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March 9, 2011

Today’s issue is brought to you by AIS's Medicare Advantage News, biweekly news and analysis on the Medicare (and Medicaid) managed care programs.

Today's Featured Story

Plans Stand to Get Better-Than-Expected 2012 Pay Based on CMS ‘45-Day Notice’
Reprinted from Medicare Advantage News

The proposed payment-rate adjustments for Medicare Advantage plans in 2012, based on CMS’s “45-day notice” released late Feb. 18, are better than expected, according to comments made by five MA plan actuarial and financial consultants .... Read Full Story


From the AIS Blogs

Acrimonious Budget Debate Puts Survival of Obama SGR Fix into Question

It’s the most comprehensive effort I’ve seen to date in a federal budget proposal to fix Medicare’s perpetually troubled Sustainable Growth Rate formula, which for years has threatened payment cuts to physicians .... Read more


Quote of the Day

While lower medical costs should eventually be reflected in premiums, “sooner or later costs will likely accelerate in an unexpected way, which could result in margin contraction that offsets any near-term improvements. The 2010 experience is basically the opposite of 2008."

— Matthew Coffina, an equities analyst at Morningstar Inc., 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

7 … years, instead of the current 12, would be the limit under President Obama’s FY 2012 budget proposal on the time that brand-name biologics would have marketing exclusivity before “biosimilars” would be allowed.

Click here to read the AIS's HEALTH REFORM WEEK article in which this datapoint appeared. (Free for HRW subscribers; $17 for non-subscribers).


Today from Washington

People on the Move

AMERIGROUP Corp. promoted Patrick Blair to chief marketing officer. Blair was CEO of the company’s Specialty Products Group....The American Society of Clinical Oncology named Deborah Kamin interim senior director of its quality department. Kamin has served as senior director of ASCO’s cancer policy and clinical affairs department since 1998.


Today's Featured Health Business Job Opening

Spartanburg Regional - Regional HealthPlus
Medical Management Coordinator
Spartanburg , S.C.

Place Your Ad Here

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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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