Latest California Healthline Stories
California Seeks Changes to Medicare Audit Program
CMS has piloted a Medicare audit program in California since 2005, but many California hospitals, nursing homes and now lawmakers say there are major problems in the program and are calling for it to be re-examined before it is rolled out nationwide.
Aging Californians Challenge State Health Care System
California policymakers are struggling to deal with the implications of a dramatic increase in the number of elderly Californians. Some of the major issues: a shortage of geriatric health care specialists, limited long-term care options and increasing numbers of Alzheimer’s patients.
Pay Attention to Prevention: A Message That People Don’t Hear
New statistics show that Medicare beneficiaries are not using the preventive care benefits that the program covers. Health care advocates assert that the situation could contribute to more serious illnesses developing later, pushing Medicare officials to plan wider outreach efforts.
Groups in California Take Aim at Medicare Payments
How much should Medicare pay doctors and hospitals? That’s the question at the heart of two claims filed in California. One argues that Medicare is shortchanging care providers, while the other maintains that inflated reimbursements are hitting beneficiaries in the wallet.
Pay for Performance a Factor in Medicare Reform
California HMOs have adopted pay-for-performance programs at a higher rate than the national average, and other states are encouraging CMS to adopt the programs, which some see as a way of addressing the sustainability of Medicare and Medicaid.
More Choices for California Medicare Beneficiaries in 2007
CMS officials are praising California beneficiaries’ wider variety of options for Medicare drug coverage in 2007, but some health care advocates say the increased options could lead to more confusion.
Legislation on Drug Benefit Assistance Stalls
Advocates had supported a bill that would have provided subsidies for drug benefit copayments, and some groups say they will seek similar legislation in 2007.
Medicare Beneficiaries Dealing With ‘Doughnut Hole’
A gap in coverage in Medicare prescription drug plans is emerging as an issue for beneficiaries with high prescription drug costs, particularly those who did not retain employer-sponsored drug coverage.
Drug Benefit Enrollment Strategies Expand
Health care advocates are working with community groups and “mining” enrollment information for programs whose membership might include Medicare beneficiaries eligible for subsidies to help offset the cost of prescription drug coverage.
Drug Benefit Enrollment Varies by County
CMS attributes variations in enrollment in the Medicare drug benefit among counties to differences in managed care penetration and populations of dual eligibles, but some health care advocates fault CMS for inadequate outreach efforts.