Monday, February 06, 2012

Weekend Update

The FEHBlog enjoyed the Super Bowl and hopes that everyone else did too. Congress is in session this week and the Presidents FY 2013 budget will be released next Monday.

While researching for this post, the FEHBlog ran across the comments that Essential Health Benefits Coalition sent to HHS last Monday. The FEHBlog previously has noted the Stop the Health Insurance Tax coalition, which recently advertised on the Politico Pulse, and the coalition seeking to repeal the Affordable Care Act's medical device tax. The medical device tax and the $2500 annual cap on health care flexible spending accounts both take effect next year. The health insurance tax takes effect in 2014.  The Affordable Care Act has been good to the association industry.

The FEHBlog is surprised that Congress has not yet repealed the Affordable Care Act requirement that health plan members obtain a prescription in order to obtain reimbursement, e.g., from a flexible spending account, for an over-the-counter drug purchase. Of course, there's a coalition to advocate for a repeal of that requirement, which doesn't make a lot of sense to the FEHBlog, but the requirement has been in effect since January 1, 2011.

Health plans beware. The New York State Attorney General is on the warpath again. Last time, his target was the Ingenix system for setting out of network reimbursement rates. Now the target is out of date in network provider directories. The AMA News reports that  
In response to complaints from patients who were frustrated by out-of-date physician directories, New York Attorney General Eric Schneiderman has ordered a group of health plans [New York State subsidiaries of Wellpoint, EmblemHealth, and United Health Group] of to improve their listings and pay back patients who were unexpectedly faced with paying out-of-network rates.
The Medical Society of the State of New York "views this action by the AG favorably," said Moe Auster, the association's vice president for legislative and regulatory affairs. He said MSSNY members adopted a resolution in 2010 calling on the state to require insurers to make timely updates to their directories and penalize insurers for inaccurate listings.
The article explains that the health plans expect cooperation from the providers to keep the directories up to date, but no matter.

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