Reimbursement

When you're calling for an ambulance, chances are good that you won't think to ask for one that's in your health plan's provider network. And in most cases, you wouldn't have much control over who it is anyway. That could leave you with hassles and extra charges for an out-of-network ride. This spring, Blue Cross Blue Shield of Massachusetts launched a policy aimed at getting more emergency medical services providers to join its network: It began sending checks for out-of-network private ambulance rides directly to plan members rather than to the EMS providers.

SACRAMENTO - Reacting to public outrage over legislative perks, a state panel decided last year to cut lawmakers' monthly car allowance to $300, but a legal glitch has allowed some to get up to nine times that amount. The Citizens Compensation Commission, which is appointed by the governor, had hoped to save taxpayers money when it voted to set the $300 limit and take state-issued cars away from lawmakers. But the attorney general's office later determined that the panel did not have the authority to approve the allowance.

Sears, Roebuck & Co. is expected to announce today that it will reimburse unhappy customers under a settlement of charges that it systematically ripped off consumers at its 70 auto repair centers in California, The Times has learned. The agreement is expected to allow Sears to remain in the auto repair business in California, where it is the largest single operator of repair shops.

Forty percent of surveyed employees at Los Angeles County's troubled child welfare agency improperly received mileage reimbursements from taxpayers on days they did not work, according to a sample of reimbursement reports for 20 employees with high mileage claims examined by the county auditor-controller. Thirteen supervisors responsible for signing off on the reports acknowledged that they routinely did not review them first, the study found. The majority of reviewed reports vastly overstated the distance between travel points, and nearly half the reviewed reimbursement requests lacked basic information.

Modesto Police Chief Roy Wasden and the mother of slain teacher Laci Peterson went to the state Capitol on Tuesday seeking reimbursement for the $1.5 million police spent on the Scott Peterson investigation. Wasden said if his department doesn't get the money soon, it may mean fewer officers on the streets. Sharon Rocha said she accompanied the chief because she wanted to make sure other investigations receive the same level of attention and commitment.

Seven homeless people who sued the city of Long Beach will be reimbursed a total of $4,000 for belongings lost during a sweep by city employees of their makeshift camp near Shoreline Park. The six men and one woman lost all their belongings during an unannounced June, 1993, sweep, despite assurances from several people left in the camp that they would move the items.

California and more than 20 other states will be "fully reimbursed" for hundreds of thousands of emergency prescriptions for seniors who ran into trouble with the new Medicare drug benefit, top federal officials said Tuesday. The promise was part of a seven-point plan by Health and Human Services Secretary Mike Leavitt to try to resolve the continuing frustration faced by many patients and pharmacists since the benefit took effect three weeks ago.

The Los Angeles City Council asked the Department of Transportation on Tuesday to come up with recommendations on how to reimburse drivers who get parking tickets as a result of faulty meters. A recent study by the department showed that 11% of the city's new digital meters are broken at any given time, leading to many erroneous parking tickets.

To aid the dozens of county employees in the military reserves, county supervisors agreed Tuesday to make up for any pay loss the employees suffer if called to active duty. So far, 10 county employees have been called to duty since the outbreak of war last week, Supervisor Don R. Roth said. While exact figures were not available, county officials estimate that 75 to 100 of the county's 16,000 employees are in the reserves. Board Chairman Gaddi H.

Humana Inc. said it had settled a six-year dispute with representatives of more than 700,000 physicians over reimbursement and would make a $40-million payment. Louisville, Ky.-based Humana joins other health insurers such as Aetna Inc. and Cigna Corp. in settling with the doctors. The agreement still must be approved by a federal judge in Miami, Humana said.

SACRAMENTO — The president of the California Fish and Game Commission violated state gift limits when he accepted a free guided cougar hunt in Idaho, ethics officials alleged Thursday. But Daniel W. Richards belatedly reimbursed the Flying B Ranch for the $6,800 hunt after media outlets reported the Idaho outing, so the enforcement chief of the Fair Political Practices Commission issued a warning letter rather than seek fines. State law bars officials from accepting gifts of more than $420 from certain sources.

Medicare agreed to settle a dispute with about 2,200 hospitals nationwide over a decade-long error in reimbursement rates, offering what could amount to a $3-billion infusion to hospitals already bracing for funding cuts under the federal healthcare law. More than 200 California hospitals are included in three similar agreements reached April 5, and they stand to share a total of more than $310 million. For instance, Cedars-Sinai Medical Center said it would receive $14.3 million and Long Beach Memorial Medical Center said it was due about $6 million.

A years-long legal fight over cuts in California's multibillion-dollar healthcare program for the poor took another twist Wednesday as the U.S. Supreme Court kicked the case back to a lower court. The high court's 5-4 decision allows medical providers to continue suing to stop the cuts, which would lower reimbursement rates for doctors who participate in the state's Medi-Cal program. But it did not affirm the lower court's decision to block the reductions, leaving the state another opportunity to argue for the right to implement them to help balance its depleted budget.

Reporting from Sacramento -- Democratic lawmakers sued state Controller John Chiang on Tuesday, arguing that he misused his power last summer when he docked their pay for passing a budget he said was not balanced. The lawsuit, filed in Sacramento County Superior Court, does not seek reimbursement of the $583,200 in withheld pay. Lawmakers want the court to bar the controller from doing it again if they approve a budget that they deem balanced. Chiang, a Democrat, said he was exercising authority given to him by voters when they approved Proposition 25, a constitutional amendment, in 2010.

A contract dispute between one of California's largest health insurers and UCLA could force thousands of patients at the university's medical centers to seek treatment elsewhere if the disagreement is not resolved by the end of December. Executives from Blue Shield of California and the University of California's health system are quarreling over reimbursement rates for medical treatment at Ronald Reagan UCLA Medical Center in Westwood and nearby Santa Monica-UCLA Medical Center and Orthopaedic Hospital.

For more evidence that the Golden State has lost some of its luster, consider this news from the federal government: California spends less per person on healthcare than all but eight states. New data show that total spending by insurers, government agencies and individuals amounted to $6,238 per resident in 2009, well below the national average of $6,815. That puts California on a bottom tier with Arkansas, Georgia, Texas, Utah, Nevada, Arizona, Colorado and Idaho. Healthcare analysts blame the low spending largely on the fact that the state has more than 7 million people who are uninsured, or about 1 in 5 Californians.

Emergency room doctors and on-call specialists treating poor, uninsured patients at private hospitals in Los Angeles County saw their reimbursement rate slashed by county supervisors Tuesday. The rate cut could lead private hospitals to close emergency rooms and send more patients to crowded county hospitals, officials said. L.A. County reimburses doctors 27% of estimated fees for patients' first three days of care at private hospitals under the Physician Services for Indigents Program.

Vernon Jordan, the prominent attorney who helped Monica Lewinsky find a job after she left the White House, will not be reimbursed for most of his legal bills arising from an investigation of then-President Clinton's relationship with Lewinsky, a federal appeals court has ruled. Jordan asked the federal government to pay the $302,719 in fees he spent to defend himself during the investigation by the independent counsel's office. But the U.S.

Reporting from Sacramento -- California lawmakers are about to lose one of their biggest perks — a car of their choice paid for mostly by taxpayers, but a legal snag could end up costing the public more. A citizen panel appointed by the governor determined in April that the state's budget crisis, which was causing deep reductions in services to Californians, required some sacrifices by those making the cuts. The Citizens Compensation Commission decided the state would stop buying cars, gas, maintenance and insurance for legislators — who repay a portion of the purchase price — and instead gave them a $300-a-month transportation allowance.

Federal regulators bent the rules to allow Bank of America Corp., Wells Fargo & Co. and PNC Financial Services Group Inc. to repay their bailout money early, missing a chance to force them into further bolstering their finances. The banks pushed for the repayment requirements to be eased in part because they wanted to avoid tough executive compensation restrictions attached to the Troubled Asset Relief Program, according to an audit released Thursday by the special inspector general monitoring the bailout fund.