"You don't need a weatherman to know which way the wind blows."

Bob Dylan
Subterranean Homesick Blues (1965)

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Notice

These managed care e-mail bulletins have been retired to an archive. The information is dated and in some cases may be obsolete. Please click the 'home' link, above, to explore the more current information I have published on managed care contracting and negotiations.

Thank you for visiting!

Gil

e-Mail Bulletins

Following is my archive of previously published Practice Management & Managed Care e-mail bulletins. If you would like to automatically receive new bulletins by e-mail as I publish them, please sign up using the brief form on my contact page.

Health Insurers Push Comparison Shopping - December 2011

Groupon Merchant Agreement Looks A Lot Like A Managed Care Contract - June 2011 #2

Many Firms to Cut Healthplans in 2014?? - June 2011

Pacificare Faces Largest Fine Ever - September 2010

Virtual Doctor Visits - December 2009

Changing dynamics of Medicare Advantage and Medicare PFFS plans - October 2009

High claims rejection rates in California - September 2009

The incredible problem that is health care reform - August 2009

More important that ever to collect at time of service - March 2009

AMA Takes on National Payors Over Underpayments Related to Ingenix Database - February 2009 #2

More on alleged links between Ingenix and third-party payors - February 2009

UHC settles suit over patient-owed amounts - January 2009

CMS to look into brokers' commissions for Medicare Advantage plans - October 2008

Special Managed Care E-Mail Bulletin - August 2008

Claim Rejection Problems upon required NPI start date - May 2008 #2

The evolving ERISA battlefield - May 2008

Few physicians embrace e-mail to communicate with patients - April 2008

District of Columbia to license drug industry sales representatives ("detailers") - January 2008

More on Physician Ranking By Third-Party Payors - October 2007 #3

Interesting anti-trust case to go forward - October 2007 #2

Most Favored Nation clause under attack - October 2007

Employee fraud in the medical workplace - August 2007

Quality according to whom??? - February 2007

Outsourcing health care services: A mind-boggling look into the crystal ball? - November 2006

Stealing cash from a medical practice. - August 2006

"Transparency" is the new word in Consumer-Directed Health Care - August 2006

Medical malpractice reform in Florida. - April 2006

Healthcare's Elephant in the Room: The Need for a Sound and Effectively Executed Strategy in an Era of Consumerism - March 2006

Who owns/controls the practice's list of patients? - November 2004

Class Action Suit Can Go Forward - September 2004

Penalty for breaking HIPAA law - September 2004

Medicare/HIPAA claims filing compliance deadline on July 1st - May 2004

RICO issues in class-action case against HMOs can go forward - January 2004

Paying for Interpreters? - October 2003

Approaching HIPAA compliance deadline - August 2003

Hackers Use Google To Access Healthcare Databases - March 2003

Computer Security and HIPAA - March 2003

Conflicts with Your Business Associates under HIPAA - February 2003

List of HIPAA-compliant practice management software - December 2002

CIGNA class action settlement blocked - December 2002

CIGNA to settle suit over improperly paid claims - November 2002

HMO Class Action Suit Pendulum Swings Again - November 2002

RICO class action suit certified! - September 2002

Texas DOI to require payers to reveal payment info - August 2002

Blues ordered to reveal fee schedule - May 2002

Texas Sues HMO For Slow Pay - February 2002

Disputed Reimbursement Lawsuit vs CIGNA Texas - October 2001

Class Action Suit Against CIGNA - October 2001

Texas Clobbers Healthplans With Huge Fines - August 2001

More on Downstream Risk - April 2001

States begin to crack down on retro-active denials - March 2001

California Gets Tough On Late Payment - February 2001

Record HMO Fine In Georgia - February 2001

Downstream Risk: Who's Responsible? - January 2001

Aetna Capitulates on All-Products Clause - January 2001

More on Prompt Payment Laws - November 2000

Know When to Say "No" - November 2000

Saying "NO" to a bad deal - October 2000

More on Prompt Payment Legislation - October 2000

More on Prompt Payment Battles - September 2000

Florida flexes its muscles on prompt payment - August 2000

Know when to say "No" - July 2000

BC/BS Must Reveal Reimbursements - July 2000

Florida Gets Tougher On Prompt Payment - June 2000

Late Payments Suit In Texas - May 2000

"Without Cause" Termination Voided? - May 2000

More on Texas--Aetna Consent Order - May 2000

More on fines for late claims payment - May 2000

Managed Care News - April 2000

HMO Bankruptcy, Positive News? - April 2000

More HMO Fines For Late Payment - April 2000

Latest On Humana Downcoding Controversy - March 2000

Penalties For Late Claim Payment - March 2000

Who Pays When IPAs Fail? Follow-up to Nov. 98 Bulletin - January 2000

More on United Health Care Returning Decision-Making to Doctors - December 1999

Doctors Given Back Control?? - December 1999

More on HMO Downcoding - November 1999

HMO Financial Problems - October 1999

Claims Downcoding - September 1999

Medicare HMO Bid Process Put On Hold - July 1999

Doctors Win Billing Bout with HMO

Who Owns The Medical Record? - April 1999

HCFA Risk-Adjustments

Financial Recovery, Insolvency - November 1998

ValueStar, Patient Satisfaction - July 1998

Downcoding and Payment Delays - October 1999

E-Mail Bulletin No. 5 - January 1999

E-Mail Bulletin No. 4 - September 1998

E-Mail Bulletin No. 3 - July 1998

E-Mail Bulletin No. 2 - June 1998

E-Mail Bulletin No. 1 - May 1998

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