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March 2, 2011

Today’s issue is brought to you by Drug Benefit News, biweekly news, proven cost management strategies and unique data for health plans, PBMs, pharma companies and employers.

Today's Featured Story

Blurry Definitions, Nebulous Language Cloud Pharmacy Benefit Contracts
Reprinted from Drug Benefit News

As competition intensifies in the drug benefit management field some of the most pitched battles are being engaged on paper. Contracts between PBMs and their plan sponsor clients are becoming venues for heated contests in which the two parties maneuver and vie for equitable treatment. From the initial request for proposal to the final signature, the contracting process has grown more contentious, with recurrent elements popping up as obstacles to negotiate. Occasionally, such impediments may even prove insurmountable ... Read Full Story


From the AIS Blogs

Catch 22 Redux: Lid on Insurance Rate Hikes, Not on Costs

The noose is tightening around health insurance rate increases. Within the past couple of weeks, there have been several developments. The first involves the Iowa insurance commissioner, who had hired an outside actuary to review a proposed Wellmark Blue Cross Blue Shield rate hike even though the department had its own staff actuary examine the proposal ... Read more


Quote of the Day

“It is pure semantics to argue that an individual who makes a choice to forgo health insurance is not ‘acting,’ especially given the serious economic and health-related consequences to every individual of that choice. Making a choice [to buy or not to buy health insurance] is an affirmative action, whether one decides to do something or not to do something. They are two sides of the same coin. To pretend otherwise is to ignore reality.”

— U.S. District Court for the District of Columbia Judge Gladys Kessler, in her 64-page ruling on Feb. 22 that upheld the constitutionality of the health reform law.


Today's Datapoint

$750 million…was targeted recently by HHS Secretary Sebelius for prevention and public health funds designated by the health care law.



Today from Washington

People on the Move

Aetna Inc. said Chairman Ronald Williams will retire on April 8, and that Mark Bertolini, CEO and president, will become the new chairman....HouseWorks, a private home care company, named Duane Rollins executive director of its Greater Washington office. Rollins was a cardiovascular administrator for the Larry King Cardiac Foundation Program at George Washington University Hospital.


Today's Featured Health Business Job Opening

Martin's Point Health Care
Manager, Enrollment
Portland, Maine

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