  • Paid news articleDMHC Fines Health Net, Aetna $400K

    Penalties Tied to 2011 Data Breach and Other Violations

    Jan 14, 2015 By Payers & Providers Staff


    The Department of Managed Health Care has fined Health Net and Aetna a combined $400,000 due to violations of state law.

    Woodland Hills-based Health Net was fined $200,000 by the agency in connection with a loss of data connected to a migration project that occurred in 2011.

  • Paid news articleMeasles Outbreak Grows Some More

    CDPH Confirms 28 Cases Tied to Disneyland Visits

    Jan 15, 2015 By Payers & Providers Staff


    The California Department of Public Health has upped the number of cases of measles tied to visits to the Disneyland Resort to 28, and suggested that more cases could be reported in the short-term.

    The CDPH originally said last week there had been seven cases tied to those who patronized the Anaheim landmark late last year. It is believed that victims of the outbreak coud continue to spread the disease until Jan. 10, according to the agency.

  • Paid news articleUnion Cites Maternity Cuts in Prime Bid

    SEIU Says Far Fewer Births Occurring at Some Hospitals

    Jan 15, 2015 By Ron Shinkman


    As the Feb. 15 deadline for Attorney General Kamala Harris to make a decision allowing Prime Healthcare Services to purchase six hospitals from the Daughters of Charity Health System draws near, charges about the chain's business practices have intensified.

    The most recent missive from a major labor union opposed to the pending deal includes accusations that Prime has slashed women's healthcare services at properties it has acquired in the past.

  • In Brief: Health Net, John Muir Health Form ACO, Tom Williams Departs IHA

    Jan 8, 2015 By Payers & Providers Staff


  • Paid news articleJob-Based Coverage Continues Slide

    More Californians Lost The Benefit Between 2009-2012

    Jan 8, 2015 By Ron Shinkman


    In California, the reforms of the Affordable Care Act may have arrived just in time to save workers who have been losing their employer-based healthcare coverage in record numbers.

    That's the conclusion of the UCLA researchers, who in the latest “State of Health Insurance in California” report detected a continued erosion in work-based healthcare benefits.

  • CDPH Identifies Measles Outbreak

    Cases Tied to Recent Visits to Disneyland Resort

    Jan 8, 2015 By Payers & Providers Staff


    The California Department of Public Health reported on Wednesday that there had been an outbreak of measles within the state connected to recent visits to the Disneyland Resort in Anaheim.

    The CDPH confirmed seven measles cases from five different areas of the state, two others in Utah, and three other suspected cases that remain under investigation.

  • Paid news articleUCSF Admits To Balance-Billing Patients

    Medical Group Sought Money From Blue Shield Enrollees

    Jan 8, 2015 By Ron Shinkman


    A medical group affiliated with University of California San Francisco and the Bay Area's largest safety net provider has admitted it illegally balance-billed emergency room patients for more than five years.

    According to a settlement reached between the leadership of the San Francisco General Hospital Medical Group and the Department of Managed Health Care, the group had been balance billing members of a Blue Shield of California PPO between January 2009 and March of 2014, apparently assuming the plan was not regulated by the DMHC and the Knox-Keene Health Act that governs managed care plans in California.

  • In Brief: Sean Parker Funds Allergy Research Center At Stanford; Kaiser Opens New Redwood City Hospital

    Dec 18, 2014 By Payers & Providers Staff


  • Suit Alleges Defective Spinal Hardware

    Connected to Pacific Hospital’s Workers’ Comp Operation

    Dec 18, 2014 By Payers & Providers Staff


    Two patients who underwent spinal surgeries at a Long Beach hospital that recently closed under growing accusations of workers' compensation fraud has sued the physicians involved, claming defective hardware was implanted in their bodies.

    The suits were filed by Abraham Pena, 35, and Frank Gomez, 62. Both received spinal implants at the former Pacific Hospital of Long Beach

  • Paid news articleChiang Opposes Prime Hospital Deal

    Says Care at Daughters of Charity Hospitals Could Suffer

    Dec 18, 2014 By Ron Shinkman


    California Controller and Treasurer-Elect John Chiang has expressed concerns to California Attorney General Kamala Harris regarding the acquisition of the Daughters of Charity hospital chain by Ontario-based Prime Healthcare Services.

    “I am concerned that Prime's very low credit rating and its exposure to potential liabilities associated with existing litigation introduces a level of worrisome risk that may distort Prime's healthcare and workforce decisions, leading to potential detriment to the communities served by Daughters,” Chiang wrote to Harris last week.

  • Paid news articleConsumer Group Raises Flags On HIE

    Claims Cal INDEX is Short on Information For Participants

    Dec 18, 2014 By Payers & Providers Staff


    A major advocacy group has warned consumers against participating in a new statewide health information exchange (HIE) initially seeded by two of the state's largest health plans.

    Santa Monica-based Consumer Watchdog, which regularly butts heads with healthcare entities, has recommended avoiding the Cal INDEX HIE until its management answers a variety of questions about its operations.

  • Paid news articleMore Big Health Plan Fines From DMHC

    $132,000 Issued During First Few Days of December

    Dec 18, 2014 By Ron Shinkman


    The California Department of Managed Health Care is ending 2014 with a regulatory flourish, handing down five five-figure fines totaling $132,000 during the first few days of December.

    The biggest penalty was levied against Oakland-based Kaiser Foundation Health Plan. It was fined $75,000 for its 2010 refusal to provide a response to a patient grievance within 72 hours and a series of violations related to that incident.

  • In Brief: Covered California Enrollment Robust; Child Vaccination Rate Increases

    Dec 11, 2014 By Payers & Providers Staff


  • L.A. Care’s Cal Medi Connect Plan: Improving Care for California’s Most Vulnerable Patients

    Health Plan Provides Support to Physicians and Patients to Ease Transition, Including Continuity of Care Options

    Dec 10, 2014


    With so many changes going on in healthcare these days, physicians and their eligible patients understandably have many questions about the various programs available to them thanks to the Affordable Care Act. Recently, Cal MediConnect has become a popular topic of discussion for doctors and individuals eligible for both Medicare and Medi-Cal.

  • Paid news articleCan Computers Outwork Doctors?

    Cedars-Sinai Study Says They Obtain Better Patient Info

    Dec 10, 2014 By Ron Shinkman


    The notion that a computer can replace some of the functions of a human being has been explored in popular culture multiple times, but Cedars-Sinai Medical Center is now suggesting that an Internet-based questionnaire whose data is automatically aggregated is better at obtaining data from patients than actual doctors.

    That's the conclusion of a new study conducted by the Los Angeles-based hospital, which noted that such questionnaires can do a better job of obtaining, aggregating and presenting information to gastroenterologists.

  • Paid news articleBlue Shield Will Buy Care1st Health

    Move is Intended to Propel Carrier Into Medi-Cal Market

    Dec 11, 2014 By Payers & Providers Staff


    San Francisco-based Blue Shield of California has broken into the Medi-Cal market with the purchase of Care1st Health Plan.

    Care1st, is based in Monterey Park, just east of downtown Los Angeles, and was founded by a group of physicians and hospitals in 1994.

  • Paid news articleDMHC Fines Blue Cross $50,000

    Says It Deviated From Its Own Patient Grievance Policies

    Dec 11, 2014 By Ron Shinkman


    The California Department of Managed Health Care has fined Anthem Blue Cross of California $50,000 for what the agency concluded was a deliberate thwarting of the enrollee grievance process.

    According to DMHC records, Anthem denied an enrollee's request in 2012 to undergo the duodenal switch form of bariatric surgery, and was contacted by the agency to conducted an independent medical review.

  • Kaiser CEO Speaks Out On Race Issues

    Bernard Tyson Wants More Empathy And Collaboration

    Dec 11, 2014 By Payers & Providers Staff


    Chief executive officers of major healthcare organizations rarely take potentially charged political stances, but Kaiser Permanente Chief Executive Officer Bernard J. Tyson has called for more empathy regarding the experiences of African-American males and more dialogue and understanding between police and the communities they serve.

    Tyson, who became CEO of the Oakland-based Kaiser last year and was also appointed chairman of the organization in January, noted in an opinion piece that despite his heading a company with annual revenue of $55 billion a year, he is still eyed as a suspected shoplifter in stores, has been lectured in restaurants regarding the staff’s desire he leave tips, and has had people lock their car doors and cross to the other side of the street when he is out exercising.

  • In Brief: Job Forecast Fairly Bullish On Growth; CMS Says Spending Increases Lowest Ever Recorded

    Dec 4, 2014 By Payers & Providers Staff


  • Few Elderly Californians Get Fall Advice

    UCLA Study Says Tumbles Kill More Than 1,800 Annually

    Dec 4, 2014 By Payers & Providers Staff


  • Paid news articleGood Samaritan Will Link To Guam

    Gets $417,560 Telemedicine Grant From The USDA

    Dec 4, 2014 By Ron Shinkman


    Good Samaritan Hospital in Los Angeles has secured a grant from the U.S. Department of Agriculture to provide telemedicine services to the nation's most remote territory.

    The hospital received a $417,560 grant from the USDA that would allow members of its medical staff to provide care via teleconferencing at six public health sites on the island of Guam.

  • Paid news articleDigoxin Linked To High Death Rates

    Kaiser Researchers Find Connection to Atrial Fibrillation

    Dec 3, 2014 By Payers & Providers Staff


    A new study by Kaiser Permanente researchers concludes that a common heart medicine could be deadly when prescribed to certain patients with atrial fibrillation.

  • Paid news articleHospital Mortality Rates Remain Stable

    Few Dramatic Changes Between 2011 and 2012 Data

    Dec 4, 2014 By Ron Shinkman


    The mortality rates in California's hospitals were fairly stable in 2012, with patients dying from specific medical conditions and surgeries at about the same rates as they had in the prior two years.

    The Office of Statewide Health Planning and Development released the data on 193 hospitals statewide earlier this week, and there were few variations reported, although some large hospitals did struggle in some categories.

  • 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.


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