State Choices on Essential Benefits May Become More Complicated
By David Gorn, California Healthline Sacramento Bureau
California Healthline, February 8, 2012
It has been called a health care candy store.
In 2011, the California Legislature approved separate measures requiring health plans operating in the state to cover maternity care, tobacco cessation and behavioral therapy for children with autism or other developmental disabilities.
Besides California, 21 other states approved laws in 2011 mandating various health services to be covered by health plans, according to research by the National Conference of State Legislatures.
Now, this year, the queue of proposed mandates might be even longer in California, as advocates push for coverage and health officials lay the groundwork for implementing the Affordable Care Act.
Gov. Brown Proposes Expansion of Managed Care for Medicare & Medi-Cal "Dual Eligible"
By Dan Diamond
California Progress Report, February 7, 2012
[Note: While California's current approach to "dual eligibles" compared to other states, ideally accountability metrics and measures of success would be added to monitor this patient population.]
[On February 6,] [t]he Brown Administration released proposed budget related legislative language -- called "budget trailer bill language" -- that would provide authorization to expand an existing effort to move hundreds of thousands of people with disabilities and seniors eligible for Medicare and Medi-Cal into "coordinated care" or managed care plans in California.
Brown's proposal builds on an existing plan passed last year as part of the 2011-2012 State Budget, that already authorizes the Department of Health Care Services to move forward with submitting a demonstration project proposal to the federal government this spring for approval, that would beginning in January 2013, shift thousands of people who are eligible for both Medicare and Medi-Cal -- known as "dual eligible" -- into managed or coordinated care plans in at least four counties.
Renal Support Network
Actor Jack Black was king of the 13th Annual Renal Teen Prom on Sunday at Notre Dame High School in Sherman Oaks.
He greeted and entertained nearly 300 patients and guests. The event was themed "An Enchanted Evening," and Black made a grand entrance to thunderous applause. He sang a few songs accompanied by "Glee's" Brad Ellis. Producer Ann Lopez also stopped by, as well as Dale Wade Davis (Showtime's "Shameless") and KABC News Anchor Phillip Palmer.
Inspired by Renal Support Network's President and Founder Lori Hartwell, who missed her own prom due to kidney disease, the Renal Teen Prom brings teens together from all over the United States, including Southern California, New York, Arizona, Colorado, Hawaii, Massachusetts, New Jersey, Texas, and Washington.
Drinking soda raises risk for asthma, COPD: Study
By Ryan Jaslow
CBS News, February 8, 2012
Soda drinkers can't seem to catch a break these days. A new study suggests drinking soda might raise the risk for respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD).
For the study, published in the Feb. 7 issue of Respirology, Australian researchers surveyed nearly 17,000 people asking about their soft drink habits. For this study's purposes, soft drinks included Coke, lemonade, flavored mineral water, Powerade, and Gatorade, and all other types of soda, the researchers said.
What did they find?
One in 10 Australian adults drink more than half a liter of soft drink per day - that's more than two cups. But that amount was tied to "dose-response relationship" with risk for asthma and COPD, meaning the more soft drinks people consume, the higher their risk. Overall, 13.3 percent of surveyed participants with asthma and 15.6 percent of those with COPD drank more than two cups of soda each day. Read more
New mental health manual is "dangerous" say experts
By Kate Kelland
Reuters, February 9, 2012
Millions of healthy people -- including shy or defiant children, grieving relatives and people with fetishes -- may be wrongly labeled mentally ill by a new international diagnostic manual, specialists said on Thursday.
In a damning analysis of an upcoming revision of the influential Diagnostic and Statistical Manual of Mental Disorders (DSM), psychologists, psychiatrists and other experts said new categories of mental illness identified in the book were at best "silly" and at worst "worrying and dangerous."
"Many people who are shy, bereaved, eccentric, or have unconventional romantic lives will suddenly find themselves labeled as mentally ill," said Peter Kinderman, head of Liverpool University's Institute of Psychology at a briefing in London about widespread concerns over the manual. Read more
Federal agencies recover more than $4 billion in health care fraud losses
By Carol Cratty
CNN, February 14, 2012
The federal government recovered almost $4.1 billion stolen in health care fraud schemes during fiscal year 2011, Obama administration officials announced Tuesday. The figure is up 58 percent from 2009.
"This is an unprecedented achievement -- and it represents the highest amount ever recovered in a single year," said Attorney General Eric Holder. The Justice Department reported more than 1,400 people were charged with fraud in 500 cases. There have been more than 700 convictions.
"We're regaining the upper hand in our fight against health care fraud," said Health and Human Services Secretary Kathleen Sebelius.
The numbers are contained in the Health Care Fraud and Abuse Control Program Annual Report, which is sent to Congress. Read more
Healthy Families Program Transition Public Meeting and Webinar
February 9, 2012
Healthy Families (HFP) is a low-cost insurance program that covers about 870,000 children in California. Current HFP enrollees will transition to Medi-Cal over a nine-month period, beginning 90 days after enactment of the transition plan or October 1, 2012, whichever is later.