Latest California Healthline Stories
Five Calif. Medical Professionals Headed to Trial Over Alleged Medicare, Medi-Cal OxyContin Scam
This summer, five medical professionals in Los Angeles, Orange and San Bernardino counties will go to trial over charges that they took part in a scam to divert 900,000 OxyContin pills and defraud Medicare and Medi-Cal of $2.7 million in reimbursements for the drugs. The defendants include three pharmacy owners, a physician assistant and an unlicensed physician assistant. Orange County Register.
Officials Haven’t Provided a Timeline for Processing Medi-Cal Backlog
California health officials have not provided any estimate as to how long it will take to process a backlog of 900,000 Medi-Cal applications. Officials said that about half of the applications were filed in the past 45 days — the maximum amount of time the state has to process applications. Kaiser Health News/San Jose Mercury News.
Sonoma County Providers Work To Help Patients Manage Diabetes, Avoid Readmissions
Medical professionals in Sonoma County have launched an initiative, called the Diabetes Care and Limb Preservation, aimed at helping patients with diabetes better manage the disease and avoid hospital readmissions. Nearly 26% of local hospital admissions in Sonoma County involve patients with diabetes, according 2011 discharge data analyzed by UCLA. Santa Rosa Press Democrat.
Intel-GE Care Innovations has launched an institute in Roseville that aims to set remote care management standards and provide validation for programs that adequately provide such services. The institute will be designed and headed by Al Lewis, a disease management and research expert and the founder and president of the Disease Management Purchasing Consortium in Massachusetts. Sacramento Business Journal.
On Wednesday, the Supreme Court unanimously ruled that cell phone searches conducted by law enforcement officials without a warrant are unconstitutional, in part because of the potential for phones to contain personal health care data. The ruling overturns a decision by a California state appeals court after a criminal conviction in a case, Riley v. California. Modern Healthcare.
Many Uninsured Gained Coverage Through Medicaid During ACA Open Enrollment, Urban Institute Finds
A new Urban Institute Health Policy Center report suggests that many of the uninsured people who gained coverage under the Affordable Care Act did so through Medicaid. Researchers noted that while the number of Medicaid beneficiaries increased by about 3.6 million between September 2013 and early March 2014, the number of uninsured declined by about 5.4 million people during the same period. Modern Healthcare‘s “Vital Signs.”
Avalere: Exchange Enrollees Could Face Higher Premiums in 2015
A new Avalere Health analysis finds that many enrollees in the Affordable Care Act’s health insurance exchanges could have significantly higher premiums in 2015 if they keep their current low-cost plans. The report shows that silver plans in some states could lose their benchmark status, which would affect federal subsidies. Kaiser Health News‘ “Capsules” et al.
Low-Cost California Hospitals Generate Higher Profits, Survey Finds
A new survey of 74 non-teaching hospitals in California finds that low-cost providers generate less revenue than higher-cost facilities but often tend to have higher profits. Specifically, low-cost hospitals had an average profit margin of 4.7%, compared with a deficit of 1.6% at high-cost hospitals. Payers & Providers.
HHS Proposes Automatic Re-Enrollment for Federal Exchange
Yesterday, HHS released new guidance and a proposed rule that would allow most U.S. residents who have health insurance through HealthCare.gov to be automatically re-enrolled in their existing plans next year, similar to the renewal process for employer-sponsored coverage. Officials said the state-run insurance exchanges also could adopt the automatic re-enrollment feature or submit an alternative renewal proposal. New York Times et al.
Report: Limited-English Speakers Underrepresented in Exchange
A Greenlining Institute report finds that Californians who do not primarily speak English are underrepresented in the state insurance exchange. The report offers several recommendations, including hiring a diversity officer and offering online materials in 13 commonly spoken languages. Sacramento Business Journal et al.