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Managed Care

October 20, 2005 | From the South Florida Sun-Sentinel
Florida Gov. Jeb Bush's plan to test a new kind of Medicaid coverage in two counties won federal approval Wednesday. U.S. Health and Human Services Secretary Mike Leavitt approved the state's application for a Medicaid waiver, which still needs final endorsement from the Florida Legislature.
September 7, 2005 | Jordan Rau, Times Staff Writer
State leaders on Tuesday put off until next year highly controversial plans to move 554,000 elderly, blind and disabled Medi-Cal beneficiaries into managed care, costing California $90 million in federal incentives. The decision was part of an overall agreement about how to divvy up $18 billion in new federal funding over the next five years in a way that would ensure no hospital loses money. The Legislature is expected to approve the deal by the end of this week.
June 23, 2005 | Jordan Rau and Charles Ornstein, Times Staff Writers
Half a million elderly, blind and disabled Californians now enrolled in Medi-Cal -- including all of those in Los Angeles County -- would be shifted into managed care as part of a complex deal with the federal government, the Schwarzenegger administration announced Wednesday. The pact dictates how California can spend $18.4 billion in Medicaid money over five years and amounts to an overhaul of hospital financing in the state.
April 9, 2005 | Lisa Girion, Times Staff Writer
HMOs, once the top choice for Americans who get healthcare as a job perk, are so last century. Tightly controlled health maintenance organizations have steadily lost ground over the last decade to preferred provider organizations, which offer greater choice of physicians and hospitals and direct access to specialists -- though at a higher price.
October 1, 2004 | Lisa Girion, Times Staff Writer
None of California's biggest health maintenance organizations excels at meeting all of the needs of its members, according to a "report card" released Thursday by the state's Office of the Patient Advocate. But HMOs and consumer advocates -- who rarely see eye to eye -- give the state's fourth annual survey poor grades for leaving out key information that could help people better choose a health plan. "It's not that we don't agree with the goal of providing ...
August 12, 2004 | From Associated Press
Surging healthcare costs have prompted a return to some unpopular money-saving measures that were scaled back after the backlash against managed care during the late 1990s, according to a new study. Requirements such as referrals for specialists and pre- authorizations for some medical services are quietly reappearing in some health plans, according to the study, released Wednesday and published in the policy journal Health Affairs.
May 24, 2004 | Jane E. Allen, Times Staff Writer
Co-payments for prescription drugs may seem like a relatively minor expense; after all, many people must foot the entire bill for their medicine. But raising those payments, especially for folks who take several medications a day, can have a dramatic effect on even the privately insured. Doubling out-of-pocket expenses for medications reduces the use of drugs for such chronic ailments as diabetes, asthma and ulcers by as much as 23%, researchers have found.
February 27, 2004 | Vicki Kemper, Times Staff Writer
Only a fraction of the nation's seniors understand the new Medicare prescription drug law, and the more they learn about it, the less they like it, according to a survey released Thursday by the Kaiser Family Foundation. The complex law, which gives private insurance companies billions of dollars to lure beneficiaries away from fee-for-service Medicare and into managed care, will require more than 40 million seniors and disabled persons to make difficult choices about their healthcare.
November 4, 2003 | David G. Savage, Times Staff Writer
The Supreme Court took up the long-running national dispute over managed health care Monday, saying it would decide whether workers and their families can sue their medical plans for providing allegedly substandard care. The justices' ruling, due by next summer, will determine the legal rights of more than 130 million Americans who receive subsidized medical care through employer- or union-sponsored plans. The high court agreed to hear a pair of cases from Texas.
October 28, 2003 | James F. Peltz and Ronald D. White, Times Staff Writers
In a deal that would create the nation's largest for-profit health insurer, Thousand Oaks-based WellPoint Health Networks Inc. agreed Monday to be acquired by Anthem Inc. of Indianapolis for $14.3 billion in cash and stock. The two companies are the leading providers of Blue Cross and Blue Shield managed-care plans. WellPoint, which owns Blue Cross of California, is the largest health insurer in the state, with 6.7 million members.
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