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July 14, 2011

Today’s issue is brought to you by Drug Benefit News, biweekly news, proven cost management strategies and unique data for health plans, PBMs, pharma companies and employers.

Today's Featured Story

New York Anti-Mail-Order Bill Underscores Feud Between PBMs and Community Pharmacists
Reprinted from Drug Benefit News

As the weather heats up, so has the battle over mail-order pharmacy. The latest assault comes in the form of legislation passed in New York state that would prevent patients from being forced to use a particular pharmacy, including mail order, or being financially punished for using the pharmacy of their choice .... Read Full Story


From the AIS Blogs

One Deadline You Need to Encounter Quickly

Amid everything else going on in Medicare Advantage these days, it would be easy to neglect something that doesn't take effect until Jan. 1 and sounds like just a systems-change issue. That would be a mistake, and it isn't. MA plans will have to submit encounter data to CMS beginning Jan. 3, and plans not doing it correctly will not only be out of compliance but also eventually could receive lower payments from the agency ... Read more


Quote of the Day

“I think the public-health associations are beginning to understand that the subsidies for their programs are on the chopping block…. A lot of public-health professionals are actually funded through discretionary accounts like the Centers for Disease Control and Health Resources and Services Administration, and those budgets are under fire right now because of fiscal concerns.”

— Dan Mendelson, president and CEO of Avalere Health LLC and a former Clinton administration budget official, 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

70 … miles from St. John’s Regional Medical Center, in Joplin, Mo., medical records were found after a recent tornado swept through the facility.



FierceHealthcare News from our partner FierceMarkets

Docs insist on brand-name drugs even with cheaper generics available

Even though generic prescription drugs may be as effective as brand-name drugs, some physicians continue to prescribe branded drugs out of habit, according to a Washington Post article ... Read more


Today from Washington

People on the Move

Global Health Ventures Inc., a specialty pharmaceutical company, appointed Lola Maksumova, M.D., senior vice president and chief operating officer. Maksumova was vice president of drug development at Pacific Therapeutics....Holon Solutions, a developer of connectivity tools to health care communities, named Worth Roberts vice president of sales for the eastern region. Roberts was a senior account executive at Lawson Healthcare.


Today's Featured Health Business Job Opening

BlueShield of Northeastern New York
Competitive Intelligence Specialist
Albany, N.Y.

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