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July 19, 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

UCLA Health System Settles HIPAA Case Over Celebrity Snooping
Reprinted from Report on Medicare Compliance

The University of California at Los Angeles Health System has agreed to pay $865,500 to settle alleged HIPAA violations over employees who peeked at two celebrities’ electronic medical records. UCLA Health System also will implement corrective actions to fix gaps in its HIPAA compliance, the HHS Office for Civil Rights announced July 7 .... Read Full Story


From the AIS Blogs

Will Health Reform Impact Specialty Drug Coverage?

According to an actuary whose company serves about 15,000 employer customers, health care reform “can potentially really derail some of the growth” of specialty drugs in the U.S. marketplace. Mike Miele, president of GBS Healthcare Analytics, contends that reform “is going to force the ‘pay or play’ evaluation” of health insurance. “Most employers prefer to play but only if they can more aggressively manage trend. Specialty pharma is a fast mover, and it has questionable employer value.”... Read more


Quote of the Day

“The pearl in this project is we showed [physicians] data [that demonstrated] it doesn’t really matter how good a physician you are if, at the end of the day, we are not providing affordable care. I think a light bulb went off in their heads.”

— Rosaleen Derington, chief medical services officer for Hill Physicians Medical Group, which teamed with Blue Shield of California and Catholic Healthcare West on a three-way-risk accountable care model, told AIS’s Health Plan Week.

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


Today's Datapoint

$29 billion … in excess capital has been amassed by the nation’s not-for-profit Blues plans, up from $18 billion at the end of 2008, according to a report from Citigroup Global Markets.

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

Medicaid insurers enter small business market

As large, brand-name health insurance companies gradually become out of reach for many small businesses trying to contain costs, insurers serving Medicaid and other government-subsidized health programs are moving into the small business market hoping to capitalize on this opportunity ... Read more


Today from Washington

People on the Move

National Council for Community Behavioral Healthcare named Carl Clark, M.D., chairman of its board of directors. Clark is a practicing psychiatrist and CEO of the Mental Health Center of Denver....The Medical Group Management Association appointed Susan Turney, M.D., president and CEO. Turney was CEO and executive vice president of the Wisconsin Medical Society.


Today's Featured Health Business Job Opening

BlueShield of Northeastern New York
Senior Product Manager
Albany, N.Y.

Place Your Ad Here

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