Feb. 22, 2012

Today’s issue is brought to you by AIS's hard-hitting new newsletter, Inside Health Insurance Exchanges, containing news and strategic insights on the development and operation of state and private exchanges.

With Many States Behind Schedule, CMS Is Likely to Set Low Bar for Certification
Reprinted from Inside Health Insurance Exchanges

While HHS collectively has awarded $729 million to help states stand up an insurance exchange, many states will run out of time long before they run out of cash. As a result, HHS is expected to set the bar low when evaluating certification applications for state insurance exchanges, industry observers tell AIS .... Read Full Story

ICD-10 Delay May be Mixed Bag

By now, most people probably know that HHS has delayed the October 2013 implementation date of ICD-10 diagnosis and procedure codes ... Read more

“Determining whether [a 50.4% increase in the retail prices for 98 specialty drugs from 2004 through December 2009] was a reasonable rate of price inflation or not needs to be established by the manufacturers, something they have not done a very good job at to date. The particularly high specialty price growth during this time shows the oft-mentioned arrogance of many biopharm companies who seemed out of touch with market trends and attitudes.”

— F. Randy Vogenberg, Ph.D., a principal with the Institute for Integrated Healthcare, told AIS’s Specialty Pharmacy News.

Click here to read the SPECIALTY PHARMACY NEWS article in which this quote appeared. (Free for SPN subscribers; $17 for non-subscribers).

Today's Datapoint

22.5 million … health plan members are enrolled in Express Scripts, Inc., making it the leading PBM in terms of enrollment, according to AIS’s Directory of Health Plans: 2012.

Click here to read the DRUG BENEFIT NEWS article in which this datapoint appeared. (Free for DBN subscribers; $17 for non-subscribers).

• Congressional Record
• Federal Register

BlueCross BlueShield of Tennessee promoted Bill Gracey to CEO. He will replace Vicky Gregg, who will retire effective Dec. 31, 2012. Gracey is president and chief operating officer....PerfectServe, a developer of clinical communication tools, appoined Todd Cozzens to its board of directors. Cozzens is CEO of Optum Accountable Care Solutions.

Content questions or suggestions should be directed to BJ Taylor, editor of AIS's HEALTH BUSINESS DAILY, at bjtaylor@aishealth.com. If you are interested in sponsoring AIS's HEALTH BUSINESS DAILY, please contact Bailey Sterrett at bsterrett@aishealth.com.

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