TGIF

The FEHBlog has been buried under legal work this week. Every day, I scan through materials to find items to post on the blog but hey it's the summertime. Not much. The FEHBlog knows like other wonks that the Congressional Budget Office and the Congressional Joint Committee on Taxation issued updated reports on the budgetary impact of the Affordable Care Act as modified by the Supreme Court decision. However, those reports are in the FEHBlog's view a mish mosh of data with not much information relevant to the FEHBP except for the increasingly looming and staggeringly large ACA taxes, like the insurer fee (2014) and the high cost health plan tax (2018).

OPM is beginning to gear up for the 2013 federal benefits open season. The open season, which runs this year from November 12, 2012, until Monday December 10, 2012, is the period in which federal and postal enrollees can make FEHBP, FEDVIP, or FedFlex changes without any preexisting condition limitations. On Wednesday, the agency issues a benefits administration letter to federal agencies which discusses things that are new for this years open season, such as the introduction of the ACA's summary of benefits and coverage ("SBC"):

Plans will provide information in their Open Season materials to their enrollees about where to find their SBC on their website as well as how to obtain a paper copy of the SBC. The plans may also have their SBC available at health fairs.

The AMA News reports on the new insurance summaries and quotes a Consumer Reports executive as follows:

“Consumers feel like when they consume medical care and have insurance, it’s like having a blindfold on,” she said. “They really need help, and this form goes a long way toward helping them.”

If that's the case, then why don't health care providers have to provide patients with SBCs explaining billing procedures and the medical benefits networks in which they participate. Confusion is limited to  the insurance side but that's the ACA's focus.

HHS announced yesterday a public-private collaboration to fight health care fraud.

The new partnership is designed to share information and best practices in order to improve detection and prevent payment of fraudulent health care billings. Its goal is to reveal and halt scams that cut across a number of public and private payers. 

AHIP comments on the initiative here.