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Feb. 24, 2011

Today’s issue is brought to you by AIS's Specialty Pharmacy News, a monthly newsletter designed to help health plans, PBMs, providers and employers contain costs and improve outcomes related to high-cost specialty products.

Today's Featured Story

More Plans Are Mandating Genetic Tests for Some Specialty Therapies
Reprinted from Specialty Pharmacy News

With many genetic tests able to aid physicians in determining what therapies would be most effective for their patients, more and more health plans are requiring the tests as part of prior authorization for a drug. More than half of 60 health plans managing 146.3 million covered lives require HER-2 testing before the breast cancer drug Herceptin (trastuzumab) is prescribed, according to ICORE Healthcare. Its Medical Injectables Oncology Trend Report also shows that almost 60% of respondents require KRAS testing in people treated for colorectal cancer .... Read Full Story


Quote of the Day

“I think the larger [health plans] will be able to meet the deadline [of Jan. 1, 2012, to have compliant electronic transaction standards in preparation for ICD-10]. Those with limited budgets and resources should find a partner to help with outsourcing, because meeting the deadlines [for 5010 and ICD-10] is critical.”

Bob Luckner, director of services product management for TriZetto, told AIS’s Health Plan Week.

Click here to read the HEALTH PLAN WEEK article in which this quote appeared. (Free for HPW subscribers; $17 for non-subscribers).


Today's Datapoint

$3 billion … would be saved in the Florida Medicaid program over two years under Gov. Rick Scott's (R) proposed budget, which recommends moving members into managed care and cutting provider reimbursement rates by 5%.



Today from Washington

People on the Move

WellPoint, Inc. promoted Nicholas Brecker to specialty market president for California local group, national accounts, consumer business and UniCare business segments. Brecker was president and general manager of WellPoint's Life and Disability companies. ...myMatrixx, a developer of pharmacy management tools, named Michael Geis director of IT infrastructure. Geis was vice president of information system operations at Lifestyle Family Fitness.


Today's Featured Health Business Job Opening

Executive Search & Placement
Manager, Medical Management
Los Angeles and Long Beach, Calif.

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