Sunday, May 03, 2015

Weekend update

The FEHBlog is visiting lovely Denver Colorado. Meanwhile back in Washington, DC, Congress is in session this coming week. Here is a link to the Week in Congress's review of last week's activities.

This is also Public Employee Recognition Week.  Thank you government and postal employees.

At the OPM FEHBP Carrier conference in late March, OPM read off a laundry list of FEHBP regulations that the agency is in the process of finalizing. While none of those regulations have been submitted to the U.S. Office of Management and Budget for final approval as yet, does tell us that an important HHS proposed rule is now pending at OMB:

TITLE: Nondiscrimination Under the Patient Protection and Affordable Care Act

This is the rule that will explain HHS's approach to a complicated ACA provision, Public Health Service Act Section 1557.   

Recently, according to the Miami Herald, CIGNA was sued under this provision claiming that "the insurer forces HIV patients to obtain their medications solely through mail-order.  The suit, filed by nonprofit consumer group Consumer Watchdog, national litigation and healthcare group Whatley Kallas, LLP, and Miami-based class action law firm Podhurst Orseck P.A., claims that Cigna’s mail-order-only policy risks the health and privacy of its patients.  Lack of choice, the lawsuit claims, equates to discrimination."  Of course, CIGNA was requiring all of its members under certain circumstances to use its mail order pharmacy. This is a standard plan design practice that helps control premiums. Hopefully, the HHS rule will sanction standard non-discriminatory benefit design practices. The FEHBlog is keeping a close eye on this rule. 

Employee Benefit News reports that last Thursday United Healthcare announced a partnership with three telehealth companies, Doctor On Demand, Optum’s NowClinic and American Well – to cover visits with a doctor via video technology, just as it would for in-person visits.  Good idea. 

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