- California Healthline Original Stories 2
- California Marketplace May Require Insurers To Pay Agent Commissions
- Health Reform Roils Downton Abbey
- Covered California & The Health Law 1
- Based On Latest Enrollment Numbers, Covered California Now 'Running In Place'
- Marketplace 2
- Zenefits Could Face Misdemeanor Charges In California, Felony Charges In Washington
- Startup Gets $45M To Fight Baffling Lung-Scarring Disease
- Public Health and Education 2
- Porn Performers To Protest Proposed State Regulations, Saying Rules Stem From Stigma Not Science
- Flu Season Remains Mild Even As San Diego Sees Bump In Cases
Latest From California Healthline:
Covered California’s Executive Director Peter Lee said the measure is needed to keep insurers from slicing commissions to avoid enrolling the sickest patients. (Chad Terhune, 2/18)
This season, Downton Abbey has a new plot line that has health wonks on the edge of their seats: a heated debate about hospital consolidation that closely parallels what’s going on in the U.S. health care system today. Jenny Gold filed this story for Marketplace. (Jenny Gold, 2/18)
Sign up to get the daily edition in your inbox
Summaries Of The News:
Despite Covered California's $29 million marketing campaign, many uninsured Californians continue to say they can't justify paying for health insurance. Meanwhile, a new startup insurer falters in the land of the giants.
The San Jose Mercury News:
Obamacare: Are Covered California's Numbers Plateauing?
With Covered California's announcement Wednesday that 1.57 million Californians selected health plans during its third open enrollment period, at least one health care expert believes that the nation's bellwether state in implementing the Affordable Care Act is now essentially running in place. Although the latest numbers don't say how many people have paid for their plan to complete their enrollment -- the only figure that really counts and which will be available in a few months -- some experts say that the net gain from last year's 1.3 million total could be minimal. (Seipel, 2/17)
Oscar Debuts In California With Extremely Low Enrollment
Oscar Insurance Corp. expanded to California this year. But the New York-based startup health insurer, known for its tech-based philosophy and subway ads, enrolled very few people. A little more than 2,000 Californians selected an Oscar health plan on the public exchange as of Feb. 7, according to figures from Covered California, the state's insurance exchange. That represents a miniscule 0.1% of the 1.57 million people who renewed or chose a 2016 plan on California's exchange. (Herman, 2/17)
The cyberattack forced Hollywood Presbyterian Medical Center to return to pen and paper for its record-keeping.
The Associated Press:
Hospital Paid 17K Ransom To Hackers Of Its Computer Network
A Los Angeles hospital paid a ransom in bitcoins equivalent to about $17,000 to hackers who infiltrated and disabled its computer network, the medical center’s chief executive said Wednesday. It was in the best interest of Hollywood Presbyterian Medical Center to pay the ransom of 40 bitcoins — currently worth $16,664 dollars — after the network infiltration that began Feb. 5, CEO Allen Stefanek said in a statement. (Dalton, 2/17)
Los Angeles Times:
Hollywood Hospital Pays $17,000 In Bitcoins To Hackers Who Took Control Of Computers
“The malware locks systems by encrypting files and demanding ransom to obtain the decryption key. The quickest and most efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key,” Hollywood Presbyterian CEO Allen Stefanek said. “In the best interest of restoring normal operations, we did this.” Stefanek said patient care was never compromised, nor were hospital records. (Winton, 2/17)
Hospital Pays Hackers $17,0000 To Unlock EHRs Frozen In 'Ransomware' Attack
Healthcare organizations, along with small businesses and schools, make good targets for ransomware attacks because they don't typically have the sophisticated backup systems and other resilience measures that are typical at large corporations, said Lillian Ablon, a cybersecurity expert with the RAND Corp., a California think tank. For example, two smaller healthcare organizations—a three-physician surgical practice in 2012 and an 18-bed critical-access hospital in 2014—were hit by ransomware attacks. The smaller ransom amount in the Hollywood Presbyterian case is more in line with customary ransomware demands, according to security experts. The demands typically track with the nuisance value of not having to restore databases and computer systems. (Conn, 2/17)
The Justice Department was looking into the overuse of implantable cardiac defibrillators, which cost about $25,000. San Francisco-based Dignity Health and its 18 affiliated hospitals were among the 508 total number of institutions involved in the probe. Dignity will pay $5.9 million over the billing allegations.
Feds Wrap Up National Probe Into Cardiac Devices; 51 More Hospitals Settle
nother 51 hospitals will pay the government to get out from under a federal probe into the suspected overuse of implantable cardiac defibrillators. The U.S. Justice Department said the settlements announced Wednesday, which tally to $23 million, mark the “final stage” of the far-reaching investigation. More than 500 hospitals in all have settled with the government in connection with the investigation. (Schencker, 2/17)
Dignity Health Pays $5.9M To Settle False Claims Act Allegations
San Francisco-based Dignity Health settled with the U.S. Department of Justice for $5.9 million to resolve False Claims Act allegations that they improperly billed Medicare for implantation of cardiac devices, Justice Department officials announced Wednesday. Dignity Health, and its 18 affiliated hospitals were among the most recent batch of 51 hospitals nationwide to settle with the Justice Department. In 2015, the department settled with 457 hospitals for more than $250 million. The final 51 hospitals will pay the Justice Department more than $23 million. (Albarazi, 2/17)
In other news, California, as one of two states that allow whistle-blowers to file lawsuits alleging fraud against private insurers, might see an increase in such cases —
Lawsuits Filed Under California, Illinois Insurer Fraud Laws May Increase
California got a $3.1-million piece of the settlement pie when drugmaker Warner Chilcott agreed to pay the federal government $125 million in October over allegations it defrauded Medicare and Medicaid. But the state did much better in a second, lesser known settlement with the drugmaker just two months later. It got $11.8 million. (Schencker, 2/17)
Both states have opened investigations on the startup, which admitted to having its employees sell insurance without the proper licensing.
The San Francisco Business Times:
Zenefits Executives And Employees Could Face Criminal Charges
Regulatory agencies in California and Washington caution that Zenefits and current or former employees could face criminal charges related to the alleged sale of health insurance without proper brokers' licenses. In Washington state, a decision on whether to pursue legal penalties could come in a matter of weeks, according to a spokeswoman for the Office of the Insurance Commissioner. (Rauber, 2/17)
Pliant Therapeutics Inc.'s CEO Dr. Bernard Coulie says the company's founders have discovered a pill that they believe is highly selective in inhibiting a specific protein on a certain cell type that is found to drive fibrosis.
The San Francisco Business Times:
Highly Selective Startup Snags $45M To Take On Deadly Lung Disease
While a handful of companies are targeting a deadly and baffling lung-scarring disease, the CEO of a Redwood City spinout from UCSF believes his company has some key advantages: a well-defined target and a group of scientific founders that are among the best in the world. Pliant Therapeutics Inc. scored $45 million in a Series A round from Third Rock Ventures in its quest to stop — and perhaps even reverse — idiopathic pulmonary fibrosis, or IPF. The company hopes to push its lead drug into the clinic in 2018. (Leuty, 2/18)
The state Division of Occupational Safety and Health is scheduled to vote on whether to mandate the use of condoms and safety goggles on set.
The Associated Press:
California Considers Condoms For Porn Actors
Condoms could be coming to porn studios across California if the state agency in charge of enforcing workplace safety adopts proposed new regulations aimed at protecting actors who make adult films. The state Division of Occupational Safety and Health was scheduled to vote on the regulations following a hearing Thursday in Oakland. (Rogers, 2/18)
The Los Angeles Daily News:
Porn Performers Set To Protest Thursday Vote Requiring Condoms, Eyewear On Film Sets
More than 100 adult film performers plan to gather in Sacramento Thursday to protest an expected ruling by California regulators that mandates condoms and eyewear for actors on all porn sets statewide. The protests are in response to regulations drawn up by the state’s Occupational Safety and Health Standards Board, produced after more than six years of discussions and public hearings about protecting actors from bloodborne pathogens and other bodily fluids. But adult film performers say such protections go too far. The use of “personal protective equipment” for eyes, for example, has been interpreted as goggles, which actors have said will ruin the aesthetics and fantasy of pornographic films. (Abram, 2/17)
California Porn Industry Protests Rules Mandating Condoms
Adult film executives are complaining that proposed state health and safety regulations threaten to drive the industry out of the state. California regulators with the Division of Occupational Safety and Health (Cal/OSHA) will vote on new rules Thursday that would require performers to use condoms, dental dams, and even eye gear on set. (Dembosky, 2/17)
The county reported its sixth flu-related death, but that number is far lower than last year's 66. In other news, cars with illegal defective device software may have taken a toll on public health, and the San Francisco AIDS Foundation has named its new CEO.
The San Diego Union-Tribune:
Flu Caseload Spikes In San Diego
The number of confirmed flu cases in San Diego County spiked last week, lending a new dynamic to what’s still a generally mild season at a time of year when influenza activity typically peaks. (Sisson, 2/17)
Green Car Reports:
Illegal VW Diesel Emissions: Tallying Public Health Damage
It's clear that the Volkswagen TDI diesel cars equipped with illegal "defeat device" software have contributed to a significant amount of extra air pollution. Some of the affected models were found to emit up to 35 times the legal levels of nitrogen oxides. But how does that looks when viewed in terms of public health? (Edelstein, 2/17)
The San Francisco Business Times:
San Francisco AIDS Foundation Names New CEO
The San Francisco AIDS Foundation has named a Chicago public health official as its new chief executive officer, filling the vacancy created when former CEO Neil Giuliano left at year-end to head a Phoenix business group. Joe Hollendoner, the nonprofit's new top executive, will start May 2. (Rauber, 2/17)
Their letter states that there is no credible research that backs up the overly rosy projections of economic growth touted by Bernie Sanders' campaign. In other 2016 election news, Donald Trump, when asked about Americans having access to health care, says as president he would work out a deal with the hospitals.
The Wall Street Journal:
Democratic Economists Say Bernie Sanders’s Math Doesn’t Add Up
Four leading Democratic economists sharply criticized Sen. Bernie Sanders for citing “extreme claims” about the economic effects of his campaign proposals, the latest in a stream of critiques from Democrats over details of his platform. Criticism has also been directed at Mr. Sanders’s plan for a single-payer, government-run health-care plan, with critics saying he underestimates the costs of providing health care to all Americans and overestimates the revenue his plan would generate. (Timiraos and Meckler, 2/17)
The Dallas Morning News:
Trump Speaks In MSNBC Town Hall To Counter Cruz, Rubio Appearance On CNN
When asked if all Americans would have access to health care, as they are supposed to under the Affordable Care Act, [Donald] Trump said that he would work out a deal with hospitals and communities. (Wise, 2/17)
Trump On Sanders: 'We're Very Similar' In This Way
Consider a political outsider who is tapping into voter anger, delivering a populist message and drawing raucous thousands to rallies. He wants the hedge fund managers to pay more taxes and argues that there should be health care for everyone. Sound familiar? (Timm. 2/17)
Meanwhile, media outlets fact check the candidates' health care claims —
The Washington Post's Fact Checker:
Trump’s Truly Absurd Claim He Would Save $300 Billion A Year On Prescription Drugs
Reining in the cost of prescription drugs has become a major issue in the 2016 presidential campaign. Both former secretary of state Hillary Clinton and Sen. Bernie Sanders (D-Vt.) have proposed detailed plans to control prescription-drug prices, with both calling for Medicare to negotiate directly with prescription-drug companies to get lower prices. Republican candidates have also decried high prescription-drug costs, though generally their policy proposals have been thinner. Developer Donald Trump ... also says he wants to allow Medicare to negotiate directly with drug companies. In fact, he makes the bold claim that he would save $300 billion a year. Is this even remotely possible? (Kessler, 2/18)
The Cincinnati Enquirer:
Fact Check: Kasich's Medicaid Expansion Exceeded Projected Costs
Gov. John Kasich's expansion of Medicaid services to lower-income Ohioans — over the objections of GOP lawmakers — hasn't won him many friends among conservatives. (Balmert, 2/17)
Veterans calling an overloaded crisis hotline run by the Department of Veterans Affairs can encounter long wait times or voicemail, according to a watchdog report. Meanwhile, two different couples fight against the VA's policy on in vitro fertilization coverage.
The Associated Press:
Report: Calls To VA Suicide Hotline Went To Voicemail
A suicide hotline operated by the Department of Veterans Affairs allowed crisis calls to go into voicemail, and callers did not always receive immediate assistance, according to a report by the agency's internal watchdog. The report by the VA's office of inspector general says calls to the suicide hotline have increased dramatically in recent years, as veterans increasingly seek services following prolonged wars in Iraq and Afghanistan and the aging of Vietnam-era veterans. (2/17)
For Fertility Treatment, Wounded Veterans Have To Pay The Bill
The Pentagon's health care system for active duty troops covers IVF. The Department of Veterans Affairs for veterans doesn't. A law passed in 1992 made it illegal for the VA to pay for IVF, which some people oppose because embryos are often destroyed in the process. In the decades since Congress banned IVF for the VA, the procedure has become much more common. And about 1,400 troops came back from Iraq and Afghanistan with severe injuries to their reproductive organs. Thousands more have head injuries, paralysis or other conditions that make IVF their best option. (Lawrence, 2/17)
Couple Fights To Change Law Preventing IVF Coverage For Vets
A current law that is the product of anti-abortion politics prohibits the Department of Veterans Affairs from covering the cost of in vitro fertilization for any of the estimated 1,800 veterans who have suffered damage to their reproductive organs. (Martin, 2/17)