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May 18, 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

MA Plans’ RADV Audit Fears Bring More Business to Prospective-Assessment Firms
Reprinted from Medicare Advantage News

It is an ill wind that doesn’t blow anybody some good, and that’s true even of the CMS risk adjustment data validation (RADV) audits now inspiring uncertainty-bred fears in the Medicare Advantage industry. The beneficiaries of the breeze, in this case, are vendors of prospective-assessment services for MA firms that are looking for, as one of the vendors put it, “RADV audit protection.” ... Read Full Story


From the AIS Blogs

FDA Releases User Fee Proposal for Biosimilars

When the health reform law created an approval pathway for so-called biosimilars, the law left most of the heavy lifting up to the FDA. Among the issues the agency is grappling with is what kind of user fees to require from the manufacturers of these drugs ... Read more


Quote of the Day

“It would be difficult to miss a stack of 200 cases of office paper that weighed over 10,000 pounds. But to know that today’s flashdrives can hold as much data as can be printed on a million sheets of paper just boggles my mind on how an entire patient database could easily be lost.”

— Frank Rules, compliance and privacy officer at Maryvale Hospital in Phoenix, told AIS’s Report on Medicare Compliance.

Click here to read the REPORT ON MEDICARE COMPLIANCE article in which this quote appeared. (Free for RMC subscribers; $17 for non-subscribers).


Today's Datapoint

$14.6 billion … could be saved over 10 years if Congress were to repeal planning grants for states to set up the reform law’s insurance exchanges, according to a recent Congressional Budget Office analysis.



Today from Washington

People on the Move

Prescription Solutions promoted Brian Solow, M.D., to chief medical officer. Solow has been senior medical director since 2007....Olympus Corp., a developer of life science imaging systems, promoted Hidenao Tsuchiya to vice president and general manager of the Scientific Equipment Group in the Americas. Tsuchiya was division manager for the Life Science Business Division at Olympus.


Today's Featured Health Business Job Opening

Epic Management, L.P.
Chief Financial Officer
Redlands, Calif.

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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

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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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