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May 17, 2011

Today’s issue is brought to you by AIS's Report on Medicare Compliance, the nation's leading source of news and strategic information on Medicare compliance, Stark and other big-dollar issues of concern to health care compliance officers.

Today's Featured Story

CMS Moves to Expand DRG Window Rule to Hospital-Owned Practices, Lower Fees
Reprinted from Report on Medicare Compliance

CMS is again modifying the MS-DRG three-day payment window rule, after hospitals have spent a year adapting to legislation, a regulation and informal clarifications .... Read Full Story


From the AIS Blogs

Retiring CEO’s 2010 Compensation Translates to Nearly $10,000 an Hour
With about $20 million in salary, bonuses and stock awards, retiring Aetna CEO Ronald Williams was last year’s best compensated health plan CEO, based on Health Plan Week's annual analysis of proxy statements filed with the SEC. Just for fun, I translated his compensation into an hourly wage based on a 40-hour work week. It works out to roughly $9,600 an hour .... Read more


Quote of the Day

“There are winners and losers in every piece of legislation. But what was sold as a cost-cutting, cost-containing, cost-reducing piece of [health reform] legislation is turning out to be just the opposite from the employers’ perspective.”

Ed Fensholt, director of compliance services for Lockton Benefit Group, told AIS’s Health Reform Week.



Today's Datapoint

5% … of plan payments are at risk in Texas’s expansion of Medicaid managed care.

Click here to read the MEDICARE ADVANTAGE NEWS article in which this datapoint appeared. (Free for MAN subscribers; $17 for non-subscribers).


FierceHealthPayer News from our partner FierceMarkets

Insurers are using health IT, joining ACOs, hiring doctors

Major health insurers, including Aetna, Humana and WellPoint, are retooling and diversifying to reach beyond the health insurance sector in the wake of the federal healthcare overhaul that is changing the industry's core business .... Read more


Today from Washington

People on the Move

Alverix, Inc., a medical device company, named Cristopher McReynolds vice president of business development. McReynolds was CEO at Satoris, Inc....Ronald Henry was appointed director of physician services at St. Joseph Medical Center in Baltimore. Henry was chief business development officer for North Fulton Hospital in Roswell, Ga.


Today's Featured Health Business Job Opening

Catalyst Rx
Clinical Manager
Reno, Nev.

Place Your Ad Here

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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

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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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Health Plans vs. Drug Coupons: Tactics to Combat Brand-Name Drug Promotions
Wednesday, July 13, 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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