UCR Rate Litigation: Health Plan Strategies for Minimizing Financial and Legal Risks - audioconference


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NOTE: Government News of the Week will not be published July 6 because of the Independence Day holiday. The next issue will be July 13.

June 29, 2009

(1) Details of health reform bill provisions affecting health plans, and the potential costs of the bills, continue to emerge from the House, Senate and White House....(more)

(2) The U.S. Supreme Court said on June 22 that it will hear a case that could dictate how whistleblowers file lawsuits, according to the court's docket....(more)

What a 'Public Option' Would Mean for Health Plans
An Audioconference — Tuesday, June 30, 2009
Get an inside look at what a public health insurance option might look like, what impact it would likely have on health plan operations, enrollments and revenues, and what private carriers can do to survive. Click here for details.

(3) Illinois Gov. Pat Quinn (D) on June 18 signed legislation that will make health insurance more affordable for laid-off workers of businesses with fewer than 20 employees....(more)

(4) Under the Medicare Fraud Strike Force's expanded operation in Detroit, 53 people have been indicted for schemes to submit more than $50 million in false Medicare claims, the Department of Justice said June 24....(more)

MANAGED MEDICARE AND MEDICAID FACTBOOK: 2008
A 505-page resource that contains up-to-date enrollment data, benefit designs, trends and strategies for all Medicare Advantage plans and managed Medicaid. You'll get current and historical statistics so you can make plan-by-plan or state-by-state comparisons. Click here.


(5) Blue Cross Blue Shield of Michigan settled a class-action lawsuit and will pay $1 million to approximately 100 families whose children were either denied coverage for autism treatment under the insurer's policies or paid for their care out of pocket after May 1, 2003...
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Specialty Pharmacy: Stakeholders, Strategies and Markets 2009
This 382-page resource paints a comprehensive picture of the specialty pharmacy marketplace - including hard data and statistics on the vendors serving this health care sector, the products involved, and the strategies employed by payers for managing and delivering these products to members. Click here for details.

(6) Rhode Island Gov. Don Carcieri (R) and Lt. Gov. Elizabeth Roberts (D) have won their battle with the state's House Finance Committee over a budget proposal that would have eliminated the state's Office of the Health Insurance Commissioner...more)

(7) Blue Cross & Blue Shield of Rhode Island on June 25 said it had notified the Office of the Health Insurance Commissioner that it will not withdraw its recent rate filing...(more)

Health Plan Pay-for-Performance Programs: The Next Generation
This 54-page report contains valuable insights you'll need to establish or modify your P4P program — including case studies from three well-respected health insurers. Click here for more information.

(8) Robert Bourseau, the former co-owner and board chairman of City of Angels Medical Center in Los Angeles, pleaded guilty to paying illegal kickbacks for patient referrals, according to the U.S. Attorney's Office for the Central District of California....(more)

(9) Louisiana State University Health Sciences Center received overpayments totaling nearly $58,000 in 2004 and 2005 for the chemotherapy drug oxaliplatin, the HHS Office of Inspector General says in an audit report (A-06-08-00086) posted June 19....(more)

(10) Eight Miami residents have been indicted in a "remarkable" and "sophisticated" scheme that attempted to defraud Medicare of about $100 million and spanned five states, the U.S. Attorney's Office for the Southern District of Florida said June 22....(more)

(11) NIH is now reviewing the 49,000 comments it received in response to its draft guidelines for human stem cell research....(more)

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The Aging of America: Implications for the Business of Health Care
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High-Risk Areas in Medicare Billing: Compliance Auditing Tools for Hospitals and Health Systems
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A Comprehensive Guide to Managing Never Events
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