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Aug. 1, 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

OIG Pushes Hospitals on Device Credits, but Manufacturers May Be Key to Compliance
Reprinted from Report on Medicare Compliance

Although government scrutiny of billing for replaced medical devices is intensifying, hospitals may find it hard to live up to compliance expectations. It’s one thing for hospitals to return Medicare overpayments stemming from manufacturer credits for devices that malfunctioned while under warranty if and when the credits come to light. But it’s a different thing entirely for hospitals to routinely identify the credits and understand what they represent .... Read Full Story


From the AIS Blogs

With Info on HIPAA Audits Released, Inhale, Exhale, Smile

Recently released information about the number and structure of the HIPAA audits should take some of the edge off for those who have been worried about the upcoming reviews. The contractor hired by the HHS Office for Civil Rights, KPMG, will conduct 150 audits by Dec. 31, 2012 ... Read more


Quote of the Day

“I am not surprised the state [of Connecticut, which offered CIGNA $80 million in assistance to relocate its headquarters] targeted one of its key industries: insurance and financial services. These are jobs that other government entities aren’t paying a lot of attention to. It’s a heck of a lot easier to move them to a state where they already have operations rather than, say, South Carolina.”

— Joseph Paduda, principal at the consulting firm Health Strategy Associates, 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

$92 billion and $130 billion … could be saved by state governments through 2019 under health reform due to provisions that would reduce the number of uninsured and increase federal support for health care functions previously financed by states, according to the Robert Wood Johnson Foundation.



Today from Washington

People on the Move

Kinney Drugs Inc. promoted Owen Halloran to senior vice president of pharmacy procurement, Michael Duteau to vice president of pharmacy operations, and Jim Spencer to vice president of retail operations. Halloran was vice president of professional services, Duteau was director of pharmacy operations, and Spencer was director of retail operations....The California HealthCare Foundation named Sandra Shewry director of state health policy. Shewry was the president and CEO of the Center for Connected Health Policy.


Today's Featured Health Business Job Opening

Blue Shield of California
Provider Relations Manager
Costa Mesa, El Segundo, Woodland Hills, Calif.

Place Your Ad Here

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Upcoming Webinars
Save $30!

Value-Based Pharmacy Benefits: How to Increase Medication Adherence and Return on Investment
Wednesday, August 10, 2011

Click here for details.

Managing Oncology Drugs: New Challenges and Payer Solutions
Tuesday, August 23, 2011

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New Insurance Exchange Regs: Strategies for Health Plans, Brokers, Providers and Employers
Wednesday, August 24, 2011

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Hot Spots in the 2012 IPPS Regulation: Practical Strategies for Compliance Officers
Tuesday, August 30, 2011

Click here for details.

New Reform-Driven Claims and Appeals Procedures: Practical Steps Plans Should Take Now
Tuesday, September 13, 2011

Click here for details.

Encounter-Data Requirements for Medicare Advantage: How to Get Ready for the Huge Change in January
Wednesday, September 14, 2011

Click here for details.

Social Media Strategies for Insurers: How to Optimize Health Plan Online Efforts
Thursday, September 22, 2011

Click here for details.

Report on Medicare Compliance
Also From AIS
AIS’s Quarterly Pharmacy Benefit Survey Results
Track growth and consolidation in the industry, and trends in costs, utilization and benefit design. Available quarterly as Excel spreadsheets! Click here. 2nd Quarter 2011 data just released!
New from the editors of AIS's Directory of Health Plans — AIS’s Employer Health Plan Database and Directories
Valuable competitive intelligence on plans, sponsors, markets and more, for health plans, TPAs, employers, consultants and vendors. Learn more.
AIS's Health Business Daily