AIS's Health Business Daily
Strategic Business News from Experienced Health Care Reporters
at Atlantic Information Services, Inc.
Drug Benefit News
Today’s issue is brought to you by Drug Benefit News, biweekly news and proven cost management strategies for health plans, PBMs, pharma companies and employers.

October 20, 2014

Today's Featured Story

CVS Will Pay $6 Million to Resolve Medicaid False Claims Allegations
Reprinted from Drug Benefit News

CVS Health’s CVS/caremark PBM unit will pay the U.S. $6 million to settle allegations that it knowingly failed to reimburse Medicaid for prescription drug costs that were the responsibility of private health plans administered by the PBM, the U.S. Department of Justice said on Sept. 26. The settlement comes as a result of a whistleblower lawsuit filed by former Caremark employee Donald Well.... Read Full Story


From the AIS Blogs

The Challenge of Innovation in Pharma

Specialty drugs have been in the news often lately, mainly because of their high prices. But many of them offer benefits over traditional drugs, according to a study by researchers with the Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.... Read more


Quote of the Day

“The security of your platform [with confidential patient data] is only as good as the security of the weakest vendor who has access to your server.”

— Robert Trusiak, chief compliance officer and associate general counsel at Kaleida Health in Buffalo, told the audience at a recent American Health Lawyers Assn. Fraud and Compliance Forum.

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

1.8% ... is the average increase in premiums for products sold in 2015 on Colorado’s state-run exchange, according to the state’s Division of Insurance.

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


Today from Washington

People on the Move

The American Academy of Actuaries appointed Tom Wildsmith president for the 2015-2016 term. Wildsmith, who was previously vice president, is senior public policy manager for Aetna, Inc. and succeeds Mary Miller....Alameda Health System named Bonnie Panlasigui chief administrative officer for Alameda Hospital. She was previously chief operating officer of Lutheran Health Network’s Dupont Hospital....Thomas Smith, M.D., joined Ameritox as chief medical officer. He was previously chief medical officer for Mallinckrodt Pharmaceuticals....ForSight VISION5 named Lisa Garrett vice president of finance and administration. She was previously chief financial officer and vice president of human resources for Corventis, Inc., which was recently acquired by Medtronic.


Content questions or suggestions should be directed to Executive Editor Jill Brown at If you are interested in sponsoring AIS's HEALTH BUSINESS DAILY, please contact Bailey Sterrett at

AIS's HEALTH BUSINESS DAILY is copyrighted and protected by federal law. The re-use of its content is restricted (see below). However, you are permitted to forward this e-mail to as many of your friends and colleagues as you wish, or better yet have them sign up for their own copy at atlantic_subscription.cfm, where you can also sign up for AIS's Government News of the Week and Spotlight on Health Insurers.

Copyright © 2014 Atlantic Information Services, Inc. (AIS). All rights reserved. It is not permissible to include all or any portion of this content on any Web site, intranet or electronic network or in any print publication, without AIS's written permission in advance. Permission requests should be directed to

With archives of AIS's Health Business Daily, features like the News Archives, AIS Blogs and more! (Free registration required)




Upcoming Webinars
Save $50!

Translate 2015 Star Ratings Into Your Plan’s New MA/Part D Strategies
Thurs., Oct. 30, 2014
Click here for details

Public Exchange Enrollment Preview: Insurer Strategies to Sidestep the Pitfalls Ahead
Wed., Nov. 5, 2014
Click here for details

Adopting PBM Formulary Exclusions: Pros and Cons for Health Plans and Purchasers
Thurs., Nov. 13, 2014
Click here for details

What CMS’s 2015 Benchmarks and Landscape Files Mean for MA and Part D Product Planning and Marketing
Tues., Nov. 18, 2014
Click here for details

Missed a Live Event?
Listen at your convenience to recent webinars with On-Demand or CD options!
Drug Benefit News
AIS E-Savings Club Weekly Specials
Private Insurance Exchanges: Bottom-Line Strategies for Insurers