Humana drops doctors; Emdeon to hunt out fraud

> Humana's Medicare HMO in Florida is dropping several long-term physicians from its network serving 24,000 members in the Volusia/Flagler market, reports the Daytona Beach News-Journal. A letter to one dermatologist who is being cut effective May 30 indicated that Humana will limit its network to doctors with whom it has a capitated agreement. Article

> Nashville-based FICO Emdeon Inc. has signed a commercial agreement to incorporate FICO Insurance Fraud Manager software into its healthcare transaction processing network in order to offer enhanced fraud prevention to its 1,200 payer clients, reports the Nashville Business Journal. Article

> Aetna Inc. in Hartford, Conn., has signed a deal to obtain in-network urgent and emergency care for its Jacksonville, Fla., area members from comprehensive urgent care provider Crucial Care, which cites cost savings of 60 percent to 70 percent compared to hospital emergency rooms, reports the Jacksonville Business Journal. Aetna members will pay the cheaper "urgent care co-payment instead of the standard emergency room co-payment. Article

> UnitedHealthcare has launched PlanBien health plans in New Mexico to address the Hispanic healthcare needs of businesses with two to 99 employees. PlanBien is already available in Arizona, California, Colorado, Florida, Illinois and Texas. Press release

> Chutes & Ladders: Robert Hatch, past president and CEO of Wells Fargo Utah, will become president of Salt Lake City-based Regence BlueCross BlueShield of Utah effective June 1, replacing the retiring Scott Ideson. Press release...Dr. Bradley Gilbert, CEO of Inland Empire Health Plan in San Bernardino, Calif., has been named to the board of the California Association of Health Plans effective June 1. Press release...SCAN Health Plan, a Medicare Advantage plan based in Long Beach, Calif., has promoted Gerald Coley to the newly created position of regional vice president for northern California. Press release

And Finally... When I look up class in the dictionary, I expect there to be a picture of this guy. Article

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