Government News of the Week: Medicare Compliance, Medicare Advantage and Part D, and Other Federal and State Developments

Government News
of the Week:

Medicare Compliance, HIPAA, Medicare Advantage and Part D, and Other Federal and
State Government Developments

Aug. 2, 2010

(1) Senate Finance Committee Chairman Max Baucus (D-Mont.) on July 28 called on health insurers to delay significant premium increases next year following recent reports by major carriers of significant profit growth....(more)

(2) House lawmakers have introduced a bill that would allow Medicare Part D to cover prescriptions used for off-label indications....(more)

Major New HIPAA Rules Issued: Learn What Steps You Need to Take Soon
A Webinar — Wednesday, August 18, 2010
Join veteran HIPAA attorney, Reece Hirsch, with Morgan, Lewis & Bockius for a summary of the major new requirements (and pitfalls) of these mammoth new regulations, and learn how your organization can incorporate the new rules into your existing HIPAA privacy and security compliance programs. Click here for details.

(3) HHS on July 28 issued interim final regulations regarding pre-existing condition exclusions for children under 19 years old that state insurance commissioners say will reduce concerns they have about a new trend of insurers dropping child-only coverage. The rules authorize insurers to establish open-enrollment periods, if allowed under state law, to cut the risk of adverse selection....(more)

(4) On July 19, Fox Insurance Co. agreed to send $13.6 million in outstanding Medicare Part D payments to its plan administrator, ProCare Pharmacy Benefit Management....(more)

Now Shipping – The AIS Guide to Blue Cross and Blue Shield Plans: 2010
*Not Affiliated with BlueCross BlueShield Association or its member companies.
This valuable resource includes hard-to-find data on revenues, earnings, enrollment and medical loss ratios, plus reports on Blues' local, multi-state and nationwide efforts. Click here for details.

(5) Rite Aid Corp. has agreed to pay $1 million to settle “potential violations” of the HIPAA privacy rule for disposing of pill bottle labels with customer information on them, HHS said July 27....(more)

MANAGED MEDICARE AND MEDICAID FACTBOOK: 2010
Get 474 pages of rates, benefit designs, enrollment data, contacts, trends and strategies on the Medicare Advantage, Medicare Part D and managed Medicaid programs. The perfect resource for tracking plan design information and market share statistics you need in the strategic planning process. Click here.

(6) On July 26, CMS released a final rule for the end-stage renal disease prospective payment system that includes payment adjustments for home dialysis training when clinically appropriate.....(more)

(7) President Obama signed The Improper Payments Elimination and Recovery Act (S. 1508) on July 22....(more)

(8) Kaiser Permanente and Anthem Blue Cross will not participate in California’s temporary federal high-risk pool, according to the state’s Managed Risk Medical Insurance Board....(more)

(9) California Insurance Commissioner Steve Poizner (R) on July 23 unveiled an online tool that allows residents to be notified by e-mail when new health insurance rate filings for the individual market are made....(more)

(10) Priority Health of Grand Rapids and Physicians Health Plan of Mid-Michigan were awarded Michigan’s temporary high-risk insurance pool contract.....(more)

Additional government news can be found at
AIS's HEALTH BUSINESS DAILY