The District of Columbia is targeting CareFirst BlueCross BlueShield in an effort to capture a portion of the large nonprofit's reserves for a new program serving the uninsured. The District has had contentious relationships with health plans for some time; in March the city brought lawsuits against two of its three Medicaid care management organizations, DC Chartered Health and AMERIGROUP, for alleged administrative abnormalities. The incidence of adult-onset diabetes has increased by some 90 percent over the past 11 years in Virginia. Employers and insurers are looking at a new study that pinpoints diabetes incidence by geographic area and also quantifies how money is spent on treating diabetes. Meanwhile, Virginia, Washington, D.C. and Maryland are among the 12 areas selected by the U.S. Department of Health and Human Services for a five-year Medicare demonstration project that will provide incentive payments to primary-care physicians for using certified electronic health records to improve the quality of patient care. Carriers for the Federal Employees Health Benefits Program felt the pinch of escalating medical and pharmaceutical costs over the last couple of years and are fighting back. For 2009, they are offering plans that have the largest premium increases in three years and encourage users to spend less on drugs.