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The potentially improper payments occurred in 2014 and 2015, when the state says it was under pressure from a massive influx of new applicants due to the Affordable Care Act’s Medicaid expansion.
The whistleblower complaint says that Sutter, one of the largest health systems in the U.S., exaggerated how sick certain Medicare patients were in order to collect higher payments from the government-funded program.
The state medical board grants probation in more than a third of cases, a KHN analysis found. Even as other institutions adapt to lessons of the #MeToo movement, the board plans no significant changes, saying it has always prioritized discipline for sexual misconduct.
To keep costs down, Blue Shield of California next year will scale back on a program allowing members to receive a wide range of care beyond the state’s borders. Customers with individual plans mostly won’t be able to get coverage out of state except for emergencies or other exceptional circumstances.
Patient advocates say the state’s new staffing regulations are a good start toward better protecting the frail, but the nursing home industry contends they’re too burdensome.
It’s not clear why Asian-American college students have higher rates of compulsive gambling than their peers, but a nonprofit in the San Francisco Bay Area arms them with strategies to avoid getting hooked.
Having fled quickly — often without medications, wheelchairs or pets to comfort them — refugees from the Camp Fire manage as best they can in makeshift shelters miles from home. A virus is spreading, and medical attention is spotty.
More than half of mass shooters have serious mental health disorders, experts say, but the vast majority of mentally ill people are not violent. Some clinicians suggest strategic interventions, including closing loopholes in background checks to buy firearms and allowing family members to confiscate guns under temporary court orders for relatives at risk of doing harm.
As wildfires blaze in Northern and Southern California, millions of people outside of the burn zones are getting exposed to dangerous wildfire smoke. For those donning face masks for protection, only a specific mask will work.
For mothers in recovery from opioid addiction, narcotic pain relief during and after delivery can put sobriety at risk.
For over a decade, federal health officials have recommended the practice, known as expedited partner therapy. It is allowed in most states, but many doctors don’t do it — either because of legal or ethical concerns, or because they are unaware of it.
In this episode of KHN’s “What the Health?” Julie Rovner of Kaiser Health News, Margot Sanger-Katz of The New York Times, Rebecca Adams of CQ Roll Call and Joanne Kenen of Politico discuss the Trump administration’s new birth control coverage rules and the potential impact of the midterm election results on health policy.
The dialysis industry raised nearly $111 million in a successful bid to defeat the measure, which also was opposed by hospitals and doctors. The union that sponsored the measure collected about one-sixth that amount.
Attorney General Xavier Becerra views his resounding Election Day win as a “clear signal” from voters to continue his work defending the Affordable Care Act and pushing back against the Trump administration.
Even though Democrat Gavin Newsom campaigned for single-payer, it’s unlikely that he and other lawmakers will completely overhaul the state’s health care system right away. Instead, they will likely propose incremental steps to provide more Californians with health insurance.
An “epidemic” of robocalls timed to open-enrollment season are largely illegal, fraudulent or aim to rope you into insurance you don’t need or can’t use. They're also really annoying.
As politicians across the country toss about such health care catchphrases, sometimes interchangeably, many voters say they’re “just confused.”
Both sides in the contentious and expensive battle over California’s Proposition 8 are cherry-picking the facts ahead of Tuesday’s vote as dialysis companies spend record amounts to persuade voters through ads.
The money was paid on behalf of more than 400,000 people who may have been ineligible for the public program, a state audit found. One had been dead for four years before payments stopped.
Although dialysis provider DaVita Inc. has taken major financial hits this year, including a $383.5 million jury award in response to wrongful death lawsuits, it still rakes in profits. The company faces its biggest threat next month, when California voters weigh in on a ballot initiative that could force it to leave the state.
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