Friday, August 28, 2015


According to the Federal Times, NARFE is trying to get Congress and/or the Centers for Medicare and Medicaid Services to expand the Medicare Part B hold harmless provision to all Medicare beneficiaries.  Under this provision, if, as expected, there is no Social Security cost of living adjustment for 2016 then there will be no Medicare Part B premium increase for FERS annuitants (this is the hold harmless aspect) but there will be a whopping increase for CSRS annuitants (who in contrast to FERS annuitants did not pay Medicare taxes during employment).  Because a large number of current retirees are under CSRS, the hold harmless exception would  throw a monkey wrench into OPM's plans to encourage FEHBP annuitants to sign up for Medicare Part B.

This week the Food and Drug Administration approved the second powerful anti-cholesterol drug known as a PCSK9 inhibitor.  Modern Healthcare reports that    
The FDA approved Repatha, an injectable drug made by Amgen that lowers a person's “bad” cholesterol level. It can be used only for patients who have certain inherited conditions or a history of serious heart ailments. Estimates put that patient base at around 5 million to 10 million people. These types of cholesterol drugs are called PCSK9 inhibitors.
Repatha's approval came about a month after Praluent, another cholesterol drug in the same class. Sanofi and Regeneron Pharmaceuticals make Praluent, which costs $14,600 a year for a normal course of treatment. Repatha is slightly cheaper at $14,100 a year.
Observers view the cholesterol drugs as potential budget-busters for public and private insurers.
Oh joy. Insurers and PBMs are evaluating their coverage rules for these expensive drugs and the existence of competition should be helpful.  Nevertheless, according to an Aon Hewitt survey reported by Fierce Health Payer
[P]harmacy cost trends will rise by 10 percent when employers renew their health insurance plans for next year. That's up from 6.3 percent at renewal last year.
What's particularly noteworthy is that increase in pharmacy costs includes an almost 23 percent rise in specialty drug prices, especially medications for cancer and cholesterol. That's up from an 18 percent increase in 2014.
In closing, here's a link to a useful NARFE article on the self plus one enrollment type which is new for 2016. The FEHBlog agrees with NARFE's reminder that "you must actively change from a Self and Family to a Self Plus One option; your agency or OPM will not automatically change your enrollment."  

1 comment:

Anonymous said...

The "hold harmless" provision is for Social Security annuitants, not Medicare patients. Most CSRS employes did indeed pay Medicare taxes while employed (at least those that worked after 1983). It is only those retirees that do not receive SS benefits that will be hit with the increase in Medicare costs.