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March 24, 2011

Today’s issue is brought to you by The HCCA-AIS Medicaid Compliance News, monthly news and valuable how-to strategies for identifying and reducing today’s top Medicaid compliance risks.

Today's Featured Story

Two Health Plans Pay Millions to Settle Federal, State Lawsuits
Reprinted from The HCCA-AIS Medicaid Compliance News

Two insurers in separate cases agreed in February to pay millions to the federal government and their respective states to settle allegations that they defrauded Medicaid .... Read Full Story


From the AIS Blogs

ACA One Year Later: ACO Regs Can Revive the Debate

As it approaches its one-year anniversary, the sweeping health reform law could benefit from a little less partisan rhetoric and more regulatory substance. The forthcoming regulations on Medicare shared savings, or accountable care organizations would handily supply this remedy, provided that the White House, HHS and Hill staffers can wrap up their differences ... Read more


Quote of the Day

The reform mandate to cover dependent children “is a major fiscal burden for employers and unions in industries with an older work force. These costs siphon capital away from real wage growth that is needed for working families….”

— Ed Kaplan, a benefits consultant in Segal Co.’s New York City office, 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

$118 billion … or more is what health reform will cost state taxpayers through 2023, according to a reported released March 2 by House and Senate Republicans.



Today from Washington

People on the Move

Catalent Pharma Solutions, Inc. named Tim McFadden vice president and general manager of consumer health softgel. McFadden was executive vice president of sales and marketing for the pharmaceutical distribution business of Cardinal Health....Via Christi Hospital on St. Francis in Wichita, Kan., appointed Sherry Hausmann president. Hausmann was president of SSM St. Clare Health Center in St. Louis, Mo.


Today's Featured Health Business Job Opening

Aegis Medical Systems, Inc.
Clinic Director / Program Manager
West Covina, Calif.

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Upcoming Webinars

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

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

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

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

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

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Medicare Advantage Marketing for 2012: Steps to Take Now to Succeed Amid Reform-Driven Changes
Tuesday, May 10, 2011

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A Practical Guide to Federal Medical Loss Ratio Requirements
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