SACRAMENTO, Calif. - When you go to an emergency room, you often don't have a say in choosing the hospital - and sometimes, patients get slapped with huge "surprise" bills if it is out-of-network with their insurance provider. On Tuesday, the state Assembly Committee on Health passed legislation to change that.

Assembly Bill 1611 would make sure patients only pay their co-pay and deductible, even at an out-of-network facility, and would cap the amount hospitals can charge on out-of-network bills.

Nicki Pogue, who went to the emergency room at Zuckerberg San Francisco General Hospital with bronchitis and came out with a massive bill, sees the practice of so-called "balance billing" as unconscionable.

"When you are suffering from life-threatening symptoms, the last thing you should be thinking about is whether or not your hospital is considered in-network," said Pogue, who gave input for the legislation. "To receive a bill for $13,000 - that I was responsible for $10,000 of - was stunning."

Hospital networks have said the changes outlined in AB 1611 would be a major blow to their finances. Last week, under pressure, Zuckerberg SF General discontinued the practice of balance billing for its insured patients.

After five months of fighting, Pogue's insurance company paid her bill. However, she said, many other patients face financial ruin for something they couldn't control. Pogue said she hopes changing the law would spur insurance companies and hospitals to negotiate lower rates.

"It gives room for the insurance companies and the hospitals to meet somewhere in the middle, and to cut the patient out of it," she said. "I mean, that's the problem, right now - the patient is in the middle, and if you don't have the resources to fight it, you get left holding the bill."

AB 1611 now goes to the Appropriations Committee.

The text of AB 1611 is online at leginfo.legislature.ca.gov.


get more stories like this via email

As the summer sun blazes, especially in the Sunshine State, it is easy to get caught up in the fun and excitement of the season. But according to health experts, staying mindful of hot weather health risks is crucial.

With searing temps causing a spike in emergency room visits for heat-related issues in some states, health experts said there are simple steps to stay cool and spot potential signs of overheating, including headaches, nausea or dizziness.

Dr. Del Carter, family medicine resident at Tallahassee Memorial Healthcare, said as a general rule, people should drink at least 64 ounces of water daily, or about eight glasses, and dress for the weather.

"Long, loosefitting clothing is helpful, sunscreen is definitely helpful to protect your skin as well," Carter outlined. "Then, really just trying to stay out of the environment when it is at its worst is going to be the most helpful things."

For being in and around water, he recommended ensuring protective barriers around pools, actively monitoring kids and wearing flotation devices. It is also smart to take swimming lessons and be CPR certified to ensure safety for all.

Heatstroke requires emergency treatment. Symptoms and signs include an altered mental state or behavior, nausea and vomiting, and a racing heart rate.

Donna O'Shea, chief medical Officer of population health for UnitedHealthcare, said virtual care is also an option for discussing symptoms with a health care professional.

"How long to wait before you go to the emergency room? Same thing, even for sunburns or for bike safety: 'Do I need to go in? Do you think I need stitches?'" O'Shea explained. "We don't think about that with virtual care, but the technology is really good."

O'Shea added among the benefits of virtual care is the ability to connect to someone for help 24/7, and most insurers offer it at no additional cost, including some of her company's plans.


get more stories like this via email

As summer kicks into full gear, North Carolina dentists stressed the importance of maintaining children's dental health.

Dr. Miranda Kalaskey, a dentist in Raleigh and member of the North Carolina Dental Society, said with more outdoor activities and changing routines, dental care can often be neglected, leading to cavities and dental trauma. Her advice is for parents to keep up with preventive care and encourage healthier eating habits.

"Try to pick a healthy summer snack. That can be fruit. That can be vegetables. Just not something dry, not something processed," Kalaskey outlined. "And the more processed you have, the more dried it is, the more likely it is to stick to their teeth."

She pointed out left-behind food can cause cavities. Tooth decay is the most common chronic disease among children in the U.S., with more than half of eight-year-olds having had at least one cavity in their baby teeth, according to the Centers for Disease Control and Prevention.

Warmer weather also means more outdoor play. Kalaskey highlighted the rise in dental trauma cases during the summer because of increased outdoor play and sports activities.

"Oftentimes, kids are going and playing basketball, and sometimes high schools are really good about, 'Hey, here's a mouth guard,' or 'You need to get a mouth guard for practice,'" Kalaskey noted. "But during the summer, a lot of times kids will play with other kids, which is great, but making sure they're aware that tooth trauma is a thing."

If a tooth gets knocked out, contact your dentist immediately. If it is after hours, she suggested the ToothSOS app for guidance.

She added another major key to dental hygiene for kids over the summer is a consistent schedule.

"Summer oftentimes is going to change that routine but your brushing, flossing routine does not need a change," Kalaskey recommended. "You still want to do brushing twice a day, flossing at least once a day. So kind of making sure we incorporate that, even though the kids might be waking up at 10 o'clock."

Kalaskey emphasized routine is also important for dental visits. She advised children should be seen by a dentist when they get their first tooth and then every six months afterward. In addition to keeping teeth healthy, she stressed it also builds a good relationship with dental visits in the long term.


get more stories like this via email

A Virginia community health center is part of a program addressing food scarcity.

The National Association of Community Health Centers' 2024 Innovation Incubator creates ways to expand healthy food access. Tri-Area Community Health Center's Laurel Fork location will have funding and guidance from experts to help them design and test community-based solutions.

Merrill Warschoff Press, senior vice president of partnership, development and innovation for the National Association of Community Health Centers, said the centers are uniquely suited to address local food issues.

"Health centers are highly effective and innovated with integrated models of care," Press explained. "They reach far beyond the walls of the traditional exam room, not only to prevent illness and treat it but to really address the social drivers that may cause poor health."

Food insecurity has grown since pandemic-era programs ended in 2023. Emergency allotments provided SNAP recipients with an added $95 per month for 470,000 families statewide. However, some people are above or below SNAP's qualifying threshold.

Other issues stem from food prices. The Consumer Price Index shows food prices grew between 2022 and 2023 but in recent months, prices have been declining.

A primary goal of the Innovation Incubator is to discover best practices for providing care for millions of people and share them with health centers nationwide. Press noted the methods being worked out can help varying populations.

"There are many health centers who have large populations of patients who come from other countries and are used to certain foods, and have different preferences," Press observed. "Being able to work with them in their own language with the foods that they like and trust is really valuable to improving access to food that'll make a difference in their lives."

Food pantries have been key to reducing food insecurity wherever possible. Virginia food banks saw a 5% to 10% increase in demand at the end of 2022, which is problematic since food banks nationwide are seeing donations decline and reduced commodities from the Emergency Food Assistance Program.