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- Written by: Elizabeth Larson
AB 744 is landmark legislation that requires true telehealth parity in coverage and reimbursement in California.
This means that health plans must provide reimbursement to healthcare providers for performing covered services, regardless of whether the care is provided in-person or through telehealth.
“California, the technology leader in our nation and the world, should also lead on access to health services. Telehealth overcomes barriers to healthcare access by using technology to connect patients to their doctors, no matter where they live, what the demands of their jobs are, or what mobility challenges they may have,” said Aguiar-Curry. “By taking advantage of technological innovations in the healthcare industry, we can use our doctors’ time and expertise more efficiently while expanding access to all types of care for Californians.”
Prior to AB 744, a loophole in existing law allowed individual health plans to lawfully exclude common and cost-effective types of telehealth.
This works by conditioning reimbursement for telehealth to only include services provided through one specific telehealth technology platform – usually a third-party vendor – or requiring the patient to be in a health facility.
In practice, this creates additional burdens for both the patient seeking care and the provider. For example, different third-party vendors contract with different plans. That places the burden on the provider to adopt multiple platforms to get paid for their work, and limits patients to only communicate with a provider who is part of their plan’s third party network.
In Lake County during the 2017 North Bay fires, Sutter Lakeside Hospital was closed for two weeks. The hospital was able to use telehealth in order to continue treating patients in the Lake County community, but they did this without knowing whether the providers would be reimbursed for their services.
In Sonoma County during the same disaster, Santa Rosa Community Health Center’s providers made 1,412 telephonic visits to patients impacted by the emergency without getting reimbursed.
“Telehealth is not just a rural issue. Though expanding the use of telehealth will create more access to care for people in small towns and rural communities, telehealth is also a critical tool for healthcare during and after natural disasters, like wildfires and floods. And, California’s working families shouldn’t have to choose between their day’s pay and the health of their loved ones to benefit from an expanded network of care,” explained Aguiar-Curry. “I am excited to see the benefits of AB 744 for Californians in the coming years, and thankful to the Newsom Administration, and the bill’s stakeholders for working on this significant policy.”
In a statement from the California Medical Association, a key supporter of the legislation, CMA President David H. Aizuss, M.D., said: “This important legislation recognizes the need to update and modernize our health care system, to improve access to care for patients and make care easier and more convenient. By creating a more consistent and reliable reimbursement structure for telehealth services, this bill will ensure that Californians, regardless of their location, have better access to necessary medical care, reduce overall costs of care for patients and to the system, and facilitate better physician communication with patients.”
Aguiar-Curry represents the Fourth Assembly District, which includes all of Lake and Napa Counties, parts of Colusa, Solano and Sonoma Counties, and all of Yolo County except West Sacramento.
- Details
- Written by: Elizabeth Larson
Topics at the event include transitioning from surviving to thriving, healthy eating, long-term side-effects of cancer treatment, exercise and more.
Presenters include:
· Jan Adrian, MSW, founder of Healing Journeys and nationwide speaker.
· Kathleen Casey, RD, registered dietician at Adventist Health Clear Lake’s Live Well Program.
· Beth Rudiger, Lake County Jazzercise instructor and owner.
· Laurie Schirling, RN, OCN, CN-BC, breast cancer nurse navigator for Adventist Health.
· Ari Umutyan, MD, medical oncologist and medical director at the Martin-O’Neil Cancer Center.
· Amber Warner, LCSW, a behavioral health specialist with Adventist Health Clear Lake.
· Colleen Winters, LCSW, OSW-C, clinical navigator for the Martin-O’Neil Cancer Center.
“The Moving Beyond Cancer seminar will be an inspiring day of learning and connection with fellow cancer survivors and caregivers,” said Winters. “A cancer survivor’s health journey is unique, which is why we are honored to support them from diagnosis to treatment and beyond.”
The event runs from 8:30 a.m. to 3 p.m. and a continental breakfast and lunch will be served.
To RSVP to the event or for more information, contact Pamela Turner at 707-967-5750 or email
The Middletown Mansion is located at 20650 Highway 29 in Middletown.
The Martin-O’Neil Cancer Center is located at the Adventist Health St. Helena Medical Center at 10 Woodland Rd. in St. Helena, and its oncology providers see patients at the Adventist Health Clear Lake Medical Office in Hidden Valley Lake.
Learn more by visiting www.martinoneilcancercenter.org or calling 707-967-5721.
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- Written by: Elizabeth Larson
“Open enrollment is under way, and now is the time to sign up for quality health coverage that will begin on Jan. 1,” said Covered California Executive Director Peter V. Lee. “We want to make sure Californians know about the new state subsidies that mean almost 1 million people can get more help with their premiums, and the restoration of the individual mandate law, which requires people to have health insurance if they can afford it.”
The two new state initiatives, the state subsidy program and the restoration of the individual mandate, are key elements in Covered California’s record-low 0.8 percent rate increase for the upcoming year.
The new state subsidies will help lower the cost of coverage for almost 1 million California consumers. The main groups of people who are projected to benefit are:
– Middle-income Californians who previously did not qualify for financial help because their incomes exceeded federal limits. The amount of their subsidy will vary based on their age and income and the health care costs in their region. While the state subsidy for this group will average $172 per household, per month, consumers will need to input their information to see what amount they would receive. For example, while some consumers may get a monthly state subsidy of $50, others could get $150, and some could receive a $750 or more.
– Covered California enrollees who currently receive federal financial help could be eligible to receive an average of an additional $15 per household, per month.
“California will be making history this year, becoming the first state in the nation to make coverage more affordable for middle-income families like small-businesses owners, entrepreneurs, contractors and gig economy workers,” Lee said. “During our first day of renewal, a family of two from Sonoma received a state subsidy of $630 per month, which is why it’s so important for people to see if they qualify.”
In addition, a Covered California analysis found that 75 percent of existing consumers will be able to reduce their cost of coverage and receive the same level of benefits if they switch to the lowest-cost plan in the same metal tier.
“Covered California puts consumers in the driver’s seat, and a majority of our current enrollees could pay less than they did last year because they can shop around and get a better deal,” Lee said.
Covered California will begin its statewide outreach campaign on Oct. 30 with a new marketing campaign that includes television ads will debut Nov. 4. The ads, titled “You Shouldn’t Have To,” center on the idea that when you have health insurance, you do not need to make tough choices like whether to try self-treatment or see a doctor.
Also new in the campaign this year is a reminder that Covered California is “in your corner,” and is a free service that helps people find the health insurance that’s right for them.
“Our name is well known, but every year the research continues to show that some consumers still don’t understand the role Covered California plays in helping them find comprehensive, affordable health insurance,” Lee said. “We want Californians to know that we are a free service that helps them get health coverage that works for them.”
In addition, research shows that some consumers still do not know they qualify financial help.
“You can get a quote within minutes by using our Shop and Compare Tool, so even if you have checked before, the new financial help available makes it worth it to check again,” Lee said. “Don’t leave money on the table when you may be able to get health coverage for less than you think.”
The outreach effort will include traveling throughout California to promote enrollment by visiting enrollment locations, meeting with partners and conducting 10 televised phone banks in Spanish and Mandarin.
New this year is a partnership between Covered California and well-known California athletes. There will be live events at four locations across the state where these trusted voices, who are committed to healthy lifestyles, will help spread the word that now is the time to sign up for health coverage through Covered California. More details about the events will be announced as they approach.
“Once again, we are making a significant investment to make sure all Californians know there are big changes this year, with new financial support and a new law that requires everyone to have coverage,” Lee said. “We will be on television and radio, in newspapers and online, and increasingly in the digital world, where more and more Californians get their information.”
Restoring the individual mandate
In addition, California restored the individual mandate that was part of the Patient Protection and Affordable Care Act from 2014 through 2018, once again making it the law to have health coverage starting in 2020. Consumers who do not get covered could face a penalty administered by the Franchise Tax Board when they file their 2020 taxes in the spring of 2021.
“Nearly nine out of 10 Covered California consumers receive financial help, which saves them an average of 80 percent off the price of their coverage,” Lee said. “If you choose to go uninsured next year, even though you can afford the coverage, you could face a penalty that could climb into the thousands of dollars.”
For those facing a penalty, a family of four would pay at least $2,000, and potentially more, for not having health insurance throughout 2020.
“Consumers need to take action now during open enrollment,” Lee said. “This is when people can sign up to get health insurance and avoid the potential of a big surprise when they file their taxes in 2021.”
Getting help enrolling
Consumers will need to sign up by Dec. 15 in order to have their coverage begin on Jan. 1, 2020.
Those interested in learning more about their coverage options can:
– Visit www.CoveredCA.com.
– Get free and confidential in-person assistance, in a variety of languages, from a certified enroller.
– Have a certified enroller call them and help them for free.
– Call Covered California at 800-300-1506.
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- Written by: California Department of Public Health
In California, flu usually begins to increase in late November or December. It takes a couple of weeks after vaccination for the body to build immunity, so now is the time to get vaccinated to have the best protection now the flu season has started.
“Getting vaccinated is the best line of defense against flu,” said acting State Public Health Officer Dr. Charity Dean. “Vaccination will help you stay healthy for work or school, avoid visits to the doctor or hospitalization, and protect others from coming down with the flu.”
A person with the flu may be contagious and infect others before they even feel sick.
According to the Centers for Disease Control and Prevention, or CDC, during the 2017-2018 season, flu immunization prevented an estimated seven million illnesses and 8,000 deaths in the United States.
Flu vaccines are administered as a shot or nasal spray. For the 2019-20 flu season, the CDC recommends vaccination with no preference for any one vaccine type over another.
CDPH recommends the annual flu vaccination for everyone six months of age and older. While anyone can get the flu, pregnant women, children under five, adults 65 years of age and older, and people with chronic conditions such as heart disease, lung disease, diabetes and asthma are particularly at risk for flu-related complications.
Flu vaccinations are needed every year to maintain the greatest protection because the vaccine changes each year to match circulating viruses and annual vaccination boosts immunity.
For pregnant women, flu complications can include premature birth, low birth weight, and stillbirth of the baby.
Besides helping prevent flu complications, flu vaccine given during pregnancy also helps protect babies from flu infection for several months after birth, before the baby can be immunized, which is a time that babies are at high risk for flu complications.
Common symptoms of the flu, which typically develop within a few days of exposure, include fever or feeling feverish, a cough and/or sore throat, a runny or stuffy nose, chills, fatigue and body aches. Children may also have nausea, vomiting or diarrhea.
To stop the spread of flu and other respiratory illnesses, you should also:
· Stay home while sick and limit contact with others.
· Cover coughs or sneezes with your sleeve or disposable tissue.
· Wash hands frequently and thoroughly with soap and warm water, or use an alcohol-based hand sanitizer.
· Avoid touching your eyes, nose and mouth.
CDPH encourages Californians to contact their health care provider, physician’s office or clinic about getting the flu vaccine. When flu vaccine is in stock, adults with Medi-Cal can also get immunized at the pharmacy where they generally pick up their prescriptions. Some local health departments may also offer low- or no-cost flu immunizations.
For more information about the flu, visit CDPH’s Web site. For the flu vaccine location nearest you, visit www.flu.gov.