Tuesday, February 06, 2018

Inspector General Report

The acting OPM Inspector General has posted on the internet his semi-annual report to Congress for the period ended September 30, 2017. The report, which has a flashy cover, leads with a lousy recommendation in the FEHBlog's view.

The acting Inspector General wants Congress to apply a horribly complicated Medicare, Medicaid and TRICARE law, known as the federal healthcare programs anti-kickback act, to the FEHBP.  This law places restrictions on discount arrangements between healthcare providers and health plans. This law makes some sense with Medicare, Medicaid and TRICARE where the government dictates the pricing for the most part. The law makes no sense with the FEHBP where the discount arrangements are contractually negotiated. If the OIG's recommendation is accepted, FEHB plans would be required to re-negotiate thousands of contracts and providers may be unwilling to play ball under the new rules. This type of chaos will not lead to better, more affordable healthcare.

The FEHBlog had hoped that OPM management would push back on this request but the management response does not oppose the recommendation, notwithstanding the President's call for de-regulation.  This is a big bowl of wrong.

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