Latest California Healthline Stories
Report: Some California Hospitals Still Rated as Being Highly Collapsible
Office of Statewide Health Planning and Development data show that in San Bernardino County, more than 40 hospital buildings are rated as highly collapsible. Hospital officials say they are facing financial challenges in trying to comply with seismic safety rules. San Bernardino Sun.
Authorities Bust L.A.-Based Insurance Fraud Operation
Last week, investigators charged 14 individuals, including two physicians, with operating a Los Angeles-based scheme to illegally obtain prescription medication. The indictment also states that Los Angeles-based Lake Medical Group improperly billed Medicare and Medi-Cal for $6 million worth of services that were unnecessary or never performed. Authorities said that the scheme was in operation between August 2008 and February 2010 and that the clinic used “cappers” to recruit patients who were given a prescription for the painkiller OxyContin, which typically costs $6 per pill. After the prescriptions were filled, they were sold on the black market for about $25 apiece. The indictment also accuses some defendants of using patients’ identities and Medicare information to obtain OxyContin. United Press International et al.
National Health Service Corps Has Nearly Tripled in Size
Last week, HHS announced that the National Health Service Corps — a federal program that places clinicians in underserved communities — has almost tripled in size from about 3,600 members in 2008 to 10,000 this year. The program provides scholarships and loan repayments to health care providers who commit to practice for two to four years in underserved communities. Funding provided by the federal health reform law and the 2009 economic stimulus package has allowed HHS to provide about $900 million to the providers, who serve about 10.5 million patients in underserved areas. Washington Post, The Hill‘s “Healthwatch.”
CMS Unveils Quality Ratings for Medicare Advantage Plans
On Wednesday, CMS released its 2012 Medicare Star Quality Ratings, which rates Medicare Advantage plans based on 36 measures. Kaiser Permanente operates four of the nine MA plans that received five-star ratings. Top-scoring plans can enroll new members at any time, instead of just during the open enrollment period, which runs from Oct. 15 to Dec. 7. Meanwhile, a recent Kaiser Permanente survey found that just 18% of Medicare beneficiaries are aware of the star ratings and just 2% know their current plan’s rating. New York Times‘ “Prescriptions” et al.
Colleges Partner To Offer Hybrid Nursing Program
Beginning in fall 2012, Humboldt State University and California State University-San Bernardino will offer graduates of College of the Redwoods’ nursing program the chance to earn their bachelor’s or master’s degree in nursing through a new joint online program. Under the program, registered nurses can complete their general and prerequisite courses at HSU and their nursing courses online through CSU-San Bernardino. HSU Dean of Professional Studies John Lee said that the program is not designed to replace HSU’s nursing program, which will be phased out by the end of the fall 2012 semester. Eureka Times-Standard.
Report Finds Insurers in Most States Do Not Face Much Competition
A Kaiser Family Foundation report concludes that health insurers face “modest” competition in many states. According to researchers, one insurer covered at least 51% of consumers in the small group market in 24 states and Washington, D.C. Modern Healthcare.
Eating Disorder Ruling Sparks Debate Over Mental Health Parity
The insurance industry and patient advocates are monitoring the effects of a recent federal court’s ruling that California health insurers must cover residential treatment for mental health conditions such as anorexia under the state’s Mental Health Parity Act. New York Times.
California Hospital News Roundup for the Week of October 14, 2011
Eisenhower Medical Center has received accreditation to become a teaching hospital and plans to start training physicians in 2013 to help address primary care physician shortages. Meanwhile, Los Angeles County officials opened the Martin Luther King Public Health Center.
Opinion: Calif. Medicaid Case Key to Reform Law Goals
A case before the Supreme Court to determine whether health care providers and Medicaid beneficiaries can sue states over reimbursement rates could have a significant effect on whether the health reform law “can meet the goal of expanding health care access by broadening eligibility for Medicaid,” former CMS Administrator Bruce Vladeck and American University law professor Stephen Vladeck write in a New York Times opinion piece. The case stems from Medi-Cal reimbursement rate cuts that the California Legislature approved in 2008 to help address the state budget shortfall. The authors ask, “if beneficiaries or providers can’t enforce the equal access provision, who will?” California officials and the Obama administration argue that HHS will enforce the equal access mandate, they note. However, “the department utterly lacks the financial, legal, logistical and political wherewithal to enforce the provision,” they write. They conclude that “the Obama administration may be complicit in eviscerating Medicaid — and setting back the broader goal for ensuring that all Americans have access to quality health care.” New York Times.
House Democrats Offer Recommendations to Debt-Reduction Panel
House Democrats are urging the federal debt-reduction committee to allow implementation of the health reform law to move forward. They also are encouraging the panel to avoid making Medicare and Medicaid cuts and to maintain the Medicare eligibility age. Politico et al.