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March 11, 2011

Today’s issue is brought to you by AIS's Medicare Part D News, monthly business, compliance and management news and strategies to help Part D plans increase enrollment, boost revenues and minimize their risks of CMS fines, penalties and repayments.

Today's Featured Story

Despite Part D Enrollment Drop in 4Q10, Sponsors Are Still Optimistic About Future
Reprinted from Medicare Part D News

While CMS showed an increase in year-to-date enrollment in Part D products as of Jan. 14, 2011, some Part D sponsors said they lost Part D enrollees for the fourth quarter of 2010. And although the new Open Disenrollment Period for Medicare Advantage enrollees didn’t seem to produce big gains for Part D, many sponsors were encouraged about the outlook for 2011 and beyond .... Read Full Story


From the AIS Blogs

CMS Identifies Hot Issues in Compliance Newsletter

CMS has released the second issue of the Medicare Quarterly Provider Compliance Newsletter, which highlights major findings identified by CMS contractors — MACs, RACs, PSCs, and ZPICs — as well as OIG .... Read more


Quote of the Day

“It bodes well that the states receiving these [HHS awards to become “early innovators” with insurance exchanges] represent a broad range of demographic, geographic, health delivery system and insurance market environments. It is also promising that organizations and states as varied as [Kansas, Oregon and Maryland] are committed to developing effective, efficient and readily accessible health insurance exchanges….”

— Rick Curtis, president of the Institute for Health Policy Solutions, a nonpartisan organization providing technical assistance to California and other states on exchange design.

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


Today's Datapoint

10%…of patient outcomes are affected by medical care, while family genes and socioeconomic status account for about 55%, with behavioral/lifestyle decisions the biggest driver, according to Steven Adelman, M.D., director of behavioral health and addiction medicine for Harvard Vanguard Medical Associates.

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


Today from Washington

People on the Move

Pro-Pharmaceuticals Inc. promoted Peter G. Traber, M.D., to president and CEO, effective March 17. Traber was interim chief medical officer....The American Medical Association named Howard Bauchner, M.D., editor-in-chief of its Journal of the American Medical Association, effective July 1. Bauchner is editor-in-chief of the Archives of Disease in Childhood, the official publication of the Royal College of Paediatrics and Child Health in the United Kingdom.


Today's Featured Health Business Job Opening

WellPoint, Inc
Regulatory Compliance Manager
Milwaukee; Mason, Ohio; or Denver

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.

AIS's Directory of Health Plans: 2011
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