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April 13, 2017

Today's Featured Story    

2016 Audit Notices Highlight Growing Misclassification Issue
Reprinted from MEDICARE ADVANTAGE NEWS

A new set of civil monetary penalties (CMPs) based on audits conducted by CMS last year indicate that Medicare Advantage and Part D plan sponsors are continuing to make some of the same mistakes in the drug-related areas of Formulary & Benefit Administration and Part D Coverage Determinations, Appeals, and Grievances (CDAG) as well as on the Part C side, where they are slow to process organization determination requests.... Read Full Story

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Today's AIS Health Datapoint

8.4 million ... was the number of returning consumers to public health exchanges who reenrolled in the same plan, switched plans or automatically crosswalked to a new plan. 3.8 million new customers purchased exchange coverage for the first time. Statistically, white females between the ages of 55 and 64 constituted the highest number of enrollees.

From AIS's HEALTH INSURANCE EXCHANGE DATABASE

 

People on the Move

Human Longevity, Inc. named David Heckerman, M.D., Ph.D., chief data scientist. Heckerman is a 25-year veteran of Microsoft, where he most recently led the Microsoft Genomics team….Mark S. Soberman, M.D., was elected the 2017-2018 president of the Association of Community Cancer Centers. Soberman now is medical director, oncology service line and chief physician executive, Monocacy Health Partners at Frederick Regional Health System….Kaiser Permanente Northern California promoted CJ Bhalla to senior vice president and chief financial officer. Her most recent position was vice president, national financial performance and planning.

 

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