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July 12, 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

The Obligation to Research the History of Errors Makes CMS’s 60-Day Repayment Rule a Nightmare
Reprinted from Report on Medicare Compliance

With the 60-day Medicare and Medicaid refund deadline hanging over their heads, hospitals are scrambling to nail down their overpayments in time, although some may miss the deadline.... Read Full Story


From the AIS Blogs

Business Is Booming for Phantom Pharmacies

The federal government, PBMs and health insurers are paying close attention to so-called “phantom pharmacies....” Read more


Quote of the Day

“There are a lot of folks who don’t like the [reform law] at all, and one way of slowing it down in a relatively low-profile way [is to cut off funds for public health. House Republican staff] see a lot of work-force spending as being very redundant, and it doesn’t have the strongest constituencies.”

— Bruce Sigel, M.D., CEO of the National Assn. of Public Hospitals and Health Systems, 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

19.3%… is the average claims-processing error rate of the seven large health plan operators featured in the AMA’s fourth annual National Health Insurer Report Card.

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


FierceHealthPayer News from our partner FierceMarkets

Massachusetts Blues refunds $4.2M to customers

In an apparent effort to boost public confidence and close the controversy surrounding executive payouts, Blue Cross Blue Shield of Massachusetts is refunding its customers $4.2 million--the same amount of severance pay it gave to former CEO Cleve Killingsworth.... Read more


Today from Washington

People on the Move

Richard Noffsinger was named president and CEO of ActiveHealth Management. He takes over for Gregory Steinberg, M.D., who will head clinical innovation at Aetna….Blue Cross Blue Shield of Arizona named Audrey Halvorson vice president of actuarial services and health care economics. Halvorson most recently owned and operated an actuarial consulting firm. Prior to that, she was chief actuary and vice president and general manager of actionable analytics at Premera Blue Cross…. Colorado Gov. John Hickenlooper (D) appointed Rep. Jim Riesberg as the state’s new commissioner of insurance. He resigned his House seat June 30 and began his new role July 1. Riesberg will replace John Postolowski, who was appointed as interim insurance commissioner Dec. 1.


Today's Featured Health Business Job Opening

B. E. Smith
Director of Risk Management
Sioux Falls, SD

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Tuesday, August 23, 2011

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