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September 21, 2017
Today's Featured Story
 
Radiologists Push Back as Anthem Alters Coverage Policy for Some Hospital Imaging
Reprinted from HEALTH PLAN WEEK
 
Close on the heels of its controversial policy aimed at placing constraints on emergency room visits, which has met with resistance, Anthem, Inc. is implementing another coverage policy based on “medical necessity.” This time it’s for hospital-based outpatient imaging across its Blue Cross and Blue Shield plans in 13 states. The upshot is that the Indianapolis-based health insurance giant won’t pay for certain imaging tests done on an outpatient basis in hospitals that the insurer asserts could be done in less costly settings. The move is getting strong pushback from radiologists amid their concerns that other insurers may follow suit....  Read Full Story
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Today's AIS Health Datapoint
 
1,319,067 ... is the number of lives served by Colorado's five Medicaid Behavioral Health Organizations (BHOs) as of the second quarter of 2017.
 

People on the Move
 
Beacon Health Options named Daniel McCoy executive vice president and chief operating officer. He previously served as COO of Amedisys….Fallon Health appointed Rigoberto Serrano senior care products account executive. Previously, Serrano worked as a geriatric services support coordinator for Greater Springfield Senior Services and as a case worker for the Department of Children and Families….AmeriHealth New Jersey promoted Ryan Petrizzi to vice president of sales. He most recently served as vice president of consumer markets and product development….Anthem, Inc. subsidiary Amerigroup Kansas appointed Frank Clepper health plan president. He joined Amerigroup five years ago and most recently served as interim president, regional vice president and chief operation officer of Amerigroup Kansas.

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