From Health Plan Week - Early signs from rate filings for 2014 — as in Maryland, where the dominant Blues plan recently asked state regulators for a 25% premium increase compared with 2013 policies for individual plans sold on the state-based marketplace opening next year — are indications of the uncertainties about how accurate pricing will be in the initial year of the public exchanges, health insurance industry insiders say, since other carriers asked for… Read more

From Medicare Advantage News - Medicare Advantage plan sponsor Universal American Corp. is building a potentially substantial new business helping rural providers start MA plans of their own, sometimes in areas where the company itself has MA operations. Universal American will be supplying capital, taking risk and performing insurance-related functions in return for 50% of the net profits in an approach linked partly to aiding the providers as managed care business for Medicare-Medicaid dual eligibles… Read more

From Report on Medicare Compliance - Compliance officers may grumble when they aren’t included in meetings with executives, but it’s up to them to insert themselves. Don’t wait for an invitation because you are, by definition, on the list. “Go to the meeting and bring donuts,” said attorney Brian Beard, director of compliance and ethics at McKesson Specialty Health in Houston. Similarly, consider revising the way you interact with departments, such as lab, pharmacy and radiology. Read more