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Molina Extends Affordable Care Act Coverage to OC

Molina Healthcare Inc. will add Orange County to its Covered California service area next year.

Long Beach-based Molina insures about 676,000 people in six counties—Los Angeles, San Diego, Riverside, San Bernardino, Imperial and Sacramento—via Medi-Cal, Medicare and Covered California.

Covered California is the state entity overseeing access to the Patient Protection and Affordable Care Act, often called Obamacare.

Molina will work with Monarch Health Plan Inc. in Irvine and Affiliated Doctors of Orange County Medical Group in Orange to provide coverage.

Monarch has about 2,500 doctors and specialists. It offers access to 90 hospitals and urgent care facilities and 60 lab and radiology sites. It is affiliated with Monarch HealthCare, which is owned by UnitedHealth Group Inc. in Minnesota under its Optum Inc. unit.

Affiliated Doctors has about 900 doctors and specialists. The medical group is part of Heritage Provider Network in Northridge. A second Heritage group—Regal Medical Group, also in Northridge—has some Orange County reach as well, according to the Heritage website.

Molina said it also may expand its Covered California service in the Inland Empire with a new medical group.

Medtronic Appeal

Medtronic Inc. wants a court to reverse a $15.4 million judgment in favor of Pabban Development Inc.

Medtronic, a Minneapolis medical device maker with its corporate headquarters in Ireland, employs 1,500 in Irvine and Santa Ana.

Irvine-based Pabban in 2008 sold a bone cement delivery system called Natrix to Medtronic for $19 million upfront and about $31 million in milestones and royalties.

Medtronic had the previous year bought a Swiss company, Kyphon, which had created a way to inflate and then deflate balloons to open up space in fractured vertebrae and fill the gaps with bone cement.

The Federal Trade Commission let Medtronic buy the balloon part of the procedure but required it to sell Kyphon’s cement delivery system, which it did for about $100 million, said trade newsletter MassDevice. That apparently led to the buy of Pabban’s cement delivery system.

Medtronic made the first payment to Pabban, but the companies disagreed over whether the cement delivery system was ready to go to market and payments stopped.

Pabban sued Medtronic in March 2010 and in May 2014 won the $15.4 million jury verdict.

Medtronic on Aug. 31 asked the Ninth Circuit Court of Appeals to reverse the judgment.

Joseph Thomas of Thomas Whitelaw & Kolegraff LLP in Irvine represents Pabban; Richard Derevan of Snell & Wilmer LLP in Costa Mesa joined the case on behalf of Pabban last month.

News reports said 550,000 of the spinal cement delivery procedures, called kyphoplasty, are done each year.

Tester Notes New Business

CombiMatrix Corp. in Irvine said a large U.S. health insurer added reimbursement for one of its assays.

The company develops genetic screenings for pre-implantation, prenatal and pediatric diagnostics.

It said Health Care Service Corp. in Chicago, which runs Blue Cross and Blue Shield programs in five states, “issued a medical policy to include reimbursement for chromosomal microarray analysis for the evaluation of pregnancy loss.”

About 20 insurers have added reimbursement for the test this year, according to CombiMatrix, which has a market cap of about $7.5 million and lost $6.6 million on revenue of slightly more than $10 million last year.

“We reported a 33% revenue increase from miscarriage analysis testing for the first half of this year driven mainly by higher average revenue per test, which is in part related to these favorable coverage decisions,” said CombiMatrix Chief Executive Mark McDonough.

The company separately said it signed a deal with Universal Diagnostic Laboratories in Van Nuys to market and distribute the test in California.

Bits & Pieces

Hoag Breast Center in Newport Beach was named a certified quality breast center of excellence by the National Quality Measures for Breast Centers Program for the fourth year running. Hoag, which does 40,000 screen mammograms a year, said it was the only OC center and one of only 48 nationally to get the nod. … Sue Hewitt of Project Independence in Costa Mesa got a 2016 Regional Center of Orange County Direct Support Professional Spotlight Award. Project Independence works with the developmentally disabled community in OC. … Allergan Plc Chief Executive Brent Saunders has the fifth-highest golden parachute among the 90% of Fortune 500 companies that provide details on their CEOs’ departure compensation packages, according to Bloomberg. His $140.7 million includes cash, accelerated vesting and other benefits. Allergan is based in Ireland, keeps its operating headquarters in Parsippany, N.J., and maintains hubs for eye and aesthetics business lines at its campus in Irvine.

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