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Thursday, June 10, 2010

Daily news & Analysis

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Insurers Defend Medicare Advantage in Wake of HHS Warning

By: Elyas Bakhtiari, for HealthLeaders Media, June 9, 2010

The deadline for 2011 Medicare Advantage carrier bids this Monday provided another flash point in the ongoing clash between insurers and the government, as cuts to the MA program—as well as the possibility of higher rates for seniors—inch closer to enactment.

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7 Changes for Medical Schools to Train Doctors for Reform Era Care

By: Cheryl Clark, for HealthLeaders Media, June 10, 2010

The U.S. must aggressively reform the way it trains its physicians if they are to competently provide care to meet the mandates, hopes, and expectations of health reform, according to a report from The Carnegie Foundation for the Advancement of Teaching. "It's generally recognized that our healthcare system is not functioning well," explains one of the report's three authors, Molly Cooke, MD, an HIV specialist at the University of California San Francisco and a member of the National Board of Medical Examiners, which oversees the licensing of American physicians.

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Missing RAC Records: Another Snag Thrown at Providers

By: James Carroll, for HealthLeaders Media, June 10, 2010

In the increasingly stressful realm of RAC coordination the last thing providers need is additional complications to add to the workload. Unfortunately for them, the latest wave of RAC obstacles brings just that. A number of providers across different RAC regions have been sending records to their RACs via verifiable means (i.e., FedEx), and having their RACs come back and deny receipt of the records, despite the signatures on file.

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Cochlear Americas Pays $950,000 to Settle Federal Kickback Allegations

By: Cheryl Clark, for HealthLeaders Media, June 10, 2010

To resolve charges that it illegally paid health providers to influence purchases of cochlear implants bought with federal money, Cochlear Americas has agreed to pay $880,000, plus $70,000 in legal fees, under a federal False Claims Act settlement with the U.S. Department of Justice. According to federal documents, the U.S. Office of Inspector General alleged that between Jan. 1, 2001 and March 1, 2004, Cochlear Americas "paid remuneration" to audiologists, surgeons, and audiology clinics that purchased the implants with money from a Medicare and Medicaid.

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New York Enacts Health Insurance Law With New Medical Loss Ratio

By: Janice Simmons, for HealthLeaders Media, June 10, 2010

In what may become part of a trend among the states, New York Gov. David Paterson signed into law Wednesday a bill that reinstates the New York State Insurance Department's authority to review and approve health insurance premium increases before they take effect and adds a medical loss ratio that insurers must meet. Beginning in 2000, New York had regulated health insurance premiums with a "file and use" law that limited the state's ability to disapprove health insurance premium increases and allowed the insurance industry to self regulate.

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A Code of Conduct for Physicians

By: Elyas Bakhtiari, for HealthLeaders Media, June 9, 2010

The AMA recently released a 10-point "Code of Conduct" for health insurers. Payers and physicians have a long history of bad blood, and the AMA's somewhat aggressive code didn't do much to improve relations.

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Simple 'Three Bucket' Tool Helps Prevent Huge Cause of Inpatient Death

By: Cheryl Clark, for HealthLeaders Media, June 9, 2010

VTEs are a growing nightmare for hospitals, not just because they are potentially preventable, but also because patients who survive them have inpatient costs of an additional $10,000 to $20,000 per year.

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Streamline Service Lines to Avert Brand Identity Crisis

By: Marianne Aiello, for HealthLeaders Media, June 9, 2010

Once an organization's logo well bursts, it's difficult to stop the flow of disjointed logos. But Lehigh Valley Health Network attacked the spill head on and streamlined its service lines under one cohesive brand.

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