Sunday, May 08, 2011

Weekend Update

Happy Mothers Day!!

The Affordable Care Act expands FEHB Program coverage to Indian tribes at the tribes' expense. OPM explains
Section 10221 of the Affordable Care Act incorporated S. 1790, the Indian Health Care Improvement Reauthorization and Extension Act of 2009 (IHCIREA). IHCIREA amended and reauthorized the Indian Health Care Improvement Act (IHCIA). Section 409 of the IHCIA allows eligible Indian tribes, tribal organizations, and urban Indian organizations to purchase Federal Employees Health Benefits (FEHB), rights and benefits for their employees. Eligible employees of urban Indian organizations and tribes or tribal organizations carrying out programs under the Indian Self-Determination and Education Assistance Act are entitled to purchase coverage, rights, and benefits for their employees, providing the necessary contributions are paid into the appropriate trust fund(s).
OPM has been working with the tribes for the past year in an effort to implement this provision.  Last week, OPM created a website dedicated to this ongoing effort. A May 2, 2011, OPM letter posted on the site explains that
In the coming weeks, we [OPM] will be circulating a consultation schedule, along with documents that will summarize and outline many of the questions we will work through during consultation. At the conclusion of the consultative process, we plan to convene a Tribal-Federal work group to discuss remaining technical requirements, and we will be providing additional information on that as well. We will conduct the consultative process over the summer, and make access to this coverage available as quickly as possible thereafter.
The FEHBlog will continue to track the progress of this initiative.

Last week HHS Secretary Kathleen Sebelius (who wrote a Mother's Day paean to the Affordable Care Act) had the pleasure of appearing before Senate and House Committees last Thursday about the Affordable Care Act implementation. The Senate Committee on Health, Education, Labor, and Pensions heard her testimony as part of a hearing on the Affordable Care Act's impact on consumers. The FEHBlog notes the following observation from the Committee's minority ranking member, Sen. Mike Enzi (R Wyoming)
During a hearing today on improving health quality and patient safety, Senator Enzi asked where the promised health care savings are for government initiatives like the Partnership for Patients program.  Enzi said that Congress should focus on substantive changes that can really improve patient care instead of providing funds to encourage providers to do what they should already be doing. 
Sen. Enzi added that he would be sending a letter to the CMS actuary requesting an estimate of the net savings that the Partnership for Patients program wll generate.   Secretary Sebelius also testified before the House Education and the Workforce Committee to discuss her agency's implementation of the new law.

Kaiser Health News and Modern Healthcare report on the current state of the medical community's efforts to fix the statutory sustainable rate of growth formula for adjusting the amounts that Medicare Part B pays doctors. For the past several years, the formula has produced a reduction that Congress has temporarily overridden thereby increasing the cost of correcting the problem. The current temporary fix expires at the end of this year. As Newman (from the Seinfeld show) once said in a slightly different context, it's "quite a conundrum."

Finally, although the FEHBlog suffers from allergies, the FEHBlog failed to notice that in March the allergy medicine Allegra became with Food and Drug Administration approval an over the counter drug. This means that health plans no longer cover Allegra. But it's still good news for consumers. Consumer Reports has weighed in on OTC Allegra vs. generic OTC versions of the drug.
We found a 30-day supply of Allegra Allergy for $19.99 at and $25.88 at But a 30-day supply of generic loratadine at was $6.99, and the Walmart store-brand version of loratadine (Equate) was just $3.81 for 30 pills. Those are some of the reasons generic loratadine was our recent Best Buy Drugs pick for allergy drugs.

Of course, not all allergy drugs work equally well for all people. In fact, our survey published last year found that allergy sufferers tried an average of three medications to get relief, and 26 percent tried five or more. Some even took two or more medications simultaneously to treat different symptoms. So if loratadine doesn’t work for you, it might be worth giving Allegra Allergy a try. 
Forbes reports that Walgreen's earnings have been hurt by this switch.

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