On July 3, OPM issued a benefits administration letter and a carrier letter about the expansion of FEHBP coverage to same sex spouses. The FEHBlog notes that the Supreme Court's decision which authorized OPM to define the term spouse found in the FEHBA's definition of family member to include same sex spouses also has the same effect on the Internal Revenue Code's dependent definition (IRC § 51). Before the June 26, 2013, Supreme Court decision, any employer that extended benefits coverage to same sex spouses would have to impute the cost of that coverage to the employee due to DOMA. That requirement no longer applies to same sex spouse coverage but it still applies to same sex domestic partners coverage. Moreover, the OPM letters explain that "This decision does not extend [FEHBP] coverage to registered domestic partners or those employees or annuitants in civil unions."
OPM joined with CMS in encouraging a reduction in hospital readmissions. Newswise reports that a SUNY Binghampton study reports on the value of using social workers to assist recently discharged patients with Medicare coverage. The social workers coordinate care and visit the patient at home to assess the home environment, e.g., reduce risks for falling. Early results show that the approach is effective in reducing readmissions by over 50%.
Health Data Management reports that NCQA is soliciting public comments on proposed changes to the HEDIS performance measures required by the transition to the ICD-10 code set. The comment period is open until December 16, 2013. HDM further reports that
NCQA also has released the 2014 edition of technical specifications for HEDIS measures, including a new measure on non-recommended cervical cancer screening in adolescent females. Changes also were made in existing measures covering breast cancer screening, cervical cancer screening for adult females, care for older adults, potential drug-disease interaction in the elderly and relative resource use. More information is at ncqa.org/publications.Finally, the AMA News reports on what's next now that the AMA has decided that obesity is a disease. (Hint: more money for doctors).