Latest California Healthline Stories
Preliminary Ruling on Autism Treatment Coverage Stands
A preliminary ruling by a Sacramento Superior Court judge denying an attempt by HMOs to receive a quick decision as to whether health insurers must cover a certain autism treatment will stand. The California Association of Health Plans, which had filed a lawsuit claiming that only lawmakers can mandate a new insurance benefit, did not request a hearing following the tentative ruling. A new court date on the issue has not been set. Sacramento Business Journal.
Health Plan Issues Arise in Transition Plan for ADHC
APS Healthcare — one of the firms that the state could contract with under the adult day health care services transition — earlier this year paid $13 million to the U.S. Department of Justice to settle allegations that it did not provide services to hundreds of Georgia Medicaid beneficiaries. Meanwhile, the California Association of Health Plans — a trade group representing managed care plans — has sent a letter to the state Department of Health Care Services stating that managed care plans “are not responsible for” administering services previously provided by ADHC centers and that state officials should “temper beneficiaries’ expectations” of what benefits might be offered. California Watch.
State Awards Denti-Cal Contract to Delta Dental
The California Department of Health Care Services has awarded Delta Dental of California a new contract to provide benefits for Denti-Cal, the dental program under Medi-Cal. The benefits cover 6.9 million beneficiaries and could be worth up to $7.3 billion. Delta Dental has administered Denti-Cal since the program began in 1974. San Francisco Business Times, Sacramento Bee.
Poll: Knowledge About Health Reform Benefits Lower Now Than in 2010
A recent poll released by the Kaiser Family Foundation concludes that uninsured individuals generally know less about the benefits of the federal health reform law than they did when a similar poll was conducted last year. The Hill‘s “Healthwatch” et al.
Rate Regulation Bill Stalls; Other Health-Related Measures Advance
Legislation that would allow regulators to reject health plan rate hikes has been shelved in the Senate. Proponents of the bill plan to drum up support for it for next year. Meanwhile, lawmakers have passed several other health-related measures. Capitol Weekly et al.
Increasing Number of Parents Are Exempting Children From Vaccines
More California parents are opting not to have their children vaccinated by exercising personal belief exemptions, which allow children to enter school without having some or all inoculations. The trend is raising concern among health officials. Santa Cruz Sentinel.
California Health Care Personnel News Update for August 2011
Peter Lee has been approved as the first executive director of the California Health Benefit Exchange. Meanwhile, Cal eConnect CEO Carladenise Edwards is stepping down as head of the health information exchange organization and will serve as a senior adviser.
San Francisco Coalition Aims To Reduce Costs, Improve Patient Care
Blue Shield of California has collaborated with hospitals and physicians to create an accountable care organization for about 26,000 public employees in the San Francisco area. The model aims to improve patient care and reduce costs. San Francisco Chronicle.
Lab-Testing Firm Settles Case on Medi-Cal Overbilling
Last week, California Attorney General Kamala Harris announced that Laboratory Corporation of America will pay $49.5 million to settle a lawsuit alleging that the company overcharged Medi-Cal. North Carolina-based LabCorp is the second largest provider of medical laboratory testing services in California. The lawsuit — filed by Hunter Laboratories, a separate diagnostic lab-testing company — claimed that the company charged Medi-Cal more than five times the amount it charged other customers for certain tests. The LabCorp settlement comes after Quest Diagnostics agreed to pay the state $241 million to resolve a similar lawsuit earlier this year. Similar cases are pending with three other defendants. Sacramento Business Journal et al.
GOP Governors Introduce Medicaid Cost-Cutting Plan
The Republican Governors Association in a report released last week outlined 31 initiatives for cutting Medicaid costs. The proposals include repealing the federal health reform law and its “maintenance of effort” provision, which requires states to maintain current benefit levels; converting Medicaid into a block grant system; and requiring the federal government to “take full responsibility for the uncompensated care costs of treating” undocumented immigrants. Wall Street Journal‘s “Washington Wire” et al.