Government News of the Week: Latest Issue

Feb. 6, 2012

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(1) HHS on Jan. 27 rejected Texas’ request for a waiver of the health reform law’s medical loss ratio requirement for individual health plans .... (more)

(2) Blue Cross Blue Shield of Michigan on Jan. 30 asked a federal judge to dismiss a lawsuit brought by Aetna Inc. accusing the Blues plan of engaging in “most-favored nation” hospital contract clauses that stifled competition .... (more)

(3) Physician recruitment agreements are at the heart of a False Claims Act settlement with Cayuga Medical Center in Ithaca, N.Y. The hospital agreed to pay $3.5 million to resolve allegations that its recruitment agreements with several physicians didn’t meet an exception to the Stark self-referral ban .... (more)

A recent GAO report on Medicare Advantage plan payment levels is a big problem for MA plans not only because of what it says but also when it comes. What do you think the effect of the report will be? And is it inevitable that the MA program will become a political football during this election year? Join the conversation at the AIS Blogs.

(4) CMS announced in late January that on Jan. 5 it had resolved two more Stark cases through its new self-referral disclosure protocol .... (more)

(5) Missouri’s Senate on Jan. 24 passed a bill that would let it block the governor from implementing a health insurance exchange without legislative or voter approval .... (more)

(6) On Feb. 16, CMS will release another comparative billing report, this time for advanced diagnostic imaging .... (more)

(7) The American Hospital Association in a Jan. 3 letter urged HHS officials to finalize the waiver provisions in connection with Medicare’s Shared Savings Program .... (more)

(8) A Morgantown, W.Va., man sued West Virginia University Medical Corporation for allowing an employee to access his medical records on several occasions. .... (more)

(9) The HR Policy Association asked HHS Sec. Kathleen Sebelius to provide final rules on health insurance exchanges by July 1, 2012 .... (more)

(10) The Essential Health Benefits Coalition is recommending that the final essential health benefits regulation evaluate benefits from both a cost and medical effectiveness perspective .... (more)

Have breaking news or an editorial question? E-mail BJ Taylor, editor of GOVERNMENT NEWS OF THE WEEK, at bjtaylor@aishealth.com. If you are interested in sponsoring GOVERNMENT NEWS OF THE WEEK please contact Bailey Sterrett at bsterrett@aishealth.com.

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