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July 2010

Wednesday, July 14, 2010

HFNI BOARD OF DIRECTORS RETREAT

On the evening of June 4th and the morning of June 5th, HFNI conducted its annual Board Retreat. Leading the discussion on Friday was Bruce Fried. Mr. Fried is currently a partner in the Washington DC office of Sonnenschein Nath & Rosenthal, LLP, a law firm. Prior to joining this firm Mr. Fried was in charge of the federal agency, Center for Medicare/Medicaid Services – CMS. Mr. Fried took the Board through a review of the provisions of the Patient Protection and Affordable Care Act. He followed that up with an interactive discussion with the Board on the implications of the act for HFNI. Saturday morning the Board continued the discussion on strategic positioning for HFNI. Of particular concern was how the new law would affect our current business with our health plan partners. The discussion also included potential for other business particularly with other providers in the Pensacola community.

SHAREHOLDER ELECTION RESULTS

The Annual HFNI Shareholder’s meeting was held on Thursday, May 6, 2010, at 6:00 P.M. at Health First Network. The HFNI Board of Directors has ratified the Shareholder Election and the results are as follows:

The Shareholders have elected to:
1) Retain O’Sullivan, Creel as HFNI’s external auditors.

Elected to the Board were:
(* Indicates New Board Member)
PCP's
William Zimmern, M.D.
* Fred Mixon, M.D.

RCP’s
Warren Herron, M.D.
* Sidney Clements, M.D.

DR. MURRAY RECEIVES AWARD FOR HIS MANY YEARS OF SERVICE ON THE HFNI BOARD OF DIRECTORS

Dr. Pat Murray ended many years of service on the HFNI Board of Directors when he chose not to run for reelection. Dr. Murray is one of the original founding members of HFNI and besides his service on the Board also served on the Contract Committee, the Credentials Committee and the Executive Committee. The Board would like to thank Dr. Murray for his years of service and the contributions he made to HFNI.

COVENTRY (VISTA) COVERSION: CLAIMS SUBMISSIONS

Vista Health Plan recently communicated several changes affecting their membership. The plan name is changing to Coventry Health Plan and they are issuing new ID cards for their members. The communication from Vista/Coventry also provided a new claims address and Payer ID for electronic claims. In an effort to avoid confusion and any misdirected claims, please note their change in Payer ID does not affect claims that would routinely be submitted to MED3000 for processing. Health First Network providers should continue to utilize the MED3000 payer IDs for Vista/Coventry claims.

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WELLCARE FORMULARY AND PHARMACY UPDATES

The cost of prescription drugs along with the ongoing cost of monthly maintenance medications continues to be a concern for both patients and physicians. When cost is an issue for your WellCare patient, the WellCare Formulary Quick Cost Reference Guide (see below) may be helpful. It has a listing of average costs per month of frequently prescribed medications and suggestions that may be an option for your patient.

WellCare has recently provided Health First Network with a list of updates to the formulary that were approved by their Pharmacy and Therapeutics Committee at the March 2010 and May of 2010 Meetings. There are several new medication additions to the formulary as well as some positive changes in tier levels of certain formulary medications. The updates begin on page 2 of the WellCare Formulary Addendum (see below).

Two additional WellCare Mail Order Specialty Pharmacy forms are available. These forms are located on the Health First Network website for use by Health First Network physician offices for their WellCare members. The first is a Mail Order Diabetic Supplies form (see below), and the second is a Mail Order Pharmacy Prescription Form (see below) from the WellCare Specialty Pharmacy to order a 3-month supply of maintenance medications for your WellCare members. There is a cost-savings advantage to both WellCare and Health First Network when maintenance medications are ordered from the Mail-Order Pharmacy. Patients will still have 3 co-pays when this form is used for a 90 day supply of mail order medications.

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