Friday, December 16, 2011

Friday Highlights

Congress is in the process of approving the final Fiscal Year 2012 appropriations bill (H.R. 2055) known colloquially as the megabus. This bill includes the now standard FEHBP appropriations provisions -- a Cost Accounting Standards exemption (OPM has created specific rules for the FEHBP), an abortion coverage limitation, and a contraception coverage mandate. The FEHBP's appropriations provisions are found in Parts 6 and 7 of Division C.

The FEHBP's contraception coverage mandate is narrower in scope than the HHS mandate issued this year under the no-cost preventive care provision of the Affordable Care Act because it allows for the impostion of enrollee cost-sharing. It is broader in the sense that it applies to all FEHB plans while the HHS mandate applies to FEHB and other health plans that are not grandfathered for Affordable Care Act purposes. The FEHBP's contraception mandate also has a more generous exception for religious institutions than the HHS mandate. The HHS mandate does not apply to the FEHBP until January 1, 2013.

HHS issued an essential health benefits bulletin for public comment today. HHS appears to be following the recommendations of the Institute of Medicine -- a good move in the FEHBlog's view. This is the next step in the process that will lead to the Secretary of HHS issuing an essential benefits package for use by qualified health plans operating in state health insurance exchanges. The guidance indicates that HHS will be allowing the States leeway in establishing a package for their respective populations. Plans operating outside the exchanges will not be required to offer the essential health benefits package but will be prohibited from imposing annual or lifetime dollar caps on those identified benefits.

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