Health Plan & Provider Report Index Summary

IDENTITY THEFT

– BCBS, increase noted as 2007 fraud probe recoveries exceeded $250, study, 702
– Electronic health records, security improvement key to progress, forum, 467

ILLINOIS

– Dual eligibles, state owes millions, IG report, 724
– Hospitals

– – Consumer Fraud Act, facility did not violate by charging uninsured patients higher rates (Ill. App. Ct.), 480
– – Evanston Northwestern Healthcare

– – – Managed care contracts with government payers, order sets negotiating terms (FTC), 461
– – – Mergers, Sherman and Clayton Act claims by injured individuals proceed (N.D. Ill.), 657

– LSCs, proposed regulatory bill may have negative impact on competition, FTC analysis, 642
– Medicaid

– – HMOs, $225 million fraud settlement over company's refusal to enroll sick or pregnant applicants (N.D. Ill.), 844
– – Managed care, plan can pay non-network emergency care providers state-set rate (Ill. App. Ct.), 588

– Medical errors, no BCBS payments for serious preventable hospital acquired conditions, 887
– PBM, TennCare contract awarded, In Brief, 500
– Physician profiles, Web site allows consumer comparisons, 427
– Universal coverage, governor proposes business tax to fund, 238

IMAGING SERVICES

See RADIOLOGY SERVICES

INCENTIVE ARRANGEMENTS

– Bonuses

See BONUSES

– E-prescriptions

– – Implementation, CMS efforts include fall conference for physicians, 797
– – Payments, federal endorsement encourages use, BNA Analysis, 820
– – Physicians, key to adoption, meeting, 575

– Pay-for-performance programs

See PAY-FOR-PERFORMANCE PROGRAMS

INDIANA

– Cardiologists, provider contact terms binding but income-sharing formula of subsequent agreement erroneously applied (Ind. Ct. App.), 847
– Self-funded plans, contractual duty satisfied by medical reviews of treatment necessity despite contradictory results (Ind. App. Ct.), 157

INDIGENT CARE

See also LOW-INCOME PERSONS
– San Diego County, means test challenged (Cal. Super. Ct.), 304

INFORMATION NETWORKS AND TECHNOLOGY

– Advancing health sector adoption, new approach required, HHS forum, 321
– Cost of health care, savings unlikely without provider incentives modification, CBO report, 570
– Electronic prescriptions

See E-PRESCRIPTIONS

– Grants

– – N.Y. awards for community-based projects, 401
– – Nonprofits, joint effort to create public-private health group, 115

– Iowa health system, new law, 551
– Medical records, electronic

See ELECTRONIC HEALTH RECORDS

– National electronic data network, groups urge federal legislation, conference, 200
– Outlook 2008, among top health issues to be addressed, Special Reports, 71
– Physicians

– – Security concerns addressed

See LEGISLATION, FEDERAL, HR 6357

– – Virtual house calls, Aetna and CIGNA expansions allow, 17

– Promoting provider use

– – Health care system savings unlikely without incentives revision, CBO report, 570
– – House panel releases draft bipartisan bill, 571
– – Penalties greater incentive than subsidies, CBO says, 697
– – Security concerns addressed

See LEGISLATION, FEDERAL, HR 6357

– Regional health information organizations, national strategy and federal funds required, hearing, 198
– Remote monitoring, Md. eCare hospital program for off-site critical care physician support, 503
– Safeguards, key to passing legislation, hearing, 642
– Specific medical questions, Aetna and Healthline launch online search program, 326
– System adoption

See LEGISLATION, FEDERAL, HR 3800, S 1693

INSTITUTE OF MEDICINE (IOM)

– Evidence-based medicine, national assessment of treatment effectiveness urged, IOM report, 115

INSURANCE INDUSTRY

– BCBS

See generally BLUE CROSS AND BLUE SHIELD PLANS (BCBS)

– Claims processing

See CLAIMS PROCESSING

– High-risk pools

See HIGH-RISK POOLS

– Long-term care

See generally LONG-TERM CARE

– Mergers

See MERGERS AND ACQUISITIONS

– Personal care services, owners of bankrupt firm fined millions for selling policies to elderly (Fla. Cir. Ct.), 749

INTERNET

– BCBS of N.C. rates, online cost estimator for procedures, 95
– Google Health

See ELECTRONIC HEALTH RECORDS

– Health care delivery models Web site, In Brief, 450
– Hospitals

– – Or. costs, 90 procedures on state Web site, 528
– – Quality of care

– – – Preventable readmission rates, Fla. Web site, 730
– – – Updated Medicare Web site, patient input, In Brief, 406
– – – Wash., patient evaluations on state association Web site, 427

– Insomnia and depression, Aetna tests HealthMedia online behavior-change programs, 705
– Medicare Physician Quality Reporting Initiative, 16 percent of eligible providers participating, CMS says, 260; payments to be sent mid-July, 695; 2007 payments totaled $36 million, 799
– Physicians

– – N.Y. ranking settlement, NCQA Web site launched, 883
– – Profiles, Ill. Web site allows consumer comparisons, 427

– Prescription drug prices

– – Data gaps limit usefulness, study, 206
– – N.Y. comparative Web site created, 204

– Prompt payment, N.J. arbitration decisions posted on Web site, 234

INTERNET PHARMACIES

– Antitrust, online vendor's suit against PBMs Medco and Caremark dismissed (E.D. Tex.), 333

INVESTIGATIONS

– BCBS fraud probes, 2007 recoveries exceeded $250 million as identity theft increases, study, 702
– Fla. Medicaid fraud, WellCare Tampa office replaces CEOs, 150
– Health insurance

– – Individual policies, House panel launches national probe of postclaims rescission, 795
– – N.Y. insurers, systematic provider underpayment based on faulty methodology, attorney general says, 215; subpoenas issued, 294

– High-risk pools, House Democrats call for GAO probe of effectiveness, 288
– MA rebates, CMS probe of federal funds use, hearing, 257
– Money laundering, 6 interagency probe arrests in Los Angles scheme to defraud federal programs and private insurers (Cal. Super. Ct.), 429
– Physicians urged to switch patients' brand-name drugs, CVS Caremark settles state fraud probes, 211
– Privacy, N.J. and federal probe of Horizon BCBS member data security breach, 176

IOM

See INSTITUTE OF MEDICINE (IOM)

IOWA

– Health information technology system, new law, 551
– Health insurance, ERISA does not preempt law mandating state policies are secondary to other coverage (Iowa), 656
– SCHIP expansion, new law, 551