Open Season begins!

Happy Veterans' Day (observed).  The Federal Benefits Open Season begins today, November 12, and will end on December 10, 2012 (subject to OPM's right to extend the Open Season to account for unusual circumstances).

On Friday, OPM posted an immediate effective interim final rule  ("IFR") that "allows agencies such as the Federal Emergency Management Agency (FEMA) to apply to OPM for authorization to offer FEHBP coverage to intermittent employees engaged in emergency response functions." This IFR closes the loop on the IFR  released last summer extending FEHBP coverage to temporary federal employees who fight forest fires for the Interior Department. That IFR solicited suggestions on further expanding coverage to other first responders. Govexec.com also credits an online petition but the FEHBlog thinks that the wheels were in motion for this IFR before the online petition coinciding with last month's "super storm" and its timing is attributable to the start of Open Season.

The AMA News reports on the Centers for Medicare and Medicaid Services final rule on Medicare Part B reimbursement to physicians for the 2013 calendar year. This rule is obviously a big deal to doctors as it features the doctor's "fiscal cliff" -- a 26.5% reimbursement cut attributable to the statutory sustainable rate of growth formula that Congress is expected to address in the lame duck session that begins tomorrow. The rule also includes a number of other features stemming from the ACA that will take effect in January:

The fee schedule includes other rate cuts to some physicians, such as lower payments for multiple advanced imaging scans and penalties for not submitting quality measurements to the Centers for Medicare & Medicaid Services. But CMS also finalized additional hardship exemptions the doctors can use to prevent pay reductions for not reporting electronic prescribing activity, and it further limited the number of physicians who will have their rates adjusted according to quality and cost scores by a value-based payment modifier in 2015.

Finally, the FEHBlog was interested to read (in a Pittsburgh Post Gazette article) that a Pennsylvania state court judge on Friday granted Highmark a preliminary injunction against the West Penn Allegheny Hospital System restoring for the time being the affiliation agreement between health insurer Highmark and the hospital system. Back in August the hospital system walked away from the deal which had not yet closed (although Highmark had invested a lot of money in the facility.) The FEHBlog knows that the law establishes a high bar for obtaining this relief. The hospital system can appeal even though the case is not over.