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Los Angeles Healthcare Law Blog

Budget cuts, Medi-Cal reduction affect health insurance access

  • 17
  • May
    2012

Having health insurance is an expensive venture for anybody, but that fact is especially true here in California. The state may be trimming the budget everywhere it can and, according to the California HealthCare Foundation, the state's per-capita spending on health care ranks among some of the lowest in the country.

Due to this reduction in spending on health care, those with health insurance are finding their visits to the doctor to be more expensive recently. It is merely a reaction to this lack of funding.

Healthcare for illegal immigrants working in L.A. restaurants

  • 10
  • May
    2012

Roughly 75,000 illegal immigrants work for restaurants in Los Angeles, California. The food service industry obviously has strict safety and health regulations for both restaurant facilities and employees -- but it can be hard to meet these regulations if your employees do not have health insurance.

St. John's Well Child and Family Center in Los Angeles is looking to help these illegal immigrants in the restaurant industry by offering a low-cost health coverage program that could not only benefit these workers, but the public at large.

In CA, letter of fed health reform may not always apply

  • 04
  • May
    2012

The federal healthcare reform effort has put a lot of things in writing. The intention of the language is quite clear and despite the lingering questions about the constitutionality of the law, provisions of the law are in effect for California. What many consumers are learning, though, is that the expectations of the law don't necessarily apply when they think they should.

Take for example the case of the mother of a 10-year-old girl with asthma. She recently tried to apply to get her child on an insurance plan based on her understanding that the healthcare reform law requires health insurers to cover children. She was rejected, presenting her with a harsh lesson about possible differences in interpretations about policy limitations. 

California lawmaker wants probe of medical debt collector

  • 27
  • April
    2012

When a person needs immediate medical attention the law says they are entitled to get it, whether they have the money to pay for it right then and there, or not. This is an issue of federal law. That means that if you enter a California hospital emergency room, refusal to authorize necessary medical treatment is outlawed.

A member of the California congressional delegation is raising concerns that that is exactly what may be happening at some facilities around the country. The lawmaker is Democrat Pete Stark. The target of his suspicion is Accretive Health, a national medical debt collection agency.

Of specific issue are allegations that Accretive Health has followed a practice at some hospitals of demanding that emergency room patients with outstanding bills pay up before being treated.

CA Assembly panel moves step closer on healthcare reform

  • 18
  • April
    2012

The dust is nowhere near settled on whether the federal Patient Protection and Affordable Care Act will be found to be constitutional. Lawmakers in Sacramento are not letting that deter them from moving ahead on one of the key provisions of that act.

Members of the Assembly Health Committee approved a bill yesterday that would prevent any denials of coverage by health insurance companies for pre-existing conditions. The measure is in keeping with the framework of the federal law and fulfills a requirement that states pass their own laws so that state jurisdictions are maintained.

Data on autism begs questions about health insurance coverage

  • 09
  • April
    2012

April is National Autism Awareness Month. It's been marked so far by a string of reports on a range of autism related issues covering everything from the spectrum of conditions that are now covered by the term, to speculations about numerous potential causes. If you live in California and follow current events, you probably have heard something related to the subject.

One item that seemed to start the ball rolling was an end-of-March announcement by federal health officials that autism is believed to be more prevalent than previously thought. That was followed by reports on research linking some cases to genetic causes, confirming higher risks in children of older fathers, or suggesting that a mother's being obese during pregnancy may play a role. The question we find ourselves concerned about is how this might affect health insurance claim disputes?

Medical groups call for less 'automatic' testing and treatments

  • 05
  • April
    2012

That there is waste and overuse of the healthcare system should surprise no one. It's said to be one of the major contributing factors to the high cost of care in California and the rest of the country. At its core, a solution to the issue seems to lay in striking a balance between the business of healthcare and the actual delivery of care.

No one has found a quick fix. Doctors call for caps on malpractice awards arguing that their skyrocketing insurance costs are driving up the cost of all care. Health policy experts say the problem is a failure by doctors to accept and apply standardized treatments that are proven to work. Health insurance companies deny, delay or underpay claims to control costs.

June likely next milestone for Affordable Care Act

  • 29
  • March
    2012

With the dust only beginning to settle from three days of U.S. Supreme Court hearings about the federal Affordable Care Act, there are pundits, some in California, who seem ready to declare that the high court has already made up its mind on the matter.

Attorneys familiar with how the court process works tend to steer clear of such predictions. It's never a safe bet to second guess what the nine-justice panel might be thinking based on the questions they pose during arguments. As important as this controversial healthcare reform law is, it's best to wait.

A final decision isn't likely to come out of Washington until perhaps June. Pending that, the law remains in force, as do all existing healthcare insurance regulatory laws. Anyone facing issues over wrongly denied claims or shortcomings in coverage ought to seek experienced legal help to resolve those issues.

Anthem rolls back planned health insurance rate hike

  • 22
  • March
    2012

While the eyes of the nation get focused on the hallowed halls of the Supreme Court ahead of next week's legal challenge to the constitutionality of the federal Affordable Care Act, there are more immediate actions taking place in California aimed at reigning in insurance rates.

According to reports out today, Anthem Blue Cross, the state's biggest for-profit health insurance company, has agreed to scale back its proposed May rate increase for some 600,000 customers in California. What had been a planned 10.4 percent hike on average will now be limited to 8.2 percent. The California Department of Insurance says the top increase anyone will see will max out at 20 percent, rather than the proposed 30 percent.

Ballot prop to control health insurance rates facing opposition

  • 15
  • March
    2012

Tighter regulation of health insurance rates apparently is not something that sits well with California doctors, hospitals and insurance companies. They've started to rally their forces behind efforts to defeat a proposed ballot initiative that would give the California Department of Insurance power to set rates for health insurance just as it does for auto and property policies.

The proposal requires the collection of 505,000 valid signatures by early May in order for it to make it onto the ballot for the November election. That effort is being headed up by Consumer Watchdog, the Santa Monica organization that successfully shepherded California's Proposition 103 for auto and property insurance controls through the ballot process in 1988.

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