bhoffman | August 25, 2010
Coordination of Benefits Handbook
The California Penal Law §202.4(f) requires that anyone who is found guilty of a criminal act that results in harm to a victim to provide restitution for economic losses incurred by the victim. A recent decision by a California Court of Appeal required such restitution based on the billed medical expenses incurred [...]
bhoffman | August 12, 2010
CCH® BENEFITS, www.hr.cch.com
California
The California Public Employee’s Retirement System (CalPERS) has approved an average increase of more than 9% in health premiums next year for state and local government workers. CalPERS blamed the rate increase on rising costs for hospital care, doctor visits, and prescriptions. The increase will mean higher premiums for public agencies and their [...]
Adam V. Russo | July 9, 2010
Business Insurance, www.businessinsurance.com
We’re disappointed that the Supreme Court ducked the opportunity to resolve the legality of “play-or-pay” laws once and for all.
As we report on page 4, the court last week declined to review a lower court decision upholding San Francisco’s health care spending law.
Adam V. Russo | July 6, 2010
MyHealthGuide Source: Jerry Geisel, 6/28/2010, Business Insurance Article
WASHINGTON–The U.S. Supreme Court, without comment, declined Monday to review and let stand a federal appeals court ruling that upheld San Francisco’s controversial health care spending law.
The San Francisco law, which took effect in 2008, requires employers with at least 100 employees to spend $1.96 per hour per [...]
Adam V. Russo | June 8, 2010
Jerry Geisel
WASHINGTON—The Obama administration is urging the U.S. Supreme Court not to review a 2008 appeals court ruling that upheld San Francisco’s controversial health care spending law.
The San Francisco law, which took effect in 2008, requires companies with at least 100 employees to spend at least $1.96 per hour per covered employee on health care, [...]
Adam V. Russo | June 7, 2010
MyHealthGuide Source:
US Department of Labor, 6/2/2010,
Case: Golden Gate Restaurant Association v. City and County of San Francisco, California, et al.
In October 2009, the U.S. Supreme Court delayed action on employer fees in San Francisco’s groundbreaking health care program to seek advice from the Obama administration.
Adam V. Russo | June 2, 2010
I received this from my buddy Burnie Burner at MW Law.
The debate over national health care reform has moved to the California Legislature, which this week will begin taking the initial steps to implement the complex series of overhauls prescribed by the federal government.
More than 20 bills have been introduced and as many as a [...]
Adam V. Russo | June 2, 2010
Victoria Colliver, Chronicle Staff Writer
Drill bits, screws, sponges, clamps, needles, catheters, electrodes. These are some of the things accidentally left inside patients after surgery at California hospitals.
These instances are referred to as “never” events, meaning they are never supposed to happen. But even though they are reported in a small percentage of surgeries, they occur [...]
Adam V. Russo | May 26, 2010
Very strange case where the plan participant never appears to defend herself against the efforts of the plan to obtain a judgment imposing a constructive trust or equitable lien against tort settlement proceeds. The case is ACS Recovery Services, Inc. v Kaplan, 2010 WL 144816 (N.D. Cal., Jan. 11, 2010)
Adam V. Russo | May 26, 2010
California regulators have filed suit to stop growing hospital chain Prime Healthcare Services from billing commercially-insured patients for fees that insurance companies don’t pay. The practice, known as balance billing, is explicitly forbidden in some states, but California law is vague on this topic, according to observers. However, Prime’s practices are so extreme in this [...]
Adam V. Russo | March 9, 2010
Robert A. Berenson, Paul B. Ginsburg and Nicole Kemper3
Faced with declining payment rates, California providers have implemented various strategies that have strengthened their leverage in negotiating prices with private health plans. When negotiating together, hospitals and physicians enhance their already significant bargaining clout. California’s experience is a cautionary tale for national health reform: It suggests [...]
Adam V. Russo | February 26, 2010
Prosecutors are seeking documents from Anthem, Aetna, Cigna, Blue Shield, Kaiser, Health Net and PacifiCare in a probe of whether they raised rates illegally and denied payment of legitimate claims.
February 25, 2010|By Duke Helfand and Marc Lifsher
Reporting from Sacramento and Los Angeles — The California state attorney general’s office said Thursday that it had subpoenaed [...]
Adam V. Russo | February 23, 2010
California. The state senate has approved the creation of a government-run health care system for the state, ignoring a veto threat from Gov. Arnold Schwarzenegger. The plan would cost an anticipated $200 billion per year. Also, the California Department of Managed Health Care has released rules that limit HMO wait times. The rules require that [...]
Adam V. Russo | January 25, 2010
Victoria Colliver, Chronicle Staff Writer
California could be disproportionately hit by a proposed annual tax in the national health overhaul legislation that critics say penalizes restrictive managed-care policies, which are far more popular in the Golden State than in the rest of the country.
An arcane provision in the Senate health bill calls for paying for expanded [...]
Adam V. Russo | September 29, 2009
Thank you to Attorney Gary Wickert of Matthiesen, Wickert, Lehrer, S.C. for bringing this case to our attention in his latest newsletter.
