Latest California Healthline Stories
Reimbursement for Emergency Transport Becomes Law
It’s been a busy week for Gov. Jerry Brown (D), and it will get busier. Brown has until midnight Sunday to approve or reject the stack of bills sent to him by the Legislature.
Since the end of last week, Brown has signed 104 bills into law and rejected 10. Among the approvals were a number of health-related measures:
Quality Ratings Offered in Medicare Enrollment Window
Open enrollment for Medicare starts at the end of next week. This week, the federal government launched its online service to help people make Medicare decisions. This year, ther service offers a little something extra, according to David Sayen, the regional administrator for CMS.
“This enrollment period is different,” Sayen said. “For the first time, we’re rewarding quality.”
Medicare Advantage plans now will be rated for quality of care. Part D prescription drug plans will continue to be rated for quality.
How Long Can We Avoid Long-Term Care?
At a conference in Sacramento last week, advocates kept calling it a crisis in care in California — and at the same time acknowledging that citizens’ and policymakers’ eyes seem to glaze over whenever the subject of long-term care comes up.
Given the huge swell of about-to-be-seniors who will need care in California, it’s certainly an important subject. One of the touchstones of the conference was that the long-term care world needs a new, less scary way of framing the issue — it needs to develop a new language.
Because it can be so difficult to engage Californians on the subject, the legislative infrastructure has not yet been fully set up. According to Diana Dooley, secretary of the Health and Human Services Agency, there is a lot of room right now for input on the subject.
UC-Davis Wins Emergency Services Lawsuit
The courts have sided with UC-Davis Medical Center, ruling this week that Sacramento County must pay for emergency services for indigent patients.
Superior Court Judge Lloyd Connelly said the county has a responsibility to pay for indigent care, whether the county contracts with a specific provider of those emergency services or not.
“The judge rejected every defense the county had to not pay us,” UC-Davis attorney David Levine said. “He conclusively confirmed that they owe us money, and they have to pay us.”
Budget Cuts Could Put Developmentally Disabled ‘in Danger’
Yesterday, The Arc of California filed a lawsuit in U.S. District Court in Fresno, saying that state officials have violated federal law by shortchanging programs for people with developmental disabilities.
The Arc, a national advocacy organization that began in 1953 as NARC — the National Association for Retarded Children — changed its name to The Arc in 1992.
“We want to stop the state from violating federal law, with both their direct and indirect payments,” according to lead attorney Bill McLaughlin.
Legislative Hearing Looks at Rural Health
The list of rural health issues is a long one, according to Steve Barrow of the California State Rural Health Association. But it can be summed up by one statistic, he said.
“In the rural areas, we have 30% of the state’s Medi-Cal patients, and we have 10% of the state’s population,” Barrow said.
Barrow was one of the presenters at a recent bipartisan legislative hearing on rural health issues, presided over by Assembly members Alyson Huber (D-El Dorado Hills) and Linda Halderman (R-Fresno).
Misreporting of Health Billing Down
Bruce Lim was pretty happy. He’s the deputy director in charge of audits and investigations for the Department of Health Care Services. A biannual review of potential fraud in fee-for-service medical billing found that — across the board — there were far fewer financial red flags than in the past.
“Bottom line, the trend lines are very favorable,” Lim said. “The total potential exposure to errors and to potential fraud has decreased. If you look at the positive numbers, 94.5% were billed and paid appropriately, that’s extremely positive.”
The outlier, Lim said, was the adult day health care program, which he said had trouble making sure patients fit “medical necessity” criteria.
A consumer advocacy group took on the chair of the Senate Health Committee at the end of last week, and it has stirred up Sacramento.
The ad was in reaction to the legislative decision to delay a vote on AB 52 by Mike Feuer (D-Los Angeles) and Jared Huffman (D-San Rafael), the proposal to regulate health insurance rate increases.
According to Jamie Court of Consumer Watchdog, Sen. Ed Hernandez (D-West Covina) was responsible for a lot of the resistance to that measure. Watchdog ran a television advertisement that attacked Hernandez for financial ties to Kaiser Permanente and for how he treated one member of the public at a hearing.
Caregivers’ Stress Remains Hot Topic
UCLA researcher Geoff Hoffman is a little alarmed. His study took a look at the health risks of caregivers in California and found that the emotional and financial load of stress on caregivers in California may be causing the caregivers themselves to develop chronic health conditions.
“There appears to be a high level of distress and risky health behaviors in caregivers,” Hoffman said. “Smoking, binge drinking and poor diet.”
Ironically, it may be the caregivers themselves who face an unhealthy future, he said.
New Law Allows Physicians To Move Children From Acute Care
Physicians in California are not allowed to transfer children who are under care of the state and in acute care facilities, even if moving them to a subacute facility would be a better option for them.
Assembly member Holly Mitchell (D-Los Angeles) wanted to change that with AB 667. Yesterday, Gov. Jerry Brown (D) agreed and signed that bill into law.
“AB 667 basically updates state law,” Charles Stewart in Mitchell’s office said. “In a number of cases, when a child [under the state’s care] is in an acute facility, the physician did not have the option to say this child doesn’t need to be in the ICU. Being in the ICU can be very restrictive — it’s harder for family members to visit, it’s very restrictive on the child.”