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March 8, 2011

Today’s issue is brought to you by AIS’s Health Reform Week, the nation’s leading publication on the business implications of the massive changes for the health industry mandated by reform.

Today's Featured Story

Plans Cite Operational Issues in Complying With Appeals-Handling Rules Effective July 1
Reprinted from AIS’s Health Reform Week

As the July 1 effective date nears for most health plans to comply with the last few provisions of new rules for handling internal and external appeals, insurers say there are substantial operational issues making the deadline difficult .... Read Full Story


From the AIS Blogs

FDA Action Date on Lupus Drug Benlysta Is Fast Approaching

The FDA is set to review Human Genome Sciences’ lupus drug Benlysta (belimumab) on March 10. If approved, the therapy would be the first approved for the condition in more than 50 years .... Read more


Quote of the Day

“For every week prior to 39 weeks of pregnancy that a baby is delivered, the chance of having health and development problems that require care in a neonatal care unit nearly doubles. We want to help our members and doctors avoid that unnecessary risk. It’s really a protective effort.”

— Marjorie Schulman, M.D., a senior medical director at Aetna and NICU doctor, 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

$241 million … in “early innovator” grants were recently awarded by HHS to Kansas, Maryland, Oklahoma, Oregon and Wisconsin to develop and implement the framework needed to operate their health insurance exchanges.



Today from Washington

People on the Move

Tom Newton joined Wellmark Blue Cross and Blue Shield as director of network engagement. He was director of the Iowa Department of Public Health....Blue Cross Blue Shield of Arizona appointed Matthew Wandoloski vice president, strategy and informatics. Wandoloski was a partner with Mercer Consulting.


Today's Featured Health Business Job Opening

Health Alliance Medical Plans
Director of Contracting and Provider Services
Urbana, Ill.

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AIS E-Savings Club Weekly Specials

Upcoming Webinars

Social Media: How Insurers Can Strengthen Sales, Improve Member Health and Avoid Privacy Risks
Tuesday, March 22, 2011

Click here for details.

Beyond Buy and Bill: Managing Specialty Therapies Under the Medical Benefit
Tuesday, March 29, 2011

Click here for details.

Medical Homes: Health Plan Pilots that Have Improved Outcomes and Lowered Costs
Thursday, March 31, 2011

Click here for details.

New Reform-Driven Claims and Appeals Procedures: Practical Steps Plans Should Take Now
Tuesday, April 5, 2011

Click here for details.

CMS’s New Past Performance Assessment: Steps MA and Part D Plans Must Take Now to Avoid Harsh Penalties
Thursday, April 14, 2011

Click here for details.

Setting Out-of-Network UCR Rates: Evaluating FAIR Health’s New Benchmark Data and Other Alternatives for Insurers and Employers
Thursday, April 21, 2011

Click here for details.

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