Sunday, October 23, 2016

Weekend update

The FEHBlog is back inside the Beltway following an enjoyable weekend in the Nutmeg State.  Congress remains out on the campaign trail.  Medpage Today makes some predictions about the lame duck session following the election.

The FEHBlog has been waiting for the Congressional Budget Office to score the postal reform legislation that the House Oversight and Government Reform Committee passed last July.  Last Thursday, the CBO released a report on one of those bills (HR 5707) but the report on HR 5714 which bears on the FEHBP remains pending. Perhaps it will be released this coming week. In that regard, a friend pointed out a new website that aggregates Congressional Research Service reports.

Fedsmith summarizes the FEHBP significant changes for 2017 letter which the FEHBlog posted last week. If you didn't have a chance to download the letter from the FEHBlog, the summary should suffice.

The Federal Times reports on the state of self plus one coverage.
Self-Plus-One has amassed more than 540,000 beneficiaries in its first year, accounting for more than half of the eligible federal employees and retirees.  In a conference call announcing [2017] premium changes for the Federal Employees Health Benefits program, agency officials said that 40 insurance plans in the program still had higher enrollee shares than family coverage plans.  In those cases, OPM Director of Healthcare and Insurance John O’Brien said the agency was actively advising beneficiaries in those cases to remain on their family plans. “While the number of plans is significant, in terms of overall share of the population, it’s relatively modest,” he said. 
On the HIPAA front, HHS's Office for Civil Rights and the Federal Trade Commission ("FTC") point out that "if you share health information, it’s not enough to simply consider the HIPAA regulations. You also must make sure your disclosure statements are not deceptive under the FTC Act."  The agencies provide guidance on the relevant provisions of the FTC Act.  Also last week, OCR took another HIPAA scalp.
St. Joseph Health (SJH) has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules following the report that files containing protected health information (PHI) were publicly accessible through internet search engines from 2011 until 2012.  SJH will pay a settlement amount of $2,140,500 and adopt a comprehensive corrective action plan.
Also last week the ACA regulators unveiled ACA FAQ 33.  This FAQ concerns student health coverage which has no relevance to the FEHBP but illustrates the breadth of this law.

The Washington Post today continued its series on the country's opioid and heroin abuse crisis. Last week, according to this U.S.A. Today report, Cigna and the N.Y. Attorney General announced a settlement under which Cigna will loosen its prior authorization rules for medication assisted treatment ("MAT") of these unfortunate conditions.
MAT, when prescribed and monitored properly, has been found to be safe, reasonably priced and effective in helping patients recover from opioid use disorder.
Unlike methadone, which must be administered under strict rules in certain clinics, MAT drugs — which usually contain buprenorphine and naloxone  — can be prescribed or dispensed in doctors’ offices for opioid dependency, as long as the doctor is authorized. Mental health therapy and management of medical issues is also recommended.
Cigna’s policy change, which is effective Oct. 15, covers all of Cigna's commercial insurance plans.

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