Latest California Healthline Stories
Calif. Doctor Shortage Could Lead to Higher Rates on Exchange Plans
California’s physician shortage is causing some providers to demand higher reimbursement rates from insurance plans offered through the state insurance exchange. Observers say the demand for increased reimbursements could result in higher premium costs and could cause some providers to withdraw from exchange plans. San Jose Mercury News.
Covered Calif. Enrollment Portal, Doctor Directory Remain Offline
After being taken down last week because of software glitches, the enrollment portion of the Covered California website remained offline as of Sunday. Meanwhile, Covered California officials have announced that the physician and hospital directory on the exchange website will remain offline for several months. KCRA, San Francisco Business Times‘ “Bay Area BizTalk.”
Former Hospital CEO, Calif. Senator Charged in Insurance Fraud Case
Michael Drobot, former CEO of Pacific Hospital of Long Beach, has agreed to plead guilty to charges that he paid physicians to refer patients to the facility for spinal surgery, one of the most lucrative services offered. In addition, Drobot reportedly agreed to testify that state Sen. Ronald Calderon was involved in the case. AP/U-T San Diego et al.
DOL Issues Final Rule on ACA Employee Coverage Waiting Period
Last week, the U.S. Department of Labor issued a final rule that says eligible workers will not have to wait more than 90 days for their employer-sponsored insurance to take effect. The rule takes effect Jan. 1, 2015, and could affect as many as 500,000 eligible workers each year. Modern Healthcare‘s “Vital Signs.”
UCSF, Samsung Partner for Mobile Health Innovation Lab
On Friday, UC-San Francisco and Samsung announced plans to establish a center that will aim to speed up the development of mobile health technology. The partnership will focus on preventive health care and the new lab will be located on UCSF’s Mission Bay campus. MedCity News.
Calif. Health Officials Confirm 15 Measles Cases
As of Friday, California health officials have confirmed 15 cases of measles across the state, with the most cases occurring in Los Angeles County. Officials are urging state residents to obtain a measles vaccination, especially if they are planning to travel to other countries where the disease is more prevalent. KQED’s “State of Health” et al.
Stanford Uses Data Analytics To Track Off-Label Rx Use
A research team from Stanford University recently compiled a list of 403 distinct off-label drug uses to help determine which medications merited further clinical trials and potential additional FDA approvals. The team used de-identified medication data from the Stanford Translational Research Integrated Data Environment, which includes two million patients treated at the university’s health system over the past decade. EHR Intelligence.
Editorial Criticizes Lack of Information on DSS Website
A Contra Costa Times editorial criticizes the California Department of Social Services’ website, saying that the site offers a list of long-term care facilities “but no useful or reliable information on the licensing status of each, much less the documentation on past violations.” The editorial argues, “Fixing [the website] should not be hard,” adding, “The biggest obstacle is not money; it’s a will to get the job done. That seems to be lacking at the agency.” Contra Costa Times.
UnitedHealth Fined $20K Over Unfair Payment Practices
UnitedHealth Group will have to pay a $20,000 fine after Department of Managed Health Care surveys found that its behavioral health plan, called Optum Health, had been engaging in unfair payment methods and denying provider claims. Specifically, the surveys found that payment authorization was withdrawn for 11 out of 20 claims after the services had been provided and that Optum rejected five out of 50 claims after authorization had been issued. Payers & Providers.
Specialty Drugs Cost More Under Some Exchange Plans, Study Finds
A new Avalere Health analysis finds that many exchange plans charge beneficiaries a coinsurance of as much as 60% of the drugs’ costs instead of set copayments. While such practices could raise consumers’ expenses, the charges are expected to be offset by savings from other Affordable Care Act provisions. The Hill‘s “Healthwatch.”