Thursday Thoughts

Today, the Department of Health and Human Services announced a proposed rule that would modify the federal healthcare programs anti-kickback act to redirect prescription drug rebates from the prescription drug plan to consumer at the point of sale.  It strikes the FEHBlog that this change, if implemented, will encourage consumer compliance with prescription drug manager formularies and will be a big help to people in high deductible plans.  The rule would apply to Medicare and Medicaid but not to the commercial market including the FEHBP or the ACA marketplace. However, once the Medicare dam breaks, commercial plans will follow the same practice in the FEHBlog's view. Of course, some commercial plans do so because the prescription drug managers can accommodate this practice already.

Speaking of PBMs, Fierce Healthcare reports that

Anthem is planning to begin moving members into its new PBM, IngenioRx, in the second quarter of 2019, bumping up the projected launch from 2020. Anthem announced the change as part of its fourth-quarter earnings (PDF), saying it moved up IngenioRx’s launch because Cigna closed its acquisition of Anthem’s current pharmacy benefit manager, Express Scripts.  Anthem’s contract with Express Scripts will end on March 1, with the yearlong process of migrating members to IngenioRx beginning the next day, it said.

This week, the Centers for Medicare and Medicaid Services have been holding its annual Quality Conference in Baltimore MD.  The conference is a hot (and free) ticket. A friend tells the FEHBlog that nearly 3,000 people were in attendance. You can watch the plenary sessions on the conference's website. Here's a link to an AJMC report on CMS Administrator Seema Verma's keynote speech. "As she has in other recent speeches, she also criticized the idea of Medicare for All, saying, 'we can barely afford the program that we have.'” Bear in mind commercial health plans, including the FEHBP, pay more to providers who can't survive solely on Medicare's low reimbursements. Ms. Verma also announced that Medicare is now making available on the Apple and Google stores a Medicare what's covered app.