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BUSINESS
June 9, 1998 | Bloomberg News
Wellpoint Health Networks Inc. shares rose nearly 5% after the company's Blue Cross of California unit said it had reached an agreement with Sutter Health on reimbursement rates. The Woodland Hills-based managed-care company's shares rose $3.13 to close at $65 on the NYSE.
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CALIFORNIA | LOCAL
November 19, 2013 | By Chris Megerian
SACRAMENTO - California authorities are investigating whether laws were broken when a government regulator went to work for healthcare giant Kaiser Permanente, a company she spent years investigating for the state. Marcy Gallagher was a supervising attorney at the California Department of Managed Health Care, where she participated in several investigations of Kaiser. Last year, she left state employment and joined the company, where she works in a unit that responds to California regulators.
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CALIFORNIA | LOCAL
August 13, 1996
In calling for greater use of managed care in the Medicare program (editorial, Aug. 7), The Times has put the cart before the horse. We'd better make certain that managed care is willing and able to serve the kind of population that Medicare represents. Senior citizens aren't the only ones who depend on Medicare for their health care. Many younger people with disabilities (including those with multiple sclerosis) also are Medicare beneficiaries. But traditionally, HMOs have worked much harder at avoiding coverage for this population than they have at finding efficient ways to deliver needed care.
CALIFORNIA | LOCAL
March 27, 2013 | By Anna Gorman, Los Angeles Times
In a major shift triggered by the national healthcare law, nearly half a million low-income California seniors and disabled patients will begin moving into a new managed care program this fall. The patients, who receive both Medi-Cal and Medicare, are among the most costly in the state. Officials believe that the program, Cal MediConnect, will reduce spending and improve care by shifting the patients out of a fragmented system and into one that is more coordinated. The state and the federal government signed an agreement Wednesday officially establishing a test program for the patients, known as dual eligibles.
HEALTH
September 29, 1997
This just out: "The Insider's Guide to HMOs: How to Navigate the Managed-Care System and Get the Health Care You Deserve" (Plume) by Dr. Alan J. Steinberg. Chapter titles in this 231-page, easy-to-follow paperback include: "How to See the Best Specialists for Your Needs," "Difficult Patients and the HMO Mentality," "The Special Problems of Medicare HMOs" and "How to Choose the Safest and Best Health Insurance for Yourself and Your Family."
CALIFORNIA | LOCAL
March 24, 1995
Westcott W. Price III correctly states in his March 14 commentary that health maintenance organizations provide substantial benefits to Medicare enrollees. These include coordinated care, more services, such as prescription drugs and preventive care, and significant cost savings. However, his article was misleading. First, HMOs do not save hundreds of millions of federal dollars. A recent study by New Jersey-based Mathematical Policy Research found that enrolling Medicare beneficiaries in HMOs costs the government money because of biased selection: Healthier Medicare beneficiaries join, while those with disabling illnesses stay with the private fee-for-service doctors and hospitals they know.
CALIFORNIA | LOCAL
February 4, 1996
I read with interest the excellent commentary by Alan J. Goldman, M.D., (Orange County Voices, Jan. 21) regarding how managed care is killing the practice of medicine. Excluded from his article are some data which may interest your readers. For example, for many major health insurance carriers, as little as 35% of the premium dollar is now going to pay benefits, with 65% going to profits and administrative costs including the costs of managed care. Insurance companies are making so much money that some of their chief executive officers have been given annual bonuses as high as $52 million.
CALIFORNIA | LOCAL
January 20, 1997
Re "Attack the Profit Motive, Not Case-by-Case Horror," by Suzanne Gordon and Timothy McCall, and "HMO Trend Demands Eagle-Eyed State Oversight," by Jamie Court, Commentary, Jan. 15: The HMO approach to medical care is akin to our voice-mail system; it is impersonal and often time-consuming, but does get the job done most of the time at less cost. Thus one cannot fault them too much for having done too good a job in paying their executives very generously and maximizing their stockholders' investment return.
CALIFORNIA | LOCAL
January 1, 1998
In the extract from his letter to his patients ("Voices," Dec. 27), Dr. Peter Waldstein makes some valid points about the problems associated with HMOs, PPOs and avaricious insurance companies. Certainly, the inadequacies of these agencies, and their quest for profits over quality medical care, have resulted in declining health delivery for many Americans. But one must not ignore the point Waldstein makes several times: He doesn't make as much money as he used to. It is precisely because of excessive fees by physicians, directly and indirectly through ancillary services like excessive lab tests from which they profited handsomely, that the need for managed care has become so crucial.
CALIFORNIA | LOCAL
October 7, 1999
Re "Searching for a Cure to What Ails Managed Care System," Oct. 4: In the case of baby Anna's protein allergy, it appears that United Healthcare needs more than an independent review board--it sorely needs a new dictionary. Neocate is sustenance, not a food supplement. Since the managed care concept has never worked well anywhere on Earth, particularly in our country, there is really nothing the House can do to repair its flawed DNA. Gasoline prices have also been soaring and gasoline is also an essential part in our lives, yet has anyone even considered managing its cost?
BUSINESS
February 9, 2013 | By Chad Terhune, Los Angeles Times
HealthCare Partners, the medical-group giant acquired last year by dialysis chain DaVita Inc. for $4.4 billion, is seeking a state license to operate as a managed-care plan after questions were raised about its compliance with California law. The California Department of Managed Health Care has been looking into the nation's largest operator of physician groups since last fall when a patient sued the Torrance company and accused it of acting like...
CALIFORNIA | LOCAL
December 23, 2012 | By Anna Gorman, Los Angeles Times
Legal aid organizations filed a lawsuit Friday against the California Department of Health Care Services, alleging that the state violated patients' rights by forcing them into managed care. The suit is on behalf of five Medi-Cal recipients, all of whom have complex medical problems. Lawyers said the patients lost access to their doctors when they were automatically defaulted into managed care. "People can't get the care that they need," said Elena Ackel, an attorney with the Legal Aid Foundation of Los Angeles.
CALIFORNIA | LOCAL
August 30, 2012 | By Anna Gorman, Los Angeles Times
State healthcare officials are warning certain Medi-Cal recipients that they are in danger of losing their ability to attend adult day healthcare centers, where they receive nursing care, social services and meals. To continue receiving the benefit, officially called Community-Based Adult Services, eligible Medi-Cal beneficiaries must be in managed care, according to state officials. Nevertheless, thousands of eligible patients have opted out of managed care, said Jane Ogle, a deputy director at the California Department of Health Care Services.
CALIFORNIA | LOCAL
July 2, 2012 | By Anna Gorman, Los Angeles Times
One year ago, California began moving certain Medi-Cal patients into a managed healthcare system with the goal of saving money while better coordinating treatment. But for some of these low-income seniors and disabled patients, the transition has been anything but smooth, forcing severely ill patients to give up their doctors, delay treatment and travel long distances for specialty care. As of this month, the state has transitioned 333,000 people, many with diseases such as multiple sclerosis, lupus and metastatic cancer.
BUSINESS
April 27, 2012 | By Chad Terhune, Los Angeles Times
Healthcare companies are tripping over themselves to profit from a flood of government contracts for treating the poor and disabled, and a family-run company in Long Beach with nearly $5 billion in revenue is trying to stay ahead of the pack. Amid the growing competition,Molina Healthcare Inc.is facing new hurdles. It has lost two key state contracts in Ohio and Missouri and its shares have tumbled 23% in recent weeks. J. Mario Molina, the company's 53-year-old chief executive, said that these are temporary setbacks and that the company remains in expansion mode.
CALIFORNIA | LOCAL
April 5, 2012 | By Anna Gorman, Los Angeles Times
California is beginning the process of shifting 1.1 million of the state's sickest and poorest patients into managed care, which healthcare officials say will cut costs and improve treatment. The move is part of a broader state plan to continue moving residents with publicly funded health coverage into managed care, prompting concerns among critics who fear that patients could lose their current doctors. State officials announced Wednesday that Los Angeles, Orange, San Diego and San Mateo will be the first counties to provide managed care to the patients, who are enrolled in both the federally run Medicare and the state-federal Medi-Cal program.
CALIFORNIA | LOCAL
March 7, 2012 | By Catherine Saillant, Los Angeles Times
A Ventura County commission is trying to keep secret the details of a state-ordered investigation into the management and claims procedures of a healthcare plan designed to serve the county's neediest residents. Complaints about alleged late payments and poor management prompted the Department of Health Care Services to request that auditors step in and examine the plan's financial condition and claims practices. Gold Coast Health Plan was launched last year to switch an estimated 110,000 Ventura County Medi-Cal beneficiaries into an HMO-style healthcare plan.  Previously, doctors and hospitals were free to charge Medi-Cal directly on a fee-for-service basis.
CALIFORNIA | LOCAL
December 14, 2011 | By Anna Gorman, Los Angeles Times
State health officials have failed to adequately or promptly review the finances of publicly funded managed-care plans responsible for serving millions of Medi-Cal recipients, according to a report released Tuesday by California's s tate auditor. The state departments of Managed Health Care and Health Care Services also didn't conduct timely medical checks, intended to ensure that Medi-Cal recipients receive high-quality care, according to the report by State Auditor Elaine M. Howle.
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