Friday, August 02, 2013


Following up on the mid-week update, the New York Times (and Politico) reports today that
The Obama administration told Congress on Thursday that it would allow the federal government to continue paying a large share of the cost of health insurance for members of Congress and their aides, averting a problem for many who work on Capitol Hill.
However, under the arrangement, lawmakers and many of their aides will have to get coverage through new health insurance marketplaces, or exchanges, being set up in every state.
This means that over 10,000 FEHBP enrollees will be leaving for the exchanges in January. Congress will not lose all interest in the FEHBP because the FEHBlog expects that the OPM rule will allow these people being booted out of the FEHBP to retain their right to FEHBP coverage at retirement (assuming five years of FEHBP or exchange coverage immediately pre-retirement). .

OPM is expected to issue a proposed rule next week. does not show the rule having arrived at OMB for review yet but these ACA rules can move through OMB quickly plus the White House was involved in this matter.

Better late than never. The ACA regulators finally have issued their 2013 CLAS County Data List. The introduction to the list explains that
PHS Act section 2719 requires non-grandfathered group health plans and health insurance issuers offering non-grandfathered health insurance coverage to provide relevant notices in a culturally and linguistically appropriate manner. The regulations implementing section 2719 require these plans and issuers to make certain accommodations for notices sent to an address in a county meeting a threshold percentage of people who are literate only in the same non-English language. This threshold percentage is set at 10 percent or more of the population residing in the claimant’s county, as determined based on American Community Survey (ACS) data published by the United States Census Bureau. 26 C.F.R. § 54.9815-2719T, 29 C.F.R. § 2590.715-2719, and 45 C.F.R. § 147.136.
It would be more helpful if the list identified changes from 2012. In any event, nationwide plans tend to provide these translation services nationwide.

Finally, Mass Device reports that a "Washington, D.C., cardiologist was hit with a $17 million [False Claims Act] judgment after being found [liable for] submitting false claims for nuclear imaging tests to Medicare and state health programs -- plus our beloved FEHBP! Here's a link to the U.S. Attorney's press release.

Have a good weekend.

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