Thursday, July 19, 2012

Mid-week update

In tomorrow's Federal Register, OPM will be publishing a proposed rule that, if finalized, will extend FEHB and FEDVIP self and family coverage to the children of a federal employee's same sex partner conditioned upon sufficient documentation of the relationship as described in the regulation. Such children would be classified as eligible step children. Under current law, taxable income must be imputed to the employee for the fair market value of such coverage. The rule rule requests public assistance with establishing a benchmark for fair market value of the coverage. The comment period will be open for 60 days from tomorrow.

Peace at last! Walgreens and Express Scripts today announced a settlement of their contract dispute effective September 15, 2012. According to the press release, "The companies are not disclosing the terms of the new contract." The FEHBlog bets that Walgreens caved because Medco which recently merged into Express Scripts had even more Walgreen's business that Express Scripts did. Ah, leverage.
File this under truth is stranger than fiction. The Sacramento Business Journal reports that "State regulators ordered Anthem Blue Cross on Monday to stop trying to collect millions in reimbursement from providers for medical claims the health plan thinks were overpaid." According to the article, California state law bars routine insurer overpayment activities beginning one year after the claim payment date, unless the insurer can prove that the provider engaged in misrepresentation or fraud. And under the regulators' view garden variety double billing is not misrepresentation or fraud. Cost curve -- UP!

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