Latest California Healthline Stories
AARP: Many Calif. Seniors Need More Health Coverage
Only about 25% of California residents older than age 50 say they have the amount of health care coverage they need, according to a new AARP survey. David Pacheco, president of AARP California, said, “Older Californians agree on what they need to live their best lives, but a significant number of them feel those needs are not currently met.” Sacramento Bee.
Legislators Aim To Avoid Ballot in Shifting First 5 Funding to Medi-Cal
State lawmakers are revising a plan to divert $1 billion from First 5 to Medi-Cal children’s services. Lawmakers said that if they take the funds on a one-time basis, they could do so with a two-thirds vote of the Legislature instead of a ballot measure. Sacramento Bee‘s “Capitol Alert.”
Nurses Group Pursues Stringent Penalties for Staffing Violations
The California Nurses Association is sponsoring legislation that aims to tighten enforcement of state-mandated nurse staffing ratios. The bill would allow the Department of Public Health to issue fines of up to $10,000 for each violation. Payers & Providers.
Study: Workplace Wellness Programs Cut Health Costs
Businesses that offer wellness programs to employees can slow the growth rate of health care costs by 15%, according to a Highmark study published in the American Journal of Health Promotion. Researchers said wellness program participants might pursue preventive care services more frequently than nonparticipants because wellness programs often provide information about such services. Healthcare Finance News.
Critics Raise Questions About Physician-Owned Facilities
Physician-owned treatment centers are coming under scrutiny from critics who say the facilities represent a conflict of interest. Critics say physicians who “self-refer” patients to facilities that they own could be ordering unnecessary procedures and adding to soaring health care costs. Washington Post.
House, Senate Panels Look Into Ways To Combat Medicare Fraud
A Senate committee and two House subcommittees held hearings on ways to reduce the growing prevalence of Medicare fraud. A new report states that unless more action is taken to curb fraud, Medicare “is fiscally unsustainable in the long term.” Modern Healthcare et al.
Officials To Schedule Medical Parole Hearings for 10 California Inmates
Ten incapacitated inmates will be scheduled for hearings under the state’s new medical parole law, according to corrections officials. California pays about $50 million annually to care for inmates who receive care in hospitals. Los Angeles Times, Sacramento Bee‘s “Capitol Alert.”
California Lawsuit Takes Aim at Defining ‘Medical Necessity’
A lawsuit that goes to trial in Los Angeles Superior Court this week raises questions about whose opinion should carry the most weight when determining what is medically necessary. A lawyer for the plaintiff argued that the opinion of the patient’s physician should carry more weight than a doctor hired by an insurance company to review claims. A lawyer for the defense could not be reached, but the insurer in court briefs argued that its policy’s coverage was “plain, clear and unambiguous.” Los Angeles Daily Journal.
Jones May Use Power To Cut Malpractice Insurance Rates
California Insurance Commissioner Dave Jones has called on six medical malpractice insurers to lower their rates following a 2009 analysis of annual insurance company reports. Jones’ spokesperson Ioannis Kazanis said the analysis of 2009 data found red flags related to loss ratios, or the percentage of premiums insurers spend on claims. The Department of Insurance still needs to analyze the insurance companies’ 2010 reports, as well as additional data. If the rates are determined to be excessive, it might be July before the insurers are able to complete a new rate filing, according to Joel Loucher, Jones’ top aide for rate reductions. After the adjusted filings are vetted by DOI, insurers would have 90 days to implement the lower rates. Capitol Weekly.
Anthem Blue Cross in Spotlight Again Over Planned Rate Hikes
Anthem Blue Cross of California has informed many of its individual policyholders that it plans to increase premiums on May 1. The latest rate hike plans come less than a year after the insurer scaled back its proposal to raise premiums by as much as 39%. San Francisco Chronicle.