Friday, October 28, 2011

Friday Highlights reports on the improvements to disease management and wellness programs that FEHBP expert Walton Francis is finding in the 2012 benefit packages of FEHBP plans. As mentioned in the FEHBlog earlier this week, OPM has posted information about those benefit packages on its website. Of course you can find more information on the individual plan websites.

The FEHBlog has been following the efforts to repeal the sustainable rate of growth formula that the Centers for Medicare and Medicaid Services must use to determine Medicare Part B reimbursements to doctors. If Congress does not repeal and replace the SRG by the end of this year, the statutory formula will generate a 29% cut in Medicare reimbursements to doctors. Congress has the alternative of extending the current patch but you never know what's going to happen with the Super Committee in the mix.

Earlier this month the federal Medicare Payment Advisory Commission or MedPAC offered its proposal to replace the SRG formula with a new formula that holds reimbursements to primacy care physicians steady and cuts reimbursements to specialists 6% annually for several years according to the Hill. Needless to say the medical societies for specialists are outraged.

Whatever happens should ease the cost shift to employer sponsored plans and the disruption to Medicare that would occur if the SGR driven reduction kicks in on January 1, 2012.

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