Latest California Healthline Stories
Post-Mortem on Physician Hiring Bills
A pilot program that has allowed some direct hiring of physicians in rural areas of California apparently generated a lot of interest in Sacramento. Three different bills were introduced to expand the scope of that pilot program, and all three of those bills failed.
In California, hospitals are not allowed to employ physicians directly, in order to maintain a kind of firewall between hospital administrators and the health care providers who make medical decisions.
But there is also a shortage of primary care physicians in rural areas of the state, so some medical centers were granted an exception to the no-direct-hiring rule, so that they could hire on their own doctor for their own facility. Many hospital administrators felt that suspension of the rule gave them a competitive hiring advantage.
Medicaid Waiver Bills Still in Play at Capitol
The legislative deadline passed more than week ago, but at least two health care bills are still at play in the Legislature.
Not only are two bills dealing with Medi-Cal waiver certain to get a vote when the legislature reconvenes to take up the budget, the legislation has several big factors in favor of its passage, according to health care expert Peter Harbage of Harbage Consulting.
“At the end of the day, the policy changes in the waiver and its funding are too valuable for California to pass up.”
End of Session Winners Wait on Governors Desk
The governor is expected to sign legislation into law that would create the state Health Benefits Exchange legislation. He has till the end of September to make up his mind about the exchange and other health care-related issues.
This is some of what’s pending:
• Seven other bills related to the pending federal health care law and coverage issues are before the governor (in addition to the two exchange bills, SB 900 and AB 1602).
California Set To Insure High-Risk Patients
On April 29, Governor Schwarzenegger signed legislation that established the state’s federally funded high-risk insurance pool. This week that insurance pool is accepting its first enrollee applications.
That means the government set up a complicated government program in about four months. In state bureaucracy terms, that is the blink of an eye.
“We’ve been working nights and weekends trying to make this happen,” Deputy Director for Legislative and External Affairs at the Managed Risk Medical Insurance Board Jeanie Esajian said.
How Budget Morass Could Spring One Bill From Limbo
The Assembly and Senate both passed a bill on the last day of the legislative session, but it ended up being put on hold after Republicans closed ranks and refused to approve it on concurrence.
According to the state’s Chief Clerk, E. Dotson Wilson, it is currently the only bill that could get a re-vote when the Legislature gathers to decide on the budget. AB 1542 by Dave Jones (D-Sacramento) would encourage establishment of patient-centered medical homes.
“Because it has an urgency clause, it is eligible to be taken up again when the legislature votes on the budget,” Wilson said. “There is a window there.”
Single Payer Goes Quietly Into That Last Night
All night long, Assembly watchers waited and wondered: When would the bill be presented to vote on establishing a single payer health system?
The answer was: Not this night. Not in this legislative session.
Political insiders sat around and wondered why Assembly speaker John Perez decided not to present a vote on SB 810 by Mark Leno (D-San Francisco), which had been passed in the legislature twice before, and vetoed twice before by Governor Schwarzenegger.
Hospitals May Need To Monitor CT Scan Radiation
There is no written record in hospitals whenever radiation, particularly CT scan radiation, is given in higher-than-prescribed doses. And that’s what AB 1237 by Alex Padilla (D-Pacoima) wants to change.
“We don’t know exactly what the risks are for accumulated radiation. But it could be pretty serious. This simply begins a data-keeping, a record at hospitals around the state,” Padilla said. “We want to make sure that whatever the dose it is, that’s what should be administered.”
The bill establishes procedures to track radiation dosage, by requiring that all CT scan dosages should be recorded electronically, and it orders an annual verification of equipment. Any incidents of over-radiation would be reported to the California Department of Public Health.
Medical Home Bill Passes Senate
In the last hours of a late-night vote, the Legislature passed a bill that establishes the Patient-Centered Medical Home Act of 2010. Passage of AB 1542 by Dave Jones (D-Sacramento) did not come easily. It failed a vote the day before, and only got the votes it needed at the end of the final day of the session.
(Update: New developments are covered in the Sept. 7 Capitol Desk.)
A relieved Dave Jones practically bounced out of Senate chambers when several Senate members changed their votes and the bill passed.
Rescission Bill Makes the Cut, Goes to Governor
Fiona Ma had the line of the day. The Speaker Pro Tem was leading the Assembly through its paces, through one bill after another, long into the day. In the late afternoon, she announced that she would lift the call vote on six items — usually a sign of wrapping up the day’s proceedings.
“Now don’t get excited,” Ma said, looking up from speaker’s desk. “We’re not going home yet.”
In fact, the Assembly and Senate worked all day, and then convened for rare night sessions yesterday. They passed a number of bills, including several health-related ones.
Should Insurers Raise Rates Whenever They Want?
Health insurers typically raise rates when customers reach a higher age bracket. It’s pretty simple, according to John Lovell of the California Association of Health Underwriters.
“The way premiums are raised is age brackets of 5 or 10 years,” Lovell said. “I always talk to my clients in the year they’re going to get a rate increase. The amount it goes up is just a trend — I notify my clients so they’re not surprised. It cuts down on the rate shock.”
But California policymakers have a different kind of rate shock in mind. The shock of two rate hikes in a year.