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June 2, 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

New York’s Office of Medicaid Inspector General Starts Reviewing Providers for Effectiveness of Compliance Programs
Reprinted from The HCCA-AIS Medicaid Compliance News

With more than a handful of compliance program effectiveness reviews now under its belt, the New York State Office of Medicaid Inspector General (OMIG) is telling providers what to expect with new tools on its website and at public events.... Read Full Story

 

From the AIS Blogs

ACOs and MA Plans: Never the Twain Shall Meet?

The health reform law specifically states that health plans such as Medicare Advantage plans cannot become an accountable care organization (ACO) in Medicare’s Shared Savings Program. But in light of the recent flurry of establishing ACOs in the private and Medicare sectors, is it likely that the two entities ever will have a direct — or indirect — impact on one another?... Read more

 

Quote of the Day

With the FDA’s recent proposal to create user fees for follow-on biologics, “they’re trying to put a process together for a market that doesn’t exist. It’s a stab in the dark. The FDA is molding the market — it’s making the market — with this user-fee program.”

— Eric Hargan, a shareholder in Greenberg Traurig, LLP’s health and FDA business practice, told AIS’s Specialty Pharmacy News.

Click here to read the SPECIALTY PHARMACY NEWS article in which this quote appeared. (Free for SPN subscribers; $17 for non-subscribers).

 

Today's Datapoint

$70 million … was earned in the first quarter of 2011 by Massachusetts’ four largest insurers, compared with a net loss of $150 million for the same period in 2010.

From HEALTH PLAN WEEK

 

FierceHealthcare News from our partner FierceMarkets

Physician-owned hospital fights reform limits

Physician Hospitals of America (PHA) has filed a formal notice of appeal in its ongoing battle against growth restrictions in the healthcare reform law that make it nearly impossible for physician-owned hospitals to expand, according to PHA.... Read more

 

Today from Washington

People on the Move

Gentiva Health Services, Inc. named Tony Strange the company’s chairman of the board. Strange is Gentiva’s president and CEO and is succeeding Ron Malone as chairman. Malone will remain a director….CHRISTUS Health announced several changes to its leadership team, including naming Ernie Sadau as its president and CEO, Gene Woods as executive vice president and COO, Randy Safady as executive vice president and CFO and John Gillean as executive vice president and chief clinical officer, among others.

 

Today's Featured Health Business Job Opening

Catalyst Rx
Director, Clinical Market Intelligence
Anywhere in the U.S.

Place Your Ad Here
 

Content questions or suggestions should be directed to BJ Taylor, editor of AIS's HEALTH BUSINESS DAILY, at bjtaylor@aishealth.com. If you are interested in sponsoring AIS's HEALTH BUSINESS DAILY, please contact Bailey Sterrett at bsterrett@aishealth.com.

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Upcoming Webinars

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

Click here for details.

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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