Weekend update

The Week in Congress reports that both houses of Congress have left Capitol Hill for the campaign trail. A lame duck session will begin on November 13. 

Last Friday, the Centers for Medicare and Medicaid Services announced traditional Medicare participant premiums and cost sharing amounts for 2019. 

Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.   

The standard monthly premium for Medicare Part B enrollees will be $135.50 for 2019, a slight increase from $134 in 2018. An estimated 2 million Medicare beneficiaries (about 3.5 percent) will pay less than the full Part B standard monthly premium amount in 2019 due to the statutory hold harmless provision, which limits certain beneficiaries’ increase in their Part B premium to be no greater than the increase in their Social Security benefits. 

CMS also announced that the annual deductible for Medicare Part B beneficiaries is $185 in 2019, an increase from $183 in 2018 

Medicare Part A covers inpatient hospital, skilled nursing facility, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment. 

The Medicare Part A inpatient deductible that beneficiaries will pay when admitted to the hospital is $1,364 in 2019, an increase of $24 from $1,340 in 2018. 

The statutory hold harmless provision referenced about applies to FERS annuitants but not to CSRS annuitants (unless a CSRS annuitant receives Social Security benefits from non-federal employment.

A few weeks ago the FEHBlog noted a Wall Street Journal article about clauses in large health care system contracts with health insurers that impinge competition. The Senate Judiciary Committee chairman Sen. Chuck Grassley (R IA) has asked the Federal Trade Commission (FTC) to investigate these allegations. Healthcare Dive predicts that

If the FTC were to conduct an investigation, it  could send chills through the hospital industry. Vertical integration is rampant in healthcare, and a number of health systems have established their own health plans. This could create more suspicion around such arrangements and increase the push for greater price transparency. 

Beckers Hospital Review explains how primary care doctors are responding to the millennial generation's preference to use walk-in clinics. Health plans should reinforce member's use primary care doctors who track their patient's care.

Good news --

• Kaiser Health News gathers new articles reporting that premiums for the most popular plans are dropping on the federally facilitated health insurance exchanges for 2019. 
• The American Hospital Association informs us that the Centers for Disease Control are finding that hospital infections are continuing to decline.