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May 12, 2011

Today’s issue is brought to you by AIS's Report on Patient Privacy, the industry's #1 source of timely news and business strategies for safeguarding patient privacy and data security.

Today's Featured Story

During ‘Limbo,’ CEs Should Tighten Their Oversight of BAs, Enhance Protections
Reprinted from Report on Patient Privacy

Many times, it seems, it isn’t the covered entity that is experiencing a privacy faux pas or a security breach, but the CE’s business associate that somehow lost protected health information .... Read Full Story


From the AIS Blogs

Prescription Solutions Boards the Restrictive Network Bandwagon

Another large PBM has joined the movement to generate savings for plan sponsor clients by deploying smaller pharmacy networks. Prescription Solutions, Inc., a subsidiary of UnitedHealth Group, unveiled its Value Network, a limited, or restrictive, pharmacy network that leverages savings by requiring enrollees to use a reduced number of designated pharmacies ... Read more


Quote of the Day

“The biggest challenge facing the [health insurance] exchanges, as we see it, is you’re going to have millions of new customers coming in, as many as 30 million a year, bouncing on and off the Medicaid rolls.”

— John Gorman, CEO of Gorman health Group, LLC, told AIS’s Health Reform Week.

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

93% … of respondents to a recent Commonwealth Fund survey of 1,011 adults said it was “important” or “very important” to have one place or doctor responsible for primary care and coordinating care.



FierceHealthPayer News from our partner FierceMarkets

Aetna, WellPoint CFOs: Mergers and Acquisition Deals Increasing

The chief financial officers at Aetna and WellPoint think that mergers and acquisitions throughout the health insurance industry are increasing .... Read more


Today from Washington

People on the Move

Yaupon Therapeutics, a privately held specialty pharmaceutical company, named Steve Tullman chairman of the board of directors and CEO. Tullman was the co-founder, president and CEO of Ception Therapeutics....Health Dialog appointed Robert Mandel, M.D., executive vice president for market and business development, effective May 23. Mandel was senior vice president of health care services at BlueCross BlueShield of Tennessee.


Today's Featured Health Business Job Opening

Blue Shield of California
Vice President and Chief Compliance Officer
San Francisco

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Register for the FIS Healthcare Payment Solutions webinar, Payer and Provider Collaboration – Strategies to Ensure Mutual Success – May 26, 2011; 2:00 p.m. EDT.

Upcoming Webinars

Optimizing Drug Benefit Plan Designs for the Coming Wave of Generic Competition
Tuesday, May 17, 2011

Click here for details.

Global Payments: Health Plan Strategies for the Brave New World of Accountable Care
Tuesday, June 14, 2011

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Strategies for Managing Part D Specialty Formulary Tiers
Wednesday, June 15, 2011

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Insurance Exchanges: How Health Plans and Employers Should Prepare for the Radical Changes Ahead
Tuesday, June 21, 2011

Click here for details.

Medical Loss Ratio Regs: What 2010 Data Suggest About Potentially Huge Rebates in 2011
Thursday, June 23, 2011

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ACO Results and Strategies: A Case Study in Three-Way Risk Sharing
Thursday, June 30, 2011

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Payer Strategies to Manage High-Cost Specialty Drugs That Will Hit the Market Soon
Thursday, July 14, 2011

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AIS's Health Business Daily