Tuesday's Tidbits

Computerworld reports that OPM likely will delay the scheduled November 15 launch of its new systems of records intended to create a warehouse of FEHB plan claims data. "Harley Geiger, policy counsel for the CDT, said on Monday that the OPM had informed the CDT that it will soon be releasing more detailed information on the database, and on the privacy and security controls that will be put into place to protect the data."

Many FEHBP enrollees also have Medicare coverage. Last week, the Centers for Medicare and Medicaid Services announced that in 2011 

the Medicare Part A deductible for inpatient hospital care will be $1,132 in 2011, an increase of $32 from this year's $1,100 deductible. The Part A deductible is the beneficiary's cost for up to 60 days of Medicare-covered inpatient hospital care in a benefit period. Beneficiaries must pay an additional $283 per day for days 61 through 90 in 2011, and $566 per day for hospital stays beyond the 90th day in a benefit period. [Medicare provides a lifetime reserve of sixty days of inpatient care for confinements lasting beyond the 90th day] For 2010, the per-day payment for days 61 through 90 was $275, and $550 for beyond 90 days. 

The Medicare Part B deductible for physician care will be $162 in 2011. When FEHBP coverage is primary to Medicare, FEHB plans typically will pay these amounts.

The standard Medicare Part B monthly premium will be $115.40 in 2011, a $4.90 increase (or 4.4-percent) over the 2010 premium. The premium is income adjusted. The majority of Medicare beneficiaries will continue to pay the same $96.40 premium amount they have paid since 2008 because there will be no cost of living adjustment to Social Security benefits in 2011. Federal annuitants who receive a CSRS annuity are not eligible for the hold harmless protection. NARFE is attempting to get a legislative fix to this problem when Congress returns for its lame duck session next week.

The AHIP staff reports that

While the agenda for this lame duck session is somewhat uncertain, it may also address a Medicare physician payment "fix," data security legislation, an extension of the 2001 and 2003 tax cuts, and possibly any recommendations that are agreed to by the National Commission on Fiscal Responsibility and Reform.

Completing the annual appropriations process, possibly through an omnibus spending bill, will be the top priority when Congress reconvenes in mid-November. To date, Congress has not approved any of the annual appropriations bills for fiscal year 2011. Instead, in late September, Congress passed a "continuing resolution" (H.R. 3081) that provides temporary funding for federal programs and agencies - including those within the Department of Health and Human Services (HHS) - from October 1, 2010 through December 3, 2010. Most programs are being funded at fiscal year 2010 levels during this time period.

The American Medical Association supported by the White House supports a 13 month long patch to the Medicare Part B physician reimbursement formula. The patch would postpone the impending 25% cut that begins to phase in on December 1, 2010, absent legislation. According to California Healthline,

Lawmakers have not yet proposed offsets for the 13-month fix, which is expected to cost an estimated $17 billion to $20 billion. According to Senate aides, the lawmakers' hesitation on offsets makes passage of the 13-month fix by Thanksgiving unlikely.

Congress reconvenes on Nov. 15 for one week prior to the Thanksgiving recess. Lawmakers then return on Nov. 29 -- two days before the Medicare cuts are scheduled to take place -- for the session's final weeks. Julius Hobson -- senior policy adviser with Polsinelli Shughart -- said lawmakers might opt for a one-month fix for reimbursements, which would buy them time to consider the 13-month patch during the final weeks of the legislative calendar before Christmas.