Friday, November 28, 2014


The FEHBlog added a question mark to TGIF today because he had the day off. Double weekend!! So this blog entry principally will follow up on some other recent entries.

Last Friday and Sunday, the FEHBlog noted the issuance of several new ACA rules.  Timothy Jost in the Health Affairs Blog wrote two lengthy entries on the ACA rules issued last Friday  -- a view of the 2016 benefit and payment parameters notice from an insurer's perspective and a discussion of the IRS's final minimum value rule and OPM's proposed revised multi state program rule.

Last Friday the Obama Administration issued the Fall 2014 semi annual regulatory agenda. Here are OPM's FEHBP regulatory priorities according to that agenda:
OPM will make several amendments to the Federal Employees Health Benefits (FEHB) regulations to adhere to the provisions of the Affordable Care Act of 2010. These amendments include enrollments for eligible employees of Tribes and Tribal organizations, changes to resolutions of disputed health claims and external reviews, rate settings for community-rated plans, enrollment options following the termination of a plan or plan option, and the expansion of eligibility to certain employees on temporary appointments and certain employees on seasonal and intermittent schedules.
Among the many items under the HHS entry in the semi annual agenda are a proposed Section 1557 non-discrimination rule scheduled for next June, the final HIPAA certification rule, scheduled for next July, and a pre-rule rule making solicitation of comments on giving complainants a cut of the penalties imposed on covered entities and business associates for HIPAA privacy and security rule violations, also scheduled for next Spring. The Section 1557 non-discrimination rule will impose new benefit mandates on FEHB plans so it's worth following. The HIPAA certification rule is a silly but onerous ACA requirement on health plans. The mid 2015 timing final HIPAA rule suggests that HHS may give health plans another year (under the end of 2016) to obtain CORE certification or HIPAA accreditation.  The penalty sharing rule making must have my brother and sisters at the bar slobbering at the bit as they say.

Here are a couple of tidbits to add to these "leftovers?":

  • Modern Healthcare examines the difference of opinions over the efficacy of employee wellness program.  It's too bad that you can't inject people with common sense. 
  • Fierce Healthcare, based on a Forbes article, looks ten of the 10 most expensive U.S. cities for healthcare. It's noteworthy that the cities are spread all of the continental U.S.

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