Weekend Update

Congress is in session for the latter part of this week following the Jewish New Year celebration that begins this evening. The House passed the continuing fund resolution funding the federal government for the first six months of the new federal fiscal year that begins on October 1, 2012.  According the Hill's Floor Watch, the Senate is expected to pass the House resolution later this week.

The White House released its statutorily mandated sequestration report on Friday.  The sequestration will take effect in January 2013 unless Congress unless Congress and the White House agree on a great compromise to reduce future budget deficits by $1.2 trillion through 2021 in the lame duck session following the election. The Hill reports that "Sequestration would cut $11 billion from Medicare and take millions of dollars away from Affordable Care Act implementation programs." Govexec.com reports that 

A senior Obama administration official could not estimate how many job losses or agency furloughs would occur if governmentwide spending cuts are triggered, but said federal employees would feel the effects of sequestration: “Clearly, if a sequester would occur, this would have a significant impact on the federal workforce.” President Obama has said he will exempt military personnel from the effects of sequestration. Veterans benefits also are protected.

According to the report (pp. 134-35), the sequester would not apply to the FEHBP trust fund held in the U.S. Treasury.  This trust provides financing for FEHB plans and OPM's administration of the program.

This could be the week that OPM releases the 2013 premiums and government contribution for the FEHBP. Last week the Kaiser Family Foundation reported that "Health insurance premiums rose 4 percent for family coverage this year, well below last year’s increase and half the 8 percent average of the previous decade – largely because people used less health care in an uncertain economy." Of course, as the FEHBlog has noted the AMA News joyously has reported an uptick in doctors visits this year.  The Kaiser article adds that a May 2012 PriceWaterhouseCoopers "report estimates [employers] will see premiums rise 5.5 percent next year. That's a benchmark against which to measure the FEHBP increase for 2013.

The FEHBlog nearly levitated this morning when he read this Washington Post article (p. A3) captioned "Doctors, Others Billing Medicare at Higher Rates."  While upcoding is nothing new, the reason for the current upcoding binge was surprising:

Many doctors and hospitals say that computerized medical records encourage the move to higher codes because the software makes it easier for providers to quickly create documentation for charges. One electronic medical records company predicts on its Web site that its product will result in an increase of one coding level for each patient visit, potentially adding $225,000 in new revenue in a year.

Of course, the government has spent nearly $7 billion over the past three paying for hospitals and doctors to use electronic health records. The gift that keeps on giving.