Tuesday Tidbits

Happy Halloween.

The Senate Homeland Security and Governmental Affairs Committee held a business meeting yesterday at which it approved for final Senate consideration the President's nomination of Emily Murphy to be General Services Administrator. The FEHBlog vainly hoped that the meeting would be televised in case there was some discussion about the status of the OPM nominees. No such luck.

The FEHBlog also hoped to attend the HCP LAN conference yesterday but law firm demands prevailed. Helpfully, CMS posted CMS Administrator Seema Verma's remarks at the conference. Here's the beginning.

“We need to move from fee-for-service to a system that pays for value and quality – but how we define value and quality today is a problem,” said Administrator Verma. “We all know it: Clinicians and hospitals have to report an array of measures to different payers. There are many steps involved in submitting them, taking time away from patients. Moreover, it’s not clear whether all of these measures are actually improving patient care.”
Administrator Verma announced a new approach to quality measurement, called “Meaningful Measures.” Meaningful Measures will involve only assessing those core issues that are most vital to providing high-quality care and improving patient outcomes. The agency aims to focus on outcome-based measures going forward, as opposed to trying to micromanage processes.
Additional agency efforts that Administrator Verma highlighted include:

• CMS is moving the Innovation Center in a new direction that will promote greater flexibility and patient engagement.
• CMS is implementing the Medicare Access and Chip Reauthorization Act (MACRA) in a way that minimizes the burden and costs providers face in meeting the requirements. 

“Our overall vision is to reinvent the agency to put patients first,” Administrator Verma said during her address. “We want to partner with patients, providers, payers and others to achieve this goal.” 

This all makes sense to the FEHBlog.  She doubles down the move away from fee for service but with a lighter and more sensible regulatory touch.

Fedsmith.com has posted a National Association of Postal Supervisor's list of FEHB plans that will reimburse Medicare prime annuitants for a share of their Medicare Part B premiums in 2018.  OPM has been encouraging carriers to take this step. CMS still hasn't announced 2018 Medicare Part B premiums and cost sharing amounts yet.

The Internal Revenue Service today released Notice 2017-67 which implements the perhaps most significant provision of the President's recent executive order on health care. The notice clarifies that small business (under 50 full time employees as defined by the ACA) can use health reimbursement accounts to fund employee purchase of coverage in the ACA marketplace up to certain dollar limits and other reasonable requirements.  The notice combines this flexible small business HRAs created by the 21st Century Cures Act ("QSEHRAs) and the President's initiative to allow the funds in these accounts to purchase marketplace coverage. The FEHBlog could never understand why in 2013 the IRS blocked this approach which should add enrollment to the marketplace.