May 25, 2012

Today’s issue is brought to you by AIS's Health Plan Week, the industry's leading source of objective business, financial and regulatory news of the health insurance industry.

Communication Error Results in $2.7 Million Fine for N.Y. Plans
Reprinted from Health Plan Week

Fifteen health insurers that do business in New York have collectively been fined $2.7 million for failing to adequately notify small employers that they were eligible to purchase supplemental mental health coverage along with medical benefits, according to the New York Dept. of Financial Services (DFS) .... Read Full Story

How I Learned to Stop Worrying and Love the Rumors Over the Supreme Court Decision

What could possibly have more suspense this week than waiting to find out the winner of American Idol Wednesday night? If you happened to be in the offices of Atlantic Information Services (AIS) this week, the answer would be speculation that the eagerly awaited Supreme Court decision on the health reform law was set to come down today. And as is usually the case, this bout of speculation ended up being nothing more than a rumor ... Read more

When it comes to adopting new Medicare compliance policies, “get a physician high up in the organization to help push it. Anytime there is an interpretation issue, I get physicians to opine on it. That way, I can tell physicians that physician leadership supports this policy.”

— Greg Radinsky, chief corporate compliance officer at North Shore-LIJ Health System, told AIS’s Report on Medicare Compliance.

Click here to read the REPORT ON MEDICARE COMPLIANCE article in which this quote appeared. (Free for RMC subscribers; $17 for non-subscribers).

Today's Datapoint

$3.1 billion … of the $3.4 billion in loans authorized under health reform for Consumer Operated and Oriented Plans (CO-OPs) might never be repaid, according to a recent letter by Republican members of the House Energy and Commerce Committee to acting CMS Administrator Marilyn Tavenner.

Click here to read the INSIDE HEALTH INSURANCE EXCHANGES article in which this datapoint appeared. (Free for HEX subscribers; $17 for non-subscribers).

• Congressional Record
• Federal Register

USHIFU, LLC, a developer of minimally invasive high intensity focused ultrasound technologies, named Mark Carol, M.D., chief development officer. After spending four years in clinical practice, Carol founded several medical device companies, including NOMOS....Geisinger Health Plan promoted Duane E. Davis, M.D., to CEO. Davis was vice president and chief medical officer.

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