Original article authored by Harris Meyer of ModernHealthcare.com on June 14, 2015 California is the latest state to address the increasingly common problem of patients getting large surprise medical bills from out-of-network physicians after receiving care at a hospital that’s in their health plan’s provider network. The issue has political legs with both Republicans and… Continue reading New AMA Leader Rejects Growing Movement to Regulate Out-of-Network Doc Bills

Hospital list prices varied sharply within individual markets, with the highest-priced hospitals routinely charging more than five times the rates of the lowest-priced facilities in the same area, new CMS data show. Those high retail prices have become a growing concern as more patients face unexpected out-of-network bills. The CMS released fiscal 2013 data last… Continue reading Out-of-network Charges Under Fire

A small segment of Medi-Cal beneficiaries run up huge health care bills (Medi-Cal 'Super-Utilizers') - but they're not necessarily the people you'd expect.

California’s ObamaCare exchange is announcing a cap on patients’ costs for high-priced specialty drugs, the first state in the country to do so. The announcement, which comes after a unanimous vote by the exchange’s board Thursday, would cap the cost for most enrollees on the insurance exchange at $250 per prescription per month. Under the… Continue reading California ObamaCare Exchange Caps Patient Drug Costs

State health officials this week said they would extend the timeline for transition into managed care plans for thousands of frail California seniors in the Multipurpose Senior Services Program. At an Assembly Budget Subcommittee on Health and Human Services hearing this week, the revised timeline was released by Mari Cantwell, chief deputy director at the… Continue reading State Responds To Concerns – Resets Timeline For Senior Program Transition

Original article authored by George Lauer of California Healthline on May 18, 2015 A consumer advocacy organization has launched a campaign to get state officials to explain why they revoked Blue Shield of California’s tax-exempt not-for-profit status last year. Consumer Watchdog also wants the state to explain why Californians didn’t learn of the decision for… Continue reading State Pressured To Explain Why it Revoked Blue Shield’s Not-for-Profit Exemption

San Bernardino’s bankruptcy plan would pay almost all money owed to CalPERS, but only a fraction to other cred San Bernardino’s plan to exit bankruptcy has at least one winner, plenty of losers and could have repercussions for other California cities. The city will pay every penny of the almost $50 million it owes to… Continue reading San Bernardino’s Bankruptcy Plan Favors CalPERS

Measures would help patients avoid being turned away by doctors and facing out-of-network costs The heathcare reforms in the 2010 Patient Protection and Affordable Care Act remain a work in progress, with some of the law’s mandates causing new problems or exacerbating older flaws. One is inaccurate lists of the healthcare providers in insurers’ networks;… Continue reading Two Bills Protecting Patients in Healthcare Networks Deserve Passage

Technology partnership with PayNearMe fills void for unbanked consumers who need to maintain mandated health insurance coverage but have no credit or debit account Twenty-eight percent of Americans have little or no relationship with a bank, leaving them with limited options when paying for health insurance because most insurance carriers require payment through credit cards,… Continue reading L.A. Care Becomes First ACA Health Plan to Offer Cash Payment Option

Californians Increasingly Visiting Hospital ERs for Non-injury Care – Original Post by Monte Morin of the Los Angeles Times on April 7, 2015 Californians are increasingly likely to visit an emergency room for complex medical problems, research shows. Californians are increasingly likely to visit a hospital emergency room for complex medical problems rather than an… Continue reading Californians Increasingly Visiting Hospital ERs for Non-injury Care