Sunday, March 28, 2010

Weekend update

Congress is now in recess until April 12.

Last week, a House Appropriations Subcommittee held a hearing on OPM's FY 2011 budget proposal.  OPM Director John Berry testified. The Director noted that
Included in the OPM budget request is $7 million to start a data warehouse to analyze the claims experience of participants in the Federal Employees Health Benefits Program (FEHBP). Through this effort we hope to identify trends in employee health issues and potentially drive down costs through a better understanding of the Federal employee and retiree population’s most common health care needs.

Availability of health, wellness, and work-life options for Federal employees is a critical tool for improving the ability of the Government to recruit and retain a high-performing workforce. In 2010, OPM received an appropriation of $2,654,000 to develop and operate a comprehensive worksite wellness pilot program for the downtown Washington campus including GSA, Interior, and OPM. The development of Government-wide health and wellness policies and programs to provide employees with a meaningful balance of work and life will continue to be a top priority at OPM in FY2011.
The Politico reports that a bill (H.R. 4851) to further extend unemployment benefits, the COBRA / TCC subsidy program, and the moratorium on a 21% cut in Medicare Part B reimbursement to doctors stalled in the Senate over funding issues. The Senate will not take up this bill again until it returns from recess on April 12. As a result, the Medicare cut will take effect on April 1, although I expect that the Centers for Medicare and Medicaid Services ("CMS") will instruct its Medicare administrators to hold Part B claims in order to allow the Senate to act. This development impacts the FEHB Program because there is a large cadre of annuitants with primary Medicare Part B coverage in the FEHB Program. Moreover, FEHB fee for service plans are entitled to use Medicare Part B pricing for claims incurred by annuitants who do not enroll for Part B (5 U.S.C. Sec. 8904(b)).

Modern Healthcare reports that President Obama is expected to nominate Donald Berwick, MD, to be the CMS Administrator.  CMS has not had a Senate confirmed Administrator since late 2006.  Here's Dr. Berwick's impressive CV from the Institute for Healthcare Improvement website:
Donald Berwick, MD, MPP, FRCP, President and CEO, Institute for Healthcare Improvement (IHI), is one of the nation's leading authorities on health care quality and improvement. He is also Clinical Professor of Pediatrics and Health Care Policy at the Harvard Medical School, and Professor in the Department of Health Policy and Management at the Harvard School of Public Health. Dr. Berwick has served as vice chair of the US Preventive Services Task Force, the first "Independent Member" of the Board of Trustees of the American Hospital Association, and chair of the National Advisory Council of the Agency for Healthcare Research and Quality. An elected member of the Institute of Medicine (IOM), Dr. Berwick served two terms on the IOM’s governing Council and was a member of the IOM’s Global Health Board. He served on President Clinton's Advisory Commission on Consumer Protection and Quality in the Healthcare Industry. He is a recipient of numerous awards, including the 1999 Joint Commission’s Ernest Amory Codman Award, the 2002 American Hospital Association’s Award of Honor, the 2006 John M. Eisenberg Patient Safety and Quality Award for Individual Achievement from the National Quality Forum and the Joint Commission on Accreditation of Healthcare Organizations, the 2007 William B. Graham Prize for Health Services Research, and the 2007 Heinz Award for Public Policy from the Heinz Family Foundation. In 2005, he was appointed “Honorary Knight Commander of the British Empire” by the Queen of England in honor of his work with the British National Health Service. Dr. Berwick is author of numerous articles and the books Curing Health Care and Escape Fire.

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