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June 8, 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

Medicare ACOs Present Unexpected New Challenges for Compliance Officers
Reprinted from Report on Medicare Compliance

Compliance officers for accountable care organizations (ACOs) have their work cut out for them, according to attorneys who are monitoring their creation .... Read Full Story

 

From the AIS Blogs

Buy and Bill vs. Mandatory Specialty Pharmacy Use

When it comes to office-administered therapies, for years physicians bought the drugs themselves, stored them in their offices and then administered them as needed to patients. But some health plans — concerned over the mark-ups on many of these drugs and not entirely sure what they’re even paying for — have begun requiring physicians to purchase these treatments through specialty pharmacies ... Read more

 

Quote of the Day

“I like to think of it as every single Medco member with a smartphone is now a 100% accurate walking formulary. While we are waiting for the wiring of health care to take place on a schedule that no one can really predict, these members are in a position to have empowered discussions with their providers at the point of care and avoid the disruption associated with prior auth.”

— Tom Feitel, chief Web officer for Medco Health Solutions, Inc., told AIS’s Drug Benefit News.

Click here to read the DRUG BENEFIT NEWS article in which this quote appeared. (Free for DBN subscribers; $17 for non-subscribers).

 

Today's Datapoint

More than
30% … has been the growth in stock prices since Dec. 31, 2010, for at least eight publicly traded health plans, with some growing substantially more.

Click here to read the HEALTH PLAN WEEK article in which this datapoint appeared. (Free for HPW subscribers; $17 for non-subscribers).

 

Today from Washington

People on the Move

XOMA Ltd., a developer of antibody therapeutics, appointed Paul Rubin, M.D., vice president and chief medical officer (CMO). Rubin was CMO at Funxional Therapeutics Ltd....Muskingum Valley Health Centers in Zanesville, Ohio, promoted Daniel Atkinson to CEO. Atkinson was chief financial officer.

 

Today's Featured Health Business Job Opening

TriWest Healthcare Alliance
Manager-Direct Contracting-Alaska
Anchorage, Alaska

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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Just Announced! Accounting for HIPAA Disclosures in EHRs: How to Comply with Onerous New HHS Rules
Thursday, July 7, 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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