Weekend update

Congress is now in recess until September following the political conventions and Labor Day.  Politico reported last week on lobbying efforts to head off the ACA's health insurance fee which takes effect in 2014. The ACA imposed that fee ostensibly to require insurers to kick back some of the revenues from all of the new insureds entering the exchanges. The hefty fee does fall on insurers in the exchanges but it also falls on insurers in the FEHBP. The hefty fees will be counterproductive particularly in the FEHBP wherre the ACA did not expand membership other than certain Indian tribal employees.

The Centers for Medicare and Medicaid Services announced last week the final Medicare Part A reimbursement rates for inpatient care beginning October 1, 2012.  While in April, CMS proposed an 0.9% increase, the final rule grants acute care hospitals a three times larger increase of 2.8%. Beckers Hospital Review offers nine observations on the final rule. Medicare pricing impacts the FEHBP because there is a large cadre of Medicare Part A eligible annuitants in the FEHBP and a smaller and decreasing cadre of annuitants who retired before 1984 and are not eligible for Medicare Part A. Fee for service FEHB plans receive Medicare pricing on Part A care rendered to those individuals.

The Beckers article notes that the final rule added two new never events for Medicare payment purposes -- surgical site infection following cardiac implantable electronic device procedures and pneumothorax with venous catheterization.