CMS Adminstrator dismisses Affordable Care Act
About 1.4 million Californians buy coverage through the state’s Obamacare exchange, Covered California, and nearly 4 million have joined Medicaid as a result of the program’s expansion under the law.
Report: Insurers aren’t always adequate at pinpointing and reporting Medicaid fraud
A report from U.S. Health and Human Services' inspector general's office said a third of the health plans it examined had referred fewer than 10 cases each of suspected fraud or abuse to state Medicaid officials in 2015 for further investigation.
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Will lawsuit against Sutter Health be a reckoning for health systems charging high prices?
California Attorney General Xavier Becerra’s suit amounts to a giant test case with the potential for national repercussions. If California prevails and is able to tame prices at Northern California’s most powerful, dominant health system, regulators and politicians in other states are likely to follow.
Study underscores infection risk reusable medical scopes pose to patients
Seventy-one percent of reusable medical scopes deemed ready for use on patients tested positive for bacteria at three major U.S. hospitals, according to a new study published in the American Journal of Infection Control.
California mistakenly enrolled approximately 450K under Medicaid expansion, federal report finds
California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services’ chief watchdog. In a Feb. 21 report, the HHS’ inspector general estimated that California spent $738.2 million on 366,078 expansion beneficiaries who were ineligible. It spent an […]
Judge orders new trial over superbug death after newly translated Olympus emails point to safety concerns
Citing those “willful discovery violations” by the Japanese device giant, King County Superior Court Judge Steve Rosen ordered a new trial Tuesday in a wrongful death case. More than 25 lawsuits against the medical scope maker have been filed nationally.
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A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
In antitrust lawsuit ruling, judge says Sutter Health destroyed evidence it knew was relevant to case
Employers and policymakers across the country are closely watching this legal fight amid growing concern about the financial implications of industry consolidation.
Calif. fines Anthem $5M for failing to resolve consumer grievances in timely manner
The state said it identified 245 grievance-system violations during this latest investigation of consumer complaints at Anthem from 2013 to 2016.
California health insurers reap billions through Medicaid
Some insurance companies are reaping spectacular profits off the taxpayer-funded program in California, even when the state finds their patient care is subpar.
Olympus ordered to pay Seattle hospital $6.6M in damages over scopes contaminated with superbug
More than 25 patients and families, from Pennsylvania to California, have sued Olympus alleging wrongful death, negligence or fraud.
Maximize Revenue and Patient Care with Strategic Weight Loss Management
We will highlight Build My Health's revenue practice management tools, which could help physician practices add up to $250,000 to their practices.
Capitol Hill health bill drama is leaving Obamacare exchanges in limbo
“It’s insane,” said John Baackes, CEO of L.A. Care Health Plan, which has about 26,000 customers on the California exchange. “Here we are in the middle of July and we don’t even know what rules we will be operating under for open enrollment.”
The medical testing overload and how California healthcare organziations are addressing it
Three of the California's largest healthcare purchasers have banded together to promote care that’s safer and more cost-effective.
Why Democratic states may be forced to roll back protections for pre-existing conditions
Even in California, a liberal bastion that enthusiastically implemented Obamacare, the law’s supporters are bracing for a fight over the waivers. But few, if any, states would be able to fund subsidies on their own if the U.S. Senate approves AHCA.
Blue Shield of California CEO says AHCA unfair to Americans with preexisting conditions
An amendment to the bill would allow states to roll back key consumer protections in the Affordable Care Act, including the popular provision that prohibits discrimination against patients with a history of illness.
HSA providers stand to gain millions more customers (and fees) with GOP healthcare bill
Health savings accounts allow people to put aside money tax-free for medical expenses. The House Republican plan proposes to nearly double the HSA contribution limits to $6,550 for individuals and $13,100 for families.