Midweek update

The FEHBlog was alarmed when he read the beginning of this Govexec.com article today:

Nov. 16 looms large for government leaders paying attention to the 1998 Federal Vacancies Reform Act. The law stipulates that 300 days after a president is sworn in, officials who have been serving in an acting capacity since that time lose much of their authority.

Of course, OPM has an acting Director, Kathleen McGettigan. The FEHBlog was relieved when he read a Congressional Research Service advisory to which the article links that

There are two distinct periods during which an employee may serve as an acting officer: (1) for a 210-day period, beginning on the date that the vacancy occurred; or (2) if the President nominates someone to that office, for the period that the nomination is pending in the Senate. There is no limitation of days on this second period—so long as a nomination is pending, an acting officer may continue to serve. But if no nomination is submitted to the Senate, the 210-day period governs the acting officer's service.

Ms. McGettigan and presumably the bulk of people in her position fall into the second category which has no deadline on legal authority.

Speaking of Ms. McGettigan, the FEHBlog read on Bankinfosecurity.com that

The head of the U.S. Office of Personnel Management cites "audit fatigue" as a factor explaining why the federal agency that experienced a massive data breach in 2015 continues to come up short in securing its information systems. 

OPM Acting Director Kathleen McGettigan, in response to the OPM inspector general's annual audit required under the Federal Information Security Modernization Act, points out that the OPM's IG is one of several entities that audit OPM IT.  

"Each time an engagement commences, OCIO (Office of the Chief Information Officer) is obligated to expend time and resources locating responsive documents, responding to questions and, ultimately, replying to these multiple, sometimes overlapping duplicative audits," McGettigan says. "We appreciate and understand the importance of these audits, but believe OCIO would benefit from an effort to achieve a more tailored, streamlined and coordinated approach from its various auditors."  

Welcome to the club Ms. McGettigan because FEHBP carriers similarly are under strict scrutiny by OPM, its Inspector General, and other government agencies.

Given OPM's interest in population health, it's worth linking to the ARHQ post on how to take a closer - state by state - look at health care quality using the agency's National Healthcare Quality and Disparties Report which was recently updated.

In ACA News, our favorite ACA expert, Prof. Timothy Jost, notes that the Internal Revenue Service is preparing to crack down on "applicable large employers" who fail to comply with the ACA's employer share responsibility provisions.

In prescription drug news,

• Becker's Hospital News reports that in 2018 CVS Health pharmacies will offer same day delivery of prescriptions in certain large markets ( Miami, Boston, Philadelphia, Washington, D.C., and San Francisco) and second day delivery in other markets.  These pharmacies will begin same day delivery in Manhattan beginning December 4. 
• Modern Healthcare reports that "Drug prescribers throughout the country should establish a seven-day supply limit for initial opioid prescriptions, and they should be written electronically to slow the abuse of the addictive painkillers, a group of pharmacies, pharmacy benefit managers and health plans wrote in a letter to President Donald Trump Wednesday."
• In the same vein, an article in the New England Journal of Medicine discusses various approaches to "Addressing the Prescription Opioid Crisis: Advancing Provider Education and Collaborating with All Stakeholders."
• Drug Channels analyzes employer-sponsored prescription drug costs as reported in Kaiser's 2017 Employer Health Benefits Survey. 

Finally, Health Tech Magazine offers CIOs some approaches to introducing blockchain security measures to healthcare.