Latest California Healthline Stories
Nearing Consensus on Dense Tissue Bill
In case you missed it, yesterday was the day to ask people if they’re dense. The Legislature last session officially approved Aug. 8 as Are You Dense Day. Not surprisingly, the occasion yesterday marked the reintroduction of a bill that would notify women if their dense breast tissue might interfere with mammogram results.
SB 1538 by Joseph Simitian (D-Palo Alto) has passed the Legislature before despite opposition from provider groups. Last year the governor vetoed it.
“Dense breast tissue can appear white in a mammogram, and cancer can appear white in a mammogram,” Simitian said at yesterday’s Assembly Committee for Appropriations hearing.
Standards Open Exchange Doors for Qualified Health Plans
Insurers, often overlooked in the discussion about who benefits from health care reform, came one step closer to participation and potential profit when the California Health Benefit Exchange released its 263-page definition of a qualified health plan.
California’s LIHP a Big Success
The Low Income Health Program, launched 20 months ago, already has more than 400,000 Californians signed up. Health care experts gathered in Sacramento yesterday to discuss one of the successes in California’s health reform effort.
“We hear about a lot of issues people have, but the issue that rises to the top is the LIHP,” said Agnes Lee, health policy advisor to the Assembly speaker’s office.
“Among the doom and gloom of the state budget, there is a bright spot out there. LIHP is one of those rare examples of an innovative, forward-thinking program … and this is something the nation is definitely looking at, as something significant,” Lee said at yesterday’s conference, “Low Income Health Program: Evolution,” sponsored by the Blue Shield of California Foundation.
Mass. Panic: Did State Wait Too Long To Try Cost Control?
Experts are cautiously optimistic that a new Massachusetts law will be a much-anticipated cure for the state’s rising health spending. But others say that the state’s new cost controls — which could be a model for the nation — aren’t the right prescription for reform.
Appropriations Committee OKs Oral Chemo Bill
The Senate Committee on Appropriations yesterday approved AB 1000 by Henry Perea (D-Fresno), which requires insurers to cover oral chemotherapy medication.
“It’s a big day for cancer patients in California,” Assembly member Perea said. “We’ve been working on this since the beginning of last year, and it’s been a hard fight, the insurance companies have come out firing at it.”
Overall, it was a busy day for the Appropriations committee and the Legislature, which returned from summer recess yesterday. The current session only lasts for the next few weeks, before going on final recess — so the legislative docket will be full this month. The Legislature has until Aug. 31 to pass all bills for the year.
Exchange Maps Out Plan for Next Year
The state Health Benefit Exchange board finalized and submitted its request to federal officials for a $196 million Level 1.2 establishment grant — essentially mapping out the exchange’s plans over the next year.
Exchange executive director Peter Lee made the announcement at the board’s July 19 meeting in Oakland.
“We have submitted our establishment funding grant, what we call our Level 1.2 grant, to ensure our continued building of our state-based exchange,” Lee said. “The funding request itself is a demonstration of the partnership that is so vital to the success of the exchange.”
Safety-Net Hospitals Face Funding Cuts on Two Federal Fronts
Safety-net hospitals are facing a double-whammy of funding cuts: The Affordable Care Act lowers Medicaid payments to hospitals for uncompensated care and changes in Medicare reimbursements could mean further reductions in payments to safety-net hospitals.
State Delays Not-for-Profit Requirement for Adult Day Centers
The Department of Health Care Services extended the not-for-profit deadline for potential providers of the Community Based Adult Services program.
Organizations providing adult day health care services now have until Jan. 1, 2013 to become not-for-profit, a new stipulation by the state to be eligible to receive Medi-Cal funding. The previous deadline was July 1, 2012.
The six-month delay in establishing not-for-profit status was done, in part, because the state will need a substantial number of former Adult Day Health Care providers to become CBAS providers.
First We Need To Agree on the Problem, New Jersey Doc Says
Jeff Brenner, a physician in Camden, New Jersey, is deeply frustrated by the health care system in America.
“The bulk of federal debt is health care,” Brenner said. “It’s 18% of the economy, and we’re exploding on a sea of debt. And it’s the system itself. It’s the system and the rules we’ve made. The system is headed for crisis and the question is, how fast will it get there.”
“The problem is, we don’t have a common agreement about what’s causing the problem, so we can’t bend the cost curve if we don’t agree on the problem,” said Brenner, founder and executive director of the Camden Coalition of Healthcare Providers.
Outsourcing May Grow as Health System Evolves
The health care industry, no stranger to outsourcing, may be looking for outside help more often and with a wider lens as the health care delivery system evolves.