Feb. 8, 2012

Today’s issue is brought to you by AIS's Report on Medicare Compliance, the nation's leading source of news and strategic information on Medicare compliance, Stark and other big-dollar issues of concern to health care compliance officers.

With More Audits, Health Systems May Need a Centralized Response
Reprinted from Report on Medicare Compliance

If it had just been facing RAC audits, Advocate Health Care in Oak Brook, Ill., might have continued its largely decentralized approach to defending against government audits at its 12 hospitals .... Read Full Story

The End of Health Insurance Companies?

That was the headline of a blog opinion piece posted on The New York Times website on Jan. 30. With a title like that, how could the piece not be interesting? ... Read more

“I think the risk down the road [for health plans] is provider groups consolidate to the point where they could very possibly offer competitive, self-contained health plans along the Kaiser Permanente model that would compete with the traditional health plans. By getting in now on the ground floor, I think the health plans are hoping to not be competitors — but to participate on that side of the business.”

— Matthew Coffina, a health care securities analyst at Morningstar, Inc., told AIS’s ACO Business News.

Click here to read the ACO BUSINESS NEWS article in which this quote appeared. (Free for ABN subscribers; $17 for non-subscribers).

Today's Datapoint

58 … Medicare Advantage plans covered fitness-club memberships for their enrollees in 2008, up from just 14 in 2002, according to a new study by Brown University researchers published in the Jan. 12 New England Journal of Medicine.

From MEDICARE ADVANTAGE NEWS.

• Congressional Record
• Federal Register

MagnaCare, a health plan management company, named Tom Considine chief operating officer, effective March 1. Considine is commissioner of the New Jersey Department of Banking and Insurance....CVS Caremark appointed Larry Burton senior vice president of government affairs. Burton was executive director at Business Roundtable in Washington, D.C.

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