Latest California Healthline Stories
Assembly To Consider Bill Capping Out-of-Pocket Rx Drug Costs
A bill that would place limits on how much health plans can charge enrollees for outpatient prescriptions will be considered by the Assembly this month. Health insurers have pushed back against price caps, saying it could drive up premiums. Modern Healthcare.
Study: Medi-Cal Beneficiaries See Gaps in Access to Health Care
A study finds that California Medicaid beneficiaries face “significant” gaps in access to care compared with individuals who are enrolled in work-based health plans. Meanwhile, a companion report finds that Medi-Cal beneficiaries have similar access to providers as Medicaid beneficiaries nationwide. Payers & Providers.
DMHC Cites Medical Group for Balance Billing
The Department of Managed Health Care has determined that the Chase Dennis Emergency Medical Group violated California law by balance billing 122 enrollees of the Sistemas Medicos Nacionales health plan since early 2009. Balance billing refers to out-of-network providers charging patients for the difference between what patients’ insurers cover and what providers’ charge for the service. DMHC did not levy a fine against the medical group, which agreed to cease and desist the balance billing and refund any incorrect payments. Payers & Providers.
San Francisco Officials Raise Concerns About Exchange Plan Costs, Effect on Low-Income Residents
Officials in San Francisco are worried that health plans sold through Covered California are unaffordable for the city’s most vulnerable residents. They say that even with federal subsidies, premiums, copayments and deductibles can still amount to hundreds or thousands of dollars annually. Los Angeles Times.
On Tuesday, the Nevada Board of Examiners voted to approve $200,000 more to continue fighting a San Francisco lawsuit over the busing of patients with mental illnesses to California. In the lawsuit, San Francisco is seeking $500,000 in reimbursement costs for treating 29 patients with mental illnesses and wants an order barring Nevada from sending any more patients to the state. AP/Capital Public Radio’s “KXJZ News.”
VA’s Patient-Centered Community Care Program Plagued With Problems, Report Finds
The Department of Veterans Affairs’ Patient-Centered Community Care program — a program allowing veterans to seek care outside of the VA health system — has been plagued with care delays and improper scheduling practices, according to a VA Office of Inspector General report. Overall, the report identified care delays, cost overruns and poor scheduling practices. As a result, most facilities had either scaled back the PCCC program or dropped it entirely. FierceHealthcare.
Number of Cancer-Related Deaths Expected To Climb
The U.S. cancer death rate is declining, although the overall number of cancer deaths is increasing because of an aging population, according to a CDC report published in Preventing Chronic Disease. The researchers estimated that between 2007 and 2020 cancer deaths will increase by more than 10% among men and black women and less than 5% among white women. HealthDay/Philadelphia Inquirer.
CVS To Leave Chamber of Commerce Over Tobacco Policies
CVS Health says it plans to leave the U.S. Chamber of Commerce after recent revelations that the chamber has advocated for tobacco deregulation in foreign countries. The chamber says it does not aim to promote tobacco use but rather is working protect intellectual property rights. Washington Post‘s “Wonkblog” et al.
Out-of-Pocket Costs Increased Slightly Over the Last Year, Study Finds
A new study published in Health Affairs shows modest increases to out-of-pocket costs over the last year, countering predictions that such costs would increase significantly under the Affordable Care Act. The study found the amount patients spent per physician visit increased by 3.5%, or about $1. The Hill.
Primary Care Adherence Linked to Fewer ED Visits Among Californians
A new study finds that previously uninsured Californians who adhered to their primary care provider after obtaining health coverage were less likely to visit an emergency department or hospital. The researchers concluded that changing “patients’ care-seeking behaviors is fundamental to improving care and health outcomes while reducing costs.” Health Affairs.