Congress picks up steam in the home stretch

  • The Wall Street Journal reports that Senate negotiators are crafting a Medicare fix bill that would be acceptable to the minority and the President because it would avoid the 10.1% Medicare cut in payments to physicians scheduled for January 1 without socking it to the Medicare Advantage plans. “The package being worked out in the Senate would cut more than $1 billion from a “stabilization fund” created in a 2003 bill to help faltering Medicare Advantage insurers, congressional aides said. The package also would cut an incentive fund passed by Congress last year to encourage physicians to report quality data to the government.” However, the fix would only last for six months. The bill may adopted this week, which would be a nice Christmas gift for FEHB plans that pay secondary to Medicare for thousand of members.
  • Congress also has passed a Freedom of Information Act reform bill. According to the AP,

    The bill restores a presumption of disclosure standard committing government agencies to releasing requested information unless there is a finding that such disclosure could do harm

    Agencies would be required to meet a 20-day deadline for responding to FOIA requests. Their FOIA offices would have to forward requests for information to the appropriate agency office within 10 days of receiving them. It they fail to meet the 20-day deadline, agencies would have to refund search and duplication fees for noncommercial requesters. They also would have to explain any redaction by citing the specific exemption under which the blacked-out information qualifies. Nonproprietary information held by government contractors also would be subject to the law. The legislation also creates a system for the media and public to track the status of their FOIA requests. It establishes a hotline service for all federal agencies to deal with problems and an ombudsman to provide an alternative to litigation in disclosure disputes.

  • The Administration has not yet announced whether the President will sign the bill into law.

  • Health Affairs published a web exclusive study on the FEHB Program’s mental health parity program. Under the FEHB Program’s well received approach, a plan must provide parity in network but not out of network. The study, funded by American Psychiatric Foundation, the National Association of Social Workers Foundation, and the American Psychological Association, concludes that “Parity proposals that do not require any coverage for out-of-network MH benefits may paradoxically have the unintended adverse consequence of decreasing access to mental health treatment.” It’s a foregone conclusion that the mental health parity bill coming out of Congress next year will require out-of-network parity, thereby increasing FEHB Program expenses.