tag:blogger.com,1999:blog-261073102012-02-17T15:40:41.748-05:00The FEHBlogAn Ermer Law Group PLLC service providing Federal Employees Health Benefits Program and general health benefits law and policy information -- but not legal adviceDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.comBlogger12521100tag:blogger.com,1999:blog-26107310.post-22073634932816264922012-02-17T12:51:00.002-05:002012-02-17T15:40:41.756-05:00TGIFThe Washington Post reports that Congress has passed the tax extenders act that allows the payroll tax cut and the Medicare Part B patch to remain in place until the end of this year. It should be a humdinger of a lame duck session following the Presidential election.
OPM has posted its FY 2013 budget justification. This interesting document discusses OPM's recent accomplishments and its plans David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-30860130362733499332012-02-14T21:21:00.001-05:002012-02-14T21:21:22.880-05:00Tuesday's TidbitsThe big news tonight is that the House and Senate reportedly are close to a compromise to extend the payroll tax cut and the Medicare patch through the end of this year according to the Washington Post. If so it will be a very good day for the American Medical Association. Earlier today, the Acting Administrator of the Centers for Medicare and Medicaid Services announced that the Administration David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-85253991051821183832012-02-12T20:10:00.001-05:002012-02-12T20:10:04.731-05:00Weekend UpdateCongress is in session this coming week, and the President will be releasing his Administration's Fiscal Year 2013 budget tomorrow.
Business Week is reporting that the Federal Trade Commission may take action on the Express Scripts - Medco merger next month.
Express Scripts is expected to certify to the
Federal Trade Commission [tomorrow] that it’s finished providing the
necessary David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-51280426237681118772012-02-09T18:49:00.000-05:002012-02-09T18:49:36.329-05:00Exciting DayThe Affordable Care Act regulators released the final summary of benefits and coverage ("SBC") and uniform glossary rule today. FEHB plans will be required to distribute this SBC for the first time during the 2013 Open Season, which begins in November 2013. This four doubled sided page summary is intended to help consumers select a health plan. However, the ACA regulators are not requiring that David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-22750320992646347382012-02-07T21:44:00.001-05:002012-02-07T21:44:30.246-05:00Tuesday's TidbitsA few years ago a group of federal retirees who were becoming for Social Security eligible sued for the right to opt out of Medicare Part A in order to remain eligible to contribute to a health savings account in their FEHB plan. Today, the U.S. Court of Appeals for the D.C. Circuit, affirming the lower court, held that people must accept Medicare Part A as a condition to receiving Social David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-86128420787751354342012-02-06T07:45:00.000-05:002012-02-06T07:45:02.042-05:00Weekend UpdateThe FEHBlog enjoyed the Super Bowl and hopes that everyone else did too. Congress is in session this week and the Presidents FY 2013 budget will be released next Monday.
While researching for this post, the FEHBlog ran across the comments that Essential Health Benefits Coalition sent to HHS last Monday. The FEHBlog previously has noted the Stop the Health Insurance Tax coalition, which recently David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-26241548378529839452012-02-03T13:53:00.000-05:002012-02-03T13:53:29.379-05:00TGIFGovexec.com reports on OPM's problems in processing federal retirement claims. The other day, the FEHBlog was speaking with a veteran Congressional staffer who is expecting a wave of staffer retirements next year on Capitol Hill because Congress and many staffers shift to the health insurance exchanges in 2014. Retiring in 2013 will allow them to preserve their FEHB coverage.
Kaiser Health News David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-43553191220120330502012-01-31T22:18:00.002-05:002012-02-01T09:47:12.465-05:00Tuesday's TidbitsToday was the deadline for commenting on the HHS Essential Benefits Bulletin, and AHIP submitted an interesting comment letter. The FEHBlog was puzzled by the Bulletin's statements that state benefit mandates don't add that much to health plan costs. The AHIP comments blow that statement out of the water. Fortunately, federal law exempts FEHB plans from those state benefit mandates. FEHB plans, David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-23184863021229925862012-01-29T22:30:00.001-05:002012-02-01T09:47:55.173-05:00Weekend UpdateCongress is in session this week. On Wednesday at 2:30 p.m. the Oversight and Government Management subcommittee of the Senate Homeland Security and Governmental Affairs Committee will hold a hearing on ensuring timely and proper federal employee retirement payments by OPM.
Kaiser Health News notes that on Friday the Bipartisan Policy Center issued a report on what needs to be done to achieve David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-32801223815426326822012-01-27T18:11:00.001-05:002012-01-27T18:11:38.280-05:00TGIFThe Wall Street Journal reported this morning that Wellpoint and Aetna are offering more money to primary care doctors in their provider networks who are willing to engage in more care coordination efforts. "The 'scale is so much bolder than things we've seen,' said Paul Ginsburg, president of the Center for Studying Health System Change, a Washington nonprofit group. "'This isn't an experiment.David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-90108839448122361842012-01-25T18:50:00.001-05:002012-01-25T18:50:48.949-05:00Mid-week updateMedscape Today is reporting that the American Medical Association and 109 other medical societies are urging Congress to use the peace dividend to fund a credible replacement for the sustainable rate of growth formula. That formula is intended to set adjustments to Medicare Part B reimbursements to doctors but Congress has prevented the use of the formula for several years because it would slashDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-19445540307682909282012-01-22T21:50:00.001-05:002012-01-22T21:50:44.338-05:00Weekend UpdateBoth Houses of Congress will be back to work tomorrow. Just about five weeks until the current two month tax extenders law, including the Medicare Part B doctor reimbursement patch, expires (February 29 -- Happy Leap Year)
The Wall Street Journal is offering opposing perspectives on various health policy issues. One of the issues is whether there should be a universal patient identifying number.David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-6966602055378983122012-01-20T18:46:00.000-05:002012-01-20T18:46:19.902-05:00Late week updateThe FEHBlog is still experiencing internet difficulties at home.
OPM announced on Wednesday that it is requiring FEHB plans to offer "Blue Button" technology to their members in mid-March 2012. "Blue Button allows patients to see, download and keep their personal health data by clicking the 'Blue Button' on a secure Internet site." The Veterans Affairs healthcare system successfully has David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-21677438076815004882012-01-17T18:30:00.000-05:002012-01-17T18:30:13.315-05:00Tuesday update
The FEHBlog has been having internet difficulties at home which prevented new posts over the weekend.
The House of Representatives is back to work today and the Senate returns next Monday to face the tax extenders issue again. The American Medical Association is pushing for a permanent replacement for the sustainable rate of growth formula used to set Medicare Part B reimbursements to doctors.David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-24218082074143412452012-01-13T14:21:00.003-05:002012-01-13T14:21:54.384-05:00No good deed ...
Effective at the beginning of 2011, OPM mandated that FEHB plans cover nicotine patches, gum and other therapies to help federal and postal employees and annuitants quit smoking. Earlier this week, the LA Times and other news outlets reported about a new study which "finds that nicotine patches and other nicotine replacement products aren't effective at preventing former smokers from relapsing David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-46040229933578146112012-01-11T07:38:00.002-05:002012-02-01T09:57:13.772-05:00Tuesday Tidbits
On Monday, the Centers for Medicare and Medicaid Services released the 2010 report on national healthcare expenditures ("NHE report"). "The report notes that U.S. health care spending grew only 3.9 percent in 2010, reaching $2.6 trillion or $8,402 per person, just 0.1 percentage point faster than in 2009." Business Insurance notes that "Government researchers say the relatively slow growth in David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-39307828858540484732012-01-08T18:03:00.003-05:002012-01-08T18:03:57.923-05:00Weekend UpdateCongress remains in recess this week. The House returns on January 17 and the Senate returns on January 23.
The FEHBlog doubts that federal regulators will approve the merger of the two large prescription benefits managers Express Scripts and Medco after the government rejected the AT&T - T-Mobile deal. However, Business Week reports that "Even as U.S. regulators take a tougher stance on David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-7811706229734881202012-01-06T17:49:00.002-05:002012-01-06T17:49:27.626-05:00Friday updateOn January 5, the Department of Health and Human Services issued new electronic standards for fund transfers under the Health Insurance Portability and Accountability Act ("HIPAA"). This interim final rule has a January 2014 compliance date. The press release explains that
Future administrative simplification rules will address adoption of:
A standard unique identifier for health plans;
A David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-27902938743546489012012-01-04T18:59:00.002-05:002012-01-04T18:59:35.384-05:00Mid-week updateMy how time flies when it's a four day work week. When Congress returns to work later this month, it must face the loose ends created by the two month long tax extenders act. One of this loose ends which impacts the health care industry is the Medicare Part B payment patch. Absent this patch the statutory sustainable rate of growth formula would cut Medicare Part B payments to doctors by 27.4%, David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-4394389252646079932012-01-02T15:03:00.001-05:002012-01-02T15:03:21.488-05:00Happy New Year!The FEHBlog wishes everyone a very happy and prosperous New Year. In 2012, we can expect final rules on the Affordable Care Act's summary of benefits and coverage rule and the HITECH changes to the HIPAA Privacy Rule. Hopefully, common sense will prevail among the regulators. Business Insurance notes that another major regulatory action will involve the Affordable Care Act's pay or play David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-24066861089352673232011-12-30T15:10:00.003-05:002011-12-30T15:10:35.109-05:00Interesting Developments
Prescription benefits manager Express Scripts and pharmacy chain Walgreens continue to stare each other down. The AP reports this afternoon that
Walgreen CEO Greg Wasson said Friday chances are probably "slim to
none" that the drugstore operator will reach an agreement with pharmacy
benefits manager Express Scripts before their current contract ends
Saturday.
Walgreen Co. announced that it David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-52599863251812716792011-12-27T17:36:00.001-05:002011-12-27T17:36:37.014-05:00Tuesday TidbitsThe FEHBlog hopes the everyone is enjoying the holidays. It's a slow week as we wind down 2011 and look forward to 2012.
Last week, CMS released a list of the thirty two health care organizations that will be serving as "pioneer" accountable care organizations beginning next week. "Under this initiative, operated by the Centers for Medicare &
Medicaid Services (CMS) Innovation Center (David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-14953230089469504072011-12-22T17:34:00.000-05:002011-12-22T17:34:01.932-05:00Mid week updateThe news that today is the FEHBlog's birthday has been eclipsed by the Hill report that
A House GOP leadership aide told The Hill that Speaker John Boehner (R-Ohio) and Senate Majority Leader Harry Reid (D-Nev.) reached an agreement to pass a version of the Senate’s two-month payroll tax cut legislation, with a fix demanded by Republicans to make implementation easier.
This means that the David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-87591750920077367262011-12-18T20:41:00.002-05:002011-12-18T21:59:14.001-05:00Weekend UpdateThe President has signed into law the megabus appropriations bill discussed in Friday's FEHBlog according to this Govexec story. The Federal Times adds that
The bill gives the U.S. Postal Service another reprieve on a
legally required $5.5 billion payment into a retiree health care fund.
The payment, which USPS officials say they lack the money to cover, was
originally due Sept. 30. David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-43369199426298867932011-12-16T15:54:00.001-05:002011-12-16T15:54:14.658-05:00Friday HighlightsCongress is in the process of approving the final Fiscal Year 2012 appropriations bill (H.R. 2055) known colloquially as the megabus. This bill includes the now standard FEHBP appropriations provisions -- a Cost Accounting Standards exemption (OPM has created specific rules for the FEHBP), an abortion coverage limitation, and a contraception coverage mandate. The FEHBP's appropriations provisionsDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-46139400223908756182011-12-14T07:08:00.001-05:002011-12-14T07:08:17.864-05:00Mid-week updateThe Washington Post this morning is reporting this morning that the threat of a government shutdown looms. The current continuing resolution funding the Government expires on Friday December 16. The final "megabus" appropriations bill for the current Government fiscal year is done or nearly done, depending on who you believe. However, the Senate leadership, in a tactical move, is keeping the David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-87846322992844199312011-12-12T07:22:00.003-05:002011-12-12T07:22:38.548-05:00Weekend UpdateMonday December 12 is the last day of the Federal Benefits Open Season and the beginning of a busy week on Capitol Hill. The Washington Post is prognosticating that Congress will achieve a compromise on the final omnibus appropriations bill by the December 16 deadline.
A Washington Post columnist Steven Pearlstein has offered his views on why the Government should prevent the merger of two largeDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-74385958641137556802011-12-09T18:16:00.001-05:002011-12-09T18:25:19.344-05:00Friday Highlights
The Federal Benefits Open Season ends on Monday December 12 and the continuing resolution funding the federal government expires next Friday December 16. Yesterday, a House-Senate conference committee started meeting on a final omnibus appropriations bill for the current federal government fiscal year. According to the Hill blog, the goal is to release a bill on Monday.
These negotiations are David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-41580499444750803622011-12-07T20:16:00.001-05:002011-12-07T20:37:51.263-05:00Mid-Week UpdateWell, the clock continues to tick down to the end of the current continuing resolution on December 16. With so many issues up in the air, as Federal News Radio reports, Your guess about the income is as good as the FEHBlog's.
In this year's call letter for benefit and rate proposals, OPM encouraged FEHB plans to utilize the patient centered medical home ("PCMH") concept which financially rewardsDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-2173372153757835632011-12-04T20:56:00.001-05:002011-12-04T21:22:59.616-05:00Weekend UpdateWe are entering the last full week of the Federal Benefits Open Season which ends on December 12. Govexec.com reports that "As the end of open season for changing health insurance elections draws
near, the refrain among health care specialists boils down to: Look into
changing your plan now, before it's too late."
The article also reports opinions that the Affordable Care Act won't David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-15282185873143060352011-12-01T21:41:00.001-05:002011-12-01T21:57:18.500-05:00Thursday PotpourriTo commemorate the introduction of the generic version of Lipitor, a bipartisan group of three Senators has sent letters to Lipitor's manufacturer, Pfizer, three major PBMs, and two insurers "after a news report alleged Pfizer agreed to provide discounts to
pharmaceutical benefit management companies (PBMs) and insurance
companies if the PBMs and the insurers would block prescriptions for
David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-43905670726475770742011-11-29T21:38:00.001-05:002011-11-29T22:02:55.271-05:00Tuesday TidbitsSenate Homeland Security and |Governmental Affairs Committee Chairman Joe Lieberman (I Conn) and Ranking Minority Member Susan Collins (R Maine) have reintroduced their bill to extend FEHB coverage to same sex domestic partners of federal employees.
The HHS Office for Civil Rights which is responsible for enforcing the HIPAA Privacy and Security Rules announced earlier this month that it has David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-72934818998319675012011-11-27T19:31:00.001-05:002011-11-27T21:32:57.209-05:00Weekend UpdateThe FEHBlog hopes that everyone has an enjoyable Thanksgiving weekend. Congress returns to work this week as we begin the third week of the annual Federal Benefits Open Season which ends on December 12. What a relief that the Redskins finally won a fourth game today.
CBS News reminds us that the best selling prescription drug Lipitor will be available in generic form beginning this coming David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-41609320886448208172011-11-23T07:11:00.001-05:002011-11-23T07:29:27.825-05:00Happy Thanksgiving!The FEHBlog wishes everyone a Happy Thanksgiving. Of course, the Super Committee did not produce any deficit cutting recommendations. Congress will return to work after the Thanksgiving break. The AMA News makes it clear that the medical community is nervous about the looming end of the Medicare Part B reimbursement patch on December 31. Modern Healthcare reports that the Democratic leadership David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-90203970179534507342011-11-20T20:53:00.001-05:002011-11-20T21:09:33.149-05:00Weekend UpdateCongress has recessed for the Thanksgiving holiday, and according to news reports, including the Wall Street Journal, the Super Committee will admit defeat tomorrow. As it turns out tomorrow, not Wednesday, is the Super Committee's effective deadline because the Committee can only vote on proposals that have been made public for at least 48 hours before the vote.
The American Medical David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-15548451833127397132011-11-18T16:46:00.001-05:002011-11-18T17:10:36.753-05:00Friday HighlightsThe Federal Times reports that the President has signed into law a minibus appropriations bill that funds several departments and extends funding for other government agencies and programs, including the FEHBP, until December 16. Congress actually is hopeful that all appropriations matters will be wrapped up by that date. The law also further "defers a legally required $5.5 billion "prepayment" David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-17514687776152166252011-11-16T20:52:00.001-05:002011-11-16T22:08:18.966-05:00Mid-week updateJoe Davidson of the Washington Post reported on the beginning of a quiet Federal Benefits Open Season (so described because the average premium increase is so low for 2012) Mr. Davidson reported from a health fair sponsored by the FEHBlog's Congressman Chris Van Hollen. He observed that "People from health insurance companies, many with logo-laden swag, were available to answer questions about David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-20524781098663381372011-11-13T20:16:00.001-05:002011-11-13T20:45:21.854-05:00Weekend UpdateThe Federal Benefits Open Season starts tomorrow and ends on December 12. During the Open Season, federal and postal employees and annuitants can switch their FEHB plans for 2012 without concern of for pre-existing conditions.
While surveying OPM's Open Season web page, the FEHBlog ran across OPM's annual report on the use of health information technology in the FEHBP. OPM finds robust use.
David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-69463667375517928682011-11-11T17:18:00.001-05:002011-11-11T17:44:47.085-05:00Friday highlightsFederal News Radio reported on the AEI conference that I discussed in Wednesday's FEHBlog post. Federal News Radio who had a reporter at the event did a good job capturing the concerns that the panelists made about the Administration's proposal to carve out FEHBP prescription drug contracting from the carriers -- who bear the underwriting risk -- to OPM. The report further states that
The OfficeDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-82571612364916016072011-11-09T21:02:00.004-05:002011-11-10T06:47:04.667-05:00Mid-week updateThe Senate Homeland Security and Government Affairs Committee held a business meeting today at which it marked up the 21st Century Postal Service Act (S. 1789) that the Chairman, Sen. Lieberman (D CT) and the Ranking Member, Sen. Collins (R Maine) introduced. The FEHBlog, who watched the meeting on the internet, was relieved when the Committee approved by an 11-6 vote a motion by Sen. Akaka (D David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-92003949346716872342011-11-06T20:44:00.000-05:002011-11-06T20:44:24.624-05:00Weekend UpdateWell, this is getting repetitive. Congress is in session this week. 12 days to go until the Continuing Resolution funding the Federal government's operations expires and 17 days until the Super Committee must make its recommendations to Congress. The Washington Post reports on the status of the appropriations process -- now featuring "minibuses." Your guess about the outcome of the Super David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-92232676689562967562011-11-04T14:38:00.001-04:002011-11-04T14:38:36.435-04:00Friday HighlightsThe American Enterprise Institute will be holding an expert panel discussion on the Administration's proposal to carve out FEHBP prescription benefit administration to one prescription benefits manager under contract with OPM. The discussion will be held next Wednesday November 9 at 9:15 am and you can watch it remotely on the internet.
Fortunately the AEI session does not conflict with OPM's David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-66117223150372372042011-11-01T22:10:00.001-04:002011-11-01T22:10:09.574-04:00Tuesday's TidbitsThe U.S. Office of Personnel Management begins to hold a series of five Federal Benefits Open Season webinars beginning tomorrow. Of course the first session is an introduction to the Open Season. OPM advises that
Each webcast will be viewable starting at 1:30pm Eastern Time. To view the webcast online, you must use a broadband (high-speed) internet connection.
The webcast stream will become David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-7711876969142017882011-10-31T14:09:00.001-04:002011-10-31T14:09:29.093-04:00Monday updateHappy Halloween! The FEHBlog missed the regular weekend update yesterday as he was travelling back from New York City. The FEHBlog will be back on track this weekend.
We are now 18 days from the end of the current continuing resolution funding the federal government and 23 days from the due date for the Super Committee's deficit reduction recommendations to Congress.
Both the House and the David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-9654996786094781872011-10-28T14:57:00.002-04:002011-10-28T14:57:57.215-04:00Friday HighlightsGovexec.com reports on the improvements to disease management and wellness programs that FEHBP expert Walton Francis is finding in the 2012 benefit packages of FEHBP plans. As mentioned in the FEHBlog earlier this week, OPM has posted information about those benefit packages on its website. Of course you can find more information on the individual plan websites.
The FEHBlog has been following David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-776586698859847672011-10-27T18:23:00.000-04:002011-10-27T18:23:14.507-04:002012 Medicare Part B premiums announcedCMS announced the Medicare Part B premium amounts today. The premium that most Medicare Part B beneficiaries will owe is $99.90 per month. The details for recent enrollees and high income enrollees are available here. That's about a 3% increase over 2011 which is in line with the S&P health care index for Medicare payments that the FEHBlog tracks.
This information is very relevant to FEHB plans David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-44906538726037665962011-10-25T21:15:00.001-04:002011-10-25T21:15:25.794-04:00Tuesday TidbitsOPM announced today that it will be circulating federal benefits news on a new Twitter feed, The FEHBlog was the fourteenth follower. OPM sent out a tweet today that its web page with information about 2012 FEHBP plans is live. The website shows a map of the United States and invites the viewer to click on a state which
takes you to a list of all plans available in that state, as well as links David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-12454489938828249242011-10-23T21:02:00.001-04:002011-11-02T10:04:23.286-04:00Weekend UpdateThe House return from recess this week while the Senate goes out. The Hill Finance and Economy blog projects that Congress will extend into December the current continuing resolution funding federal government operations. The CR expires on November 18, less than a month away.
Standard & Poors reported last week that
Data released by S&P Indices for the S&P Healthcare Economic Composite Index David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-39225247997176670662011-10-21T11:16:00.003-04:002011-11-01T13:57:31.013-04:00Friday highlightsHealth care policy expert Robert Moffit wrote a column discussing the downside of the Administration's proposal to carve out FEHBP drug benefits from the carriers to OPM. He points out that
Today, if you are in the FEHBP and you don’t like a health plan’s drug coverage, you dump that plan and get a better one. Tomorrow, if Obama’s allies in Congress are successful, you will not have that optionDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-5107357544371535942011-10-18T22:07:00.000-04:002011-10-18T22:07:21.988-04:00Tuesday TidbitsNewsy Stocks.com reports on Deutsche Bank investment analyst views on FEHB premium increases for 2012. Interesting perspective.
Modern Healthcare reports that the Express Scripts acquisition of its fellow prescription benefits manager Medco is drawing scrutiny from another Congressional committee and at least 25 State regulators. Of course, the Federal Trade Commission and the Justice DepartmentDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-63854830070336289592011-10-16T23:00:00.001-04:002011-11-02T10:09:15.344-04:00Weekend UpdateThe Los Angeles Times reports that the Congressional Joint Select Committee on Deficit Reduction (a/k/a the Super Committee has received over 175,000 suggestions from the public. The House Oversight and Government Reform Committee's majority and minority members separately and the Senate Homeland Security and Governmental Affairs Committee's members jointly submitted their recommendations as wellDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-69284597561487170692011-10-12T22:07:00.002-04:002011-10-12T22:08:06.504-04:00Mid-week MiscellanyThe U.S. Office of Personnel Management's ("OPM") legislative proposal to carve out prescription drug benefits to a single prescription benefit manager (PBM) under contract with OPM has attracted the attention of the prescription drug industry. AIS Health reports that
Elan Rubinstein, Pharm.D., founder and principal of consulting firm EB Rubinstein Associates, maintains that there is another David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-81728542260016328712011-10-10T21:24:00.000-04:002011-11-02T10:12:38.518-04:00Weekend UpdateThe FEHBlog took a few days off to tour around New England. The FEHBlog returned to a Washington Post article about the Postmaster General Patrick Donahoe attacking the FEHB Program.:
During an interview late last week, Donahoe was clearly annoyed and angry with the Obama administration and Congress for not endorsing his plans to remove USPS from FEHBP — a massive program providing an array of David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-24554227624025272612011-10-04T18:17:00.000-04:002011-10-04T18:17:19.896-04:00Tuesday TidbitsThe House did join the Senate today in passing a continuing resolution funding the federal government until November 18, 2011, according to the Federal Times. That article notes that
It is doubtful that Congress will pass all 12 annual appropriations
bills before the CR expires Nov. 18, said Thad Juszczak, a former
federal budget officer now at consulting firm Grant Thornton. Bills
covering David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-37399910095618198042011-10-02T20:46:00.000-04:002011-10-02T20:46:36.339-04:00Weekend UpdateHappy FY 2012 which began yesterday. Congress returns from a brief recess tomorrow. The House actually approved a continuing resolution funding the federal government through Tuesday October 4. The Federal Times explains that the House of Representatives "will take up a longer-term continuing resolution running through Nov. 18 and also containing the 1.5 percent cut, in accordance with spending David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-15810746663836807882011-09-30T09:29:00.001-04:002011-09-30T09:29:57.952-04:00Significant Plan Changes for 2012Yesterday, OPM released its annual notice of FEHBP plan changes for 2012. OPM reminds agencies that if an employee is in a plan that is terminating or reducing its service area in a way that affects the employee, then that employee must choose another plan during the Open Season which begins November 12. Annuitants are automatically transferred to another plan if they fail to elect new coverage David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-51186886267754256752011-09-27T22:12:00.001-04:002011-09-27T22:12:50.549-04:00OPM announces 2012 FEHBP premiumsA couple of loose ends discussed in Sunday's post have been tied up. Congress has avoided a government shutdown by agreeing to adopt a continuing resolution that funds the the federal government through November 18. As the FEHBlog recalls, that's shortly before the Super Committee must release its deficit reduction recommendations to Congress.
More importantly, from the FEHBlog's perspective, David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-86260524663919916142011-09-25T19:18:00.002-04:002011-09-25T19:18:56.653-04:00Weekend UpdateCongress remains in session (notwithstanding plans for a recess this week) as the clock clicks down toward the end of the current federal fiscal year on Friday night. Unless Congress passes a continuing resolution before then, a government shutdown will occur on Saturday. Last Spring, OPM advised that the FEHBP would be status quo in the event of a shutdown due to a lack of appropriations. David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-62634073257457833342011-09-22T21:15:00.000-04:002011-09-22T21:15:37.097-04:00Mid-week updateBusiness Insurance reports that "Employers project that their group health care plan costs will increase
an average of 5.4% in 2012, a somewhat smaller increase compared with
recent years, according to a Mercer L.L.C. survey released Wednesday." Soon we all should know about 2012 FEHB premiums and the 2012 changes to the government contribution.
Kaiser Health News discusses a cost cutting David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-49238221806314140092011-09-20T22:53:00.000-04:002011-09-20T22:53:18.163-04:00Tuesday's TidbitsThe President released his deficit reduction proposals to the Super Committee yesterday. There was one FEHBP related proposal (p. 43) -- one that was first raised in the President's FY 2012 budget
Streamline Federal Employee Health Benefit (FEHB) pharmacy benefit contracting. The Administration is committed to the efficient administration of the FEHB program in order to get the best deal for David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-64145588355312758472011-09-18T21:42:00.000-04:002011-09-18T21:42:11.248-04:00Weekend UpdateThere's a good chance that OPM will announce the 2012 FEHBP premiums and the change in the government contribution this coming week.
Of course, Congress is in session this week. The House will consider a continuing resolution (H. J. Res. 79) to fund federal government operations from October 1, 2011, the beginning of the new federal fiscal year, until November 18, 2011. Section 124 of the David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-86245024274665596162011-09-15T22:31:00.000-04:002011-10-05T09:35:31.084-04:00Mid-week updateThe Washington Post reports on the activities of the Super Committee's work to craft a package of budget cuts totalling $1.5 trillion before Thanksgiving.. The Federal Times reports that the Federal Workers Alliance, which is composed of 22 labor unions, has prepared a white paper for the Super Committee opposing the Deficit Commission's proposal to shift the FEHBP to a premium support or voucherDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-14251718154294297172011-09-13T21:19:00.003-04:002011-09-13T21:19:48.974-04:00Tuesday's TidbitsFollowing up on last Sunday's post, the House Judiciary Committee's website does show that a hearing on "The Proposed Merger between Medco and Express Scripts" is scheduled for September 20th at 3:30 pm before the Subcommittee on Intellectual Property, Competition, and the Internet." The Wall Street Journal accurately observes that "Members of Congress have no role in deciding whether the David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-37351552904001343942011-09-11T15:45:00.001-04:002011-09-11T15:47:21.342-04:00Weekend UpdateCongress remains in session. Focus will now turn to a continuing resolution to fund federal government operations, including the FEHBP, in the new fiscal year which begins on October 1. It is expected that Congress will reach a bipartisan agreement on at least the first continuing resolution without rancor.
The U.S Court of Appeals for the Fourth Circuit issued opinions last week favoring the David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-84418883935948774642011-09-07T21:48:00.001-04:002011-09-07T21:48:30.193-04:00The Big HearingAlthough the FEHBlog touted watching the Senate Homeland Security and Governmental Affairs Committee hearing on the internet, it turned out that the live streaming was quite choppy at least on my computer. Fortunately, the New York Times filled in the gaps for me with this article and the Committee posted all of the Senator's statements and the prepared testimony on its website during the course David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-84594067125377860172011-09-05T15:56:00.000-04:002011-09-05T15:56:02.818-04:00Labor Day Weekend UpdateHappy Labor Day! The Senate Homeland Security and Governmental Affairs Committee has posted an updated witness list for tomorrow's hearing that will address, among other important topics, the Postal Service's ill-advised proposal to withdraw from the FEHB Program. The first panel now includes the OPM Director John Berry, a GAO representative, the Segal Group's chief actuary, and the Postmaster David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-66237808034228314992011-09-01T21:58:00.000-04:002011-09-01T21:58:32.425-04:00Important hearing scheduled on TuesdayThe Senate Homeland Security and Government Affairs Committee will be holding a hearing on the U.S. Postal Service in Crisis - Proposals to Prevent a Government Shutdown at 2 pm next Tuesday September 6. The first panel will include the Postmaster General and OPM's Director of Planning and Policy Analysis. The second panel includes the President of the American Postal Workers Union who according David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-77378129085520200562011-08-30T22:14:00.000-04:002011-08-30T22:14:03.346-04:00Tuesday TidbitsTomorrow marks 15 months after the last day (May 31, 2010) that unemployed people could become eligible for the federal subsidy covering 65% of COBRA continuation coverage (or in the FEHBP TCC) premiums, a program that began in 2009. Because the subsidy last for 15 months, the subsidy generally will be sunsetting tomorrow. The Labor Department has posted FAQs about this change.
Health Data David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-82581043094132118982011-08-28T17:16:00.001-04:002011-08-28T17:16:46.943-04:00Weekend UpdateCongress is entering into its final week of the August recess. The Washington Post is reporting that "The Senate Homeland Security and Governmental Affairs Committee plans to hold a hearing on the postal proposals [to withdraw from the FEHB Program, etc.] Sept. 6." No information on the hearing has been posted on the Committee's website yet.
The federal government has launched a new website David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-70996455642985658582011-08-25T21:36:00.000-04:002011-08-25T21:36:18.396-04:00Mid-week miscellanyThe Washington Post and the Federal Times join Govexec.com and the FEHBlog in throwing cold water on the Postal Service's ill advised proposal to withdraw from the FEHBP in favor of a stand alone program.
Reuters offers an interesting column discussing the cultural differences between Express Scripts and Medco that would have to be resolved if the federal antitrust regulators permit the deal to David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-34998143885819626412011-08-23T18:14:00.000-04:002011-08-23T18:14:32.127-04:00Tuesday TidbitsIt's nice to have company. Yesterday, Govexec.com posted a report titled "Observers are leery of Postal Service plan to opt out of federal health and retirement programs.
Next month, we'll learn about the changes to FEHB premiums and the Government contribution for 2012. Business Insurance reported on a National Business Group on Health survey of large employers which "estimate that the cost of David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-11112114245928217862011-08-21T20:09:00.002-04:002011-08-21T20:12:17.736-04:00Weekend UpdateCongress remains in recess. Last week, the Office of Management and Budget directed federal agencies to cut their Fiscal Year 2013 budget proposals by up to 10% according to the Federal Times and Govexec.com.
Business Insurance reports on industry reaction to the proposed Affordable Care Act rule on the summary of benefits and coverage template.
“There is just not enough here to tell us what to David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-9209541184780461742011-08-18T22:29:00.000-04:002011-08-18T22:29:29.864-04:00Mid-week miscellanyThe FEHBlog is pleased to see that NARFE, an organization for federal employees and retirees, has expressed its opposition to the Postal Service's ill-advised proposed to pull its employees and annuitants out of the FEHB Program and the federal retirement programs.
Standard and Poors announced today that "Data released today by S&P Indices for the S&P Healthcare Economic Composite Index indicateDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-50137462578998732632011-08-18T22:16:00.000-04:002011-08-18T22:16:42.356-04:00Another day, another ACA regulationYesterday, the Affordable Care Act regulators proposed a rule governing the four [double sided] page summary of benefits and glossary of health insurance terms that health plans must prepare once the rule is finalized and make available to plan participants and beneficiaries. The Labor Department's Affordable Care Act website provides all of the documentation, including the template for the David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-4192200342938119252011-08-16T21:56:00.000-04:002011-08-16T21:56:13.408-04:00Tuesday TidbitsThe Wall Street Journal reports that the Affordable Care Act regulators will release a rule describing the new summary of benefits form that health plans must distribute to consumers beginning next year. The article explains that
The summary form has often been compared to the food-nutrition label, though it is substantially longer, and at six pages the draft offers considerable detail. For David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-91599762682810416182011-08-14T19:39:00.001-04:002011-08-14T19:42:53.696-04:00Weekend UpdateCongress remains in recess. The U.S. Court of Appeals for the Eleventh Circuit created a split in the circuits by deciding that the Affordable Healthcare Act's individual mandate is unconstitutional as discussed at the Scotusblog. That blog points out that the the U.S. Supreme Court already has been asked to review the U.S. Court of Appeals for the Sixth Circuit's opinion unholding that David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-22443673765942104382011-08-11T22:24:00.001-04:002011-08-11T22:25:16.044-04:00Postal Service asks to pull out of the FEHBPThe Federal Times and the Washington Post are reporting that the Postal Service is asking Congress to permit it to layoff over one hundred thousand employees and pull its employees and retirees out of the FEHB Program and the federal employees retirement programs -- in violation of its collective bargaining agreements with the Postal unions. According to the Federal Times,
The Postal Service saidDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com1tag:blogger.com,1999:blog-26107310.post-58517501380590259672011-08-09T21:54:00.002-04:002011-08-09T21:56:31.377-04:00Tuesday TidbitsHere's a link to a comprehensive CMS actuarial projection of health care costs over the remainder of this decade that recently was published in Health Affairs. The AMA News comments on the report here. (Spoiler -- The report projects increase spending on doctors so the AMA News is happy. However, the AMA News understandably is freaking out over the fact that the Medicare Part B physician David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-24364509518071712772011-08-08T07:45:00.000-04:002011-08-08T07:45:16.293-04:00Weekend UpdateCongress is in recess until after Labor Day. According to Govexec.com, Sen. Ben Cardin (D Md) that "assured federal employees that since Congress had set aside money for the fiscal 2012 budget as a result of the recent deal, another showdown in the fall over appropriations was unlikely." That is good news.
On the Express Scripts acquisition of Medco front, the Chicago Tribune reports that Rep.David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-25827933465554744772011-08-05T08:01:00.000-04:002011-08-05T08:01:55.292-04:00Wrap upToday, Congress will patch the FAA appropriations issue until September 15 so people can get back to work. As previously noted in the FEHBlog, FEHB coverage continues during a furlough like this. Employees can catch up on their share of the premiums when they return to work.
In business news and notes, the Wall Street Journal is reporting that Medco is facing the loss of its sixth largest David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-85977486230786102672011-08-02T22:00:00.002-04:002011-08-02T22:02:59.522-04:00Tuesday TidbitsThe Nation's leadership raised the debt ceiling in time to avoid the crisis that the Administration predicted. Congress recessed until last month without resolving the Federal Aviation Administration appropriations issue that has resulted in a furlough of 4,000 employees according to the Federal Times.
CBS News explains that the new debt ceiling law, among other things,
Creates a 12-person David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-14966894440243046452011-07-31T21:13:00.001-04:002011-07-31T21:14:02.310-04:00Weekend UpdateThe House and Senate remain in session this week as the leadership and the President seek to resolve the debt ceiling issue which, according to the Administration, comes to a head on Tuesday, August 2. The Wall Street Journal is now reporting that "President Barack Obama, speaking from the White House, said the leaders of both parties in both chambers of Congress have agreed to a deal to raise David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-6232111508017125142011-07-26T22:48:00.001-04:002011-07-26T22:48:38.346-04:00Tuesday TidbitsThe Affordable Care Act regulators issued in today's Federal Register corrections to the June 24, 2011, amendments to the July 23, 2010, claims, internal and external appeals procedures rule. None of the corrections impact the applicability of the rule to the FEHB Program.
The FEHBlog ran across this Institute of Medicine report on improving access to oral health for vulnerable and underserved David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-60066800386148707692011-07-24T16:53:00.001-04:002011-07-24T16:53:44.754-04:00Weekend UpdateThe House and Senate remain in session this week as the House and Senate leadership, together with the President, focus on raising debt ceiling. While scanning the internet to prepare this FEHBlog entry, I noticed articles in Govexec.com and the Federal Times reporting that the Federal Aviation Administration has furloughed 4,000 employees because the House and Senate cannot agree on a funding David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-30803687019361971002011-07-22T17:48:00.001-04:002011-07-22T17:48:18.808-04:00Blockbuster transactionYesterday, a blockbuster merger of two of the three largest prescription benefit managers -- Express Sripts and Medco -- valued at $29.1 billion was announced.
Under the agreement, Medco shareholders will receive $71.36 per share in cash and stock, or $29.1 billion, based on yesterday’s closing price. Medco shareholders will receive $28.80 in cash and 0.81 shares for each Medco share they own David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-13909197840387576042011-07-19T21:26:00.003-04:002011-07-26T10:50:12.002-04:00Tuesday TidbitsOPM has posted a new page on its website announcing that
Beginning this Open Season [which starts in November 2011], paper copies of health plan brochures will not be automatically mailed to Federal Employees Health Benefits (FEHB) Program members.You can quickly and easily view your health plan's brochure online, anytime by visiting the FEHB website, or visit your health plan's website. During David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-32335117985889263882011-07-17T21:03:00.000-04:002011-07-17T21:03:23.665-04:00Weekend UpdateThe House of Representatives and the Senate remain in session this week as their leaders continue to meet with the Administration in an effort to raise the national debt limit by August 2. The Federal Times offers various perspectives on the impact of a default situation on federal employees and annuitants. The Washington Post reports that on July 15, the Federal Postal Coalition sent a letter toDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-70918855510102509962011-07-14T21:44:00.001-04:002011-07-14T21:44:36.444-04:00Mid-week miscellanyWhile the debt limit negotiations continue, the White House has issued a formal warning that it may veto the Fiscal Year 2012 financial services and general government appropriations that the House passed last month. According to the statement, “The funding level provided by the bill would limit OPM's ability to implement and administer new statutory responsibilities.” The Senate has not passed David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-40940929402574900112011-07-12T22:26:00.001-04:002011-07-12T22:26:16.536-04:00Tuesday TidbitsYesterday, the Department of Health and Human Services released proposed rules intended to create a flexible framework for state health insurance exchanges and the federal fall back exchange under the Affordable Care Act ("ACA"). The HHS press release is titled "HHS and states move to establish Affordable Insurance Exchanges, give Americans the same insurance choices as members of Congress." David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-15629255003268595932011-07-10T20:59:00.000-04:002011-07-10T20:59:59.211-04:00Weekend UpdateThe House and the Senate are in session this week as the leadership of the two bodies work with the President to cut a deal on raising the debt limit. The Washington Post reports that the White House negotiations ended tonight after 80 minutes. The discussions will continue tomorrow. The President has said that the negotiators have 10 days to reach an agreement in order for Congress to enact the David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-30518120727017070272011-07-07T21:34:00.000-04:002011-07-07T21:34:27.186-04:00Mid-week updateThe Federal Government issued its Spring 2011 semi-annual regulatory agenda today. The semi-annual regulatory agenda gives readers a heads-up on the Government's regulatory plans. The agenda tells us that OPM has two FEHBP regulations in mind -- one to implement the Affordable Care Act's requirement to expand FEHBP coverage to employees of Indian Tribes and the other evidently to conform OPM's David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-46933066728732496952011-07-05T21:43:00.000-04:002011-07-05T21:43:07.058-04:00Tuesday TidbitsThe Wall Street Journal reports about a study published in the AMA Journal finding that
About 600,000 angioplasty procedures, which almost always involve placement of a tiny metal tube called a stent, are done in the U.S. each year [at an average cost of $20,000 per procedure]. Roughly 70% of these procedures are performed on patients suffering symptoms of a heart attack and aren't medically David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-43050697553064619142011-07-03T17:19:00.002-04:002011-07-05T16:21:31.478-04:00Weekend UpdateHappy Fourth of July Weekend! Both the House and the Senate will be in session this week following the holiday.
On Friday, the Centers for Medicare and Medicaid Services issued three proposed rules concerning updates to Medicare payment policies for physicians, hospital outpatient departments and ambulatory surgical centers and dialysis centers for 2012. CMS projects the Medicare Part B paymentsDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-35758528168177139722011-06-30T21:54:00.002-04:002011-06-30T21:55:14.198-04:00Big regulatory week for the FEHBP -- reduxYesterday, OPM reissued its interim final rule creating a new minimum loss ratio methodology for pricing community rated plans in the FEHB Program.
Today, the Department of Health and Human Services issued an interim final rule adopting common operating rules for electronic health plan eligibility verification and claim status checks. These operating rules which take effect on January 1, 2013, David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-1263183162371388312011-06-28T22:06:00.002-04:002011-07-05T16:21:03.811-04:00Tuesday TidbitsGovexec.com reports on privacy advocate reactions to the OPM system of records notices for its FEHBP claims data warehouses published in the June 15, 2011, Federal Register.
The AMA News reports on an Archives of Internal Medicine article that is provocatively titled "The Principles of Conservative Prescribing." "The article makes several recommendations on how physicians can revamp their David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-57566596798668303452011-06-26T22:03:00.001-04:002011-06-26T22:04:34.346-04:00Weekend UpdateThe House of Representatives takes its Fourth of July break this week and the Senate takes its break next week. The debt ceiling negotiations continue. On June 23, the House Appropriations Committee approved the financial services and general government appropriations bill which provides funding for the FEHB Program. The bill now goes to the House floor.
OPM has encouraged plans to address neverDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-25284929526206174922011-06-24T10:45:00.001-04:002011-06-24T10:49:22.688-04:00Big regulatory week for the FEHBPFEHB plans have two types of financing mechanisms -- retrospective experience rating and community rating. Nationwide fee for service plans must use experience rating. HMO plans (known as comprehensive medical plans under the FEHB Act) can use experience rating or community rating. Community rating sets premiums based on prices while experience rating sets premiums based on costs.
OPM David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-62942710309081257422011-06-22T11:53:00.001-04:002011-06-22T11:53:56.397-04:00Mid-week updateThe American Medical Association which is holding its annual meeting this week issued it fourth annual National Insurer scorecard. It's no surprise that the report card bashes insurers.
According to the AMA’s latest findings, commercial health insurers have an average claims-processing error rate of 19.3 percent, an increase of two percent compared last year.That is an absurd finding. MedpageDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-36197823518399598782011-06-19T18:27:00.002-04:002011-06-19T18:41:12.296-04:00Weekend UpdateHappy Fathers' Day. The FEHBlog is enjoying Fathers' Day on North Carolina's Outer Banks.
The House and Senate are in session this week. On June 22, the Subcommittee on Oversight and Investigations of the House Energy and Commerce Committee is holding a hearing that is ominously titled "Protecting Medicare with Improvements to the Secondary Payer Regime." In 2007, Congress passed the "Section David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-78972942246386674482011-06-16T20:57:00.000-04:002011-06-16T20:57:42.145-04:00Mid-week updateYesterday, the Office of Personnel Management issued two new systems of records notices -- one for the Inspector General's existing FEHBP claims data warehouse and the other for OPM's new warehouse. The FEHBP claims data will flow from the Inspector General's warehouse to OPM's warehouse under an Economy Act agreement. OPM explains that "the primary purpose" behind creating this new warehouse "isDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0