Latest California Healthline Stories
Patient Costs Increase Under Insurance Payment Method
A 2009 health insurance settlement required insurers to underwrite a new database that collects bills from insurers to calculate “usual and customary charges” for procedures in a given region. However, insurers were not required to use the database to calculate payments for out-of-network care and instead have used a calculation method based on Medicare rates that often results in lower provider reimbursements and higher patient costs. New York Times.
Calif. To Revamp 30-Year-Old Medi-Cal Computer System
California Auditor Elaine Howle recently announced that the state is developing a new computer system to handle Medi-Cal billing. The new system — called Health Enterprise — will replace the 30-year-old Medicaid Management Information System that currently processes billing. Capitol Weekly.
Report Identifies $7.3B in Operational Savings, Revenue Increases
A new California Taxpayers Association report outlines $7.3 billion in operational savings and non-tax “revenue enhancements” in state and local governments. The findings could help critics of tax hike plans developed for the November ballot. Sacramento Bee‘s “Capitol Alert.”
Prison Officials Release Plan To Reform System, Improve Inmate Care
The California Department of Corrections and Rehabilitation has released a plan for reorganizing state prisons and improving health care services for inmates. The plan seeks to end federal oversight of prison health care by the end of 2013. AP/Contra Costa Times et al.
CMS Actuary Foresees Medicare Savings From Health Care Reform Law
According to a report from CMS’ Office of the Actuary, provisions of the health reform law that curb excessive payments to some private insurers and enact new anti-fraud policies could help curb Medicare spending by more than $200 billion through 2016. Modern Healthcare et al.
Medicare Hospital Trust Fund Still Expected To Be Insolvent in 2024
A report from the board of trustees for Medicare and Social Security predicts that Medicare’s hospital insurance trust fund will become insolvent in 2024. The projected insolvency date has stayed stable since last year. AP/Washington Post et al.
Calif. Assembly Bill Targets ‘Try and Fail’ Drug Coverage
The California Assembly is considering legislation that would address health insurers’ use of step-therapy, in which patients are asked to try as many as five prescription painkillers before health plans agree to cover the drugs. Under the bill, insurers would be prohibited from asking patients to try more than two prescription medications before providing coverage. KQED’s “The California Report.”
Editorial Calls for Increased Hospital Data Transparency
A Sacramento Bee editorial argues that “improving state hospitals should not entail limiting the amount of legitimate information provided to the public.” The editorial adds that although the state must comply with federal patient privacy laws, it should “not hide behind privacy laws, obfuscate and otherwise effuse to release fundamental information.” Sacramento Bee.
Poll: Opinions on Reform Law Remain Unchanged, Knowledge Increases
A new Kaiser Family Foundation poll finds that public opinion on the federal health law remains unchanged from last month. However, more residents are aware of the law’s individual insurance mandate, according to the poll. Wall Street Journal‘s “Health Blog” et al.
FDA Unveils Criteria for Nanotechnology Products
In draft guidance released Friday, FDA described the approval process for food companies and cosmetic manufacturers that want to use nanotechnology in their products. The agency said that the tiny engineered particles are increasingly being used in FDA-regulated products, such as lotions and food, and require additional scrutiny. Officials have noted that nanotechnology is not inherently unsafe, but they caution that materials at the nano scale can pose different safety issues compared with larger materials. AP/Washington Times.