Friday, October 28, 2016


The fun never stops. Yesterday, the ACA regulators released ACA FAQ 34. FAQ 34 concerns tobacco cessation therapy and mental health parity, which was yesterday's topic of the day.  The FEHBlog noticed that OPM introduced to the FEHBP in 2011 the tobacco cessation program that is discussed in the FAQ.

Yesterday, the President's mental health parity task force released its final report.  The report made several recommendations, many of which were contemporaneously implemented as explained on the announcement page. The very last announcement (p. 34) concerns the FEHBP:
Review substance use disorder benefits in FEHBP. Federal Employees Health Benefits Program insurance carriers have made significant strides toward ensuring parity in mental health and substance use disorder benefits. Commenters noted that non-quantitative treatment limits may still need examination and modification to ensure full compliance, and consistent definitions of terms relating to residential treatment would provide greater transparency for consumers. In the coming year, the US Office of Personnel Management will undertake a detailed review of NQTLs [non-quntitative treatment limits] applicable to substance use disorder benefits, and take corrective action as indicated by the findings.
It's nice to see kind words written about FEHBP carriers.

The International Foundation of Employee Benefit Plans alerts us that the ACA regulators are releasing another final rule addressing
  • The definition of short-term, limited-duration insurance for purposes of the exclusion from the definition of individual health insurance coverage;
  • The standards for travel insurance and supplemental health insurance coverage to be considered excepted benefits; and
  • Amendment of a reference in the final regulations relating to the prohibition on lifetime and annual dollar limits.
The rule will be published in the Federal Register this coming Monday.

The FEHBlog recalls speakers warning about the looming cost of a new class of cholesterol fighting drugs called PCSK9 inhibitors.  Pharmalot reports that these drugs aren't selling like hotcakes as first expected for a number of reasons. In that regard, Healthcare Dive reports on prescription drug value pricing arrangements created by health plans and PBMs.

Speaking of innovations, the Cleveland Clinic released a list predicting the top ten medical innovations for 2017.
Topping the 11th annual list is the harnessing of the microbiome, the gut bacteria swarming in all of us. Recent discoveries have revealed the power of microbes to prevent, diagnose and treat disease. The healthcare industry will soon be pouring resources into addressing the potential for new therapies, diagnostics, probiotics and other products.
Fingers crossed, of course.

Finally Fierce Healthcare reports on a study finding that consumer are willing to price shop for health services if they are given the necessary information. That's good news.

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