Government News of the Week
Medicare Compliance, HIPAA, Medicare Advantage and Part D,
Health Care Reform, and Other Federal and State Government Developments
Government News of the Week is a weekly email newsletter with timely news stories from Washington, D.C., and the 50 state capitals. Articles are selected for their impact on hospitals, health plans, medical group practices, physicians and other health care providers. Subscribe now to get an issue delivered to your inbox every Monday!
 

August 31, 2015

You must be a registered user on AISHealth.com to access the stories below. If you haven't yet registered, please take a minute to register now, and get access to thousands of articles, blogs and more.

(1) The Nevada Health Consumer Operated and Oriented Plan (CO-OP) is shutting down operations at the end of the year .... (more)

(2) A California physician was convicted in connection with a fraud scheme involving unapproved intrauterine devices (IUDs) .... (more)


  From the AIS Blogs
  Is Maryland — which bills itself as The Free State — in its burgeoning provider-owned Medicare Advantage product lines, a harbinger of the future in MA or just an anomaly as usual? Join the conversation at the AIS Blogs.

(3) Republican presidential hopeful Wisconsin Gov. Scott Walker on Aug. 18 unveiled a health care reform proposal intended to replace the Affordable Care Act (ACA) if he were to win the White House. Without saying how he would pay for the plan, Walker said its centerpiece is refundable tax credits to individuals who do not have employer-based coverage. "This would strengthen health insurance markets by enabling individuals to use their tax credits to buy insurance outside the workplace," he said. Some elements of the ACA would remain, such as the ban on denial of coverage for pre-existing medical conditions. But states would assume more power to reject or accept the federal reforms, including whether to allow adult children to remain on parental plans.(From Inside Health Insurance Exchanges' E-Alert)

(4) The Arkansas Insurance Dept. on Aug. 25 said rate increases approved for the 2016 plan year were held below 10%. Individual products sold by Arkansas Blue Cross and Blue Shield, the biggest player on the exchange, will increase by an average of 7.15%, while premiums for its small-group plans will increase 3.01%. Individual plans sold by Celtic Insurance Co., a subsidiary of Centene Corp., will increase just 0.08%, and QualChoice, part of Catholic Health Initiatives, will reduce its individual coverage rates by an average of 8.2%. In 2015, three carriers sold coverage through the exchange. UnitedHealth Group will join them for the 2016 plan year. (From Inside Health Insurance Exchanges' E-Alert)


  From Congress and the Federal Agencies
 

(5) Eleven out of the 20 Medicare Pioneer accountable care organizations earned shared savings during the third performance year of the program .... (more)

(6) An Illinois appellate court on Aug. 21 affirmed a lower court’s ruling that Cigna Corp. did not steal trade secrets from Destiny Health, Inc. in designing its wellness program .... (more)

(7) Cigna recently agreed to settle an Employee Retirement Income Security Act (ERISA) lawsuit between two of its Texas subsidiaries and two providers for allegedly misrepresenting themselves in claims submitted to the insurer .... (more)

(8) Quest Diagnostics paid $1.79 million to settle a False Claims Act lawsuit .... (more)

(9) Plains Township is suing Highmark Health over a $90 million donation Blue Cross of Northeastern Pennsylvania (BCNEPA) made before it was acquired by Highmark .... (more)

(10) UPMC Medical Center on Aug. 10 again petitioned the Pennsylvania Supreme Court to reconsider its decision that the health system is obligated to continue serving Highmark Health’s Medicare Advantage members .... (more)

 

Content questions or suggestions should be directed to Executive Editor Jill Brown at jbrown@aishealth.com. If you are interested in advertising in GOVERNMENT NEWS OF THE WEEK please contact Bailey Sterrett at bsterrett@aishealth.com.

GOVERNMENT NEWS OF THE WEEK is copyrighted and protected by federal law. The re-use of its content is restricted (see below). However, you are permitted to forward this email to as many of your friends and colleagues as you wish, or better yet have them sign up for their own copy at http://www.magnetmail.net/actions/ atlantic_subscription.cfm, where you can also sign up for AIS's Health Business Daily and Spotlight on Health Insurers.

Copyright © 2015 Atlantic Information Services, Inc. (AIS). All rights reserved. It is not permissible to include all or any portion of this content on any Web site, intranet or electronic network or in any print publication, without AIS's written permission in advance. Permission requests should be directed to rbiehl@aishealth.com.


Visit www.AISHealth.com
With archives of AIS's Government News of the Week, features like the News Archives, AIS Blogs and more! (Free registration required)


AISHealth  Follow AISHealth on Twitter  Follow AISHealth on Facebook  Follow AISHealth on LinkedIn

 

 

AIS E-Savings Club Weekly Specials

Upcoming Webinars
Save $50!

Stark Law DOs and DON’Ts: Physician Contracting Best Practices
Thurs., Sept. 17, 2015
Click here for details

Narrow Networks: How to Avoid Legal, Regulatory and PR Landmines
Tues., Sept. 29, 2015
Click here for details

Personalized Medicine Strategies for Plans and Providers
Wed., Sept. 30, 2015
Click here for details

Missed a Live Event?
Listen at your convenience to recent webinars with On-Demand or CD options!
Proven Pharmacy Benefit Strategies for a Rapidly Changing Marketplace
The Cost and Impact of Adverse Events: Anti-Inflammatory Drugs (Cimzia, Enbrel, Humira, Otezla, Remicade, Simponi, Stelara)
AIS's Directory of Health Plans: 2015 - Shipping Now!