The Senate continues to consider HR 4213, the Tax Extenders bill. Yesterday, the Senate acting on a point of order defeated an amendment proposed by Sen. Ben Cardin (D Md) that could have accelerated the FEHB dependent child age increase into this year. As it stands, the dependent eligibility rules for the FEHB Program will change on January 1, 2011, at which point adult children up to age 26 will continue coverage under self and family enrollment regardless of marital status. This big change in the Program’s long standing eligibility rule requires significant operations planning and computer program changes. The January 1, 2011 implementation date allows for that planning to occur.
OPM issued in today’s Federal Register its annual rule identifying the medically underserved states for 2011. The only change for next year is the addition of Oklahoma to the list. OPM explains that the FEHB Act, 5 USC Section 8902(m)(2), requires non-HMO FEHB plans to reimburse beneficiaries, subject to their contract terms, for covered services obtained from any licensed provider in these States.” The list of medically underserved states for this year includes Alabama, Arizona, Idaho, Illinois, Kentucky, Louisiana,
Mississippi, Missouri, Montana, New Mexico, North Dakota, South Carolina, South Dakota, and Wyoming.
Business Insurance reports that the interim final rule interpreting the Affordable Care Act’s ambiguous grandfathered plan provision will be made public soon.
Businessweek reports that the Caremark and Walgreens pharmacy chains, which also own prescription benefit managers, may be seeking a negotiated settlement of their dispute discussed in yesterday’s FEHBlog entry.
Finally, Modern Healthcare reports that President Bill Clinton told an AHIP conference today that “Americans tend to blame insurers for problems that may be caused by providers,” to applause from the audience.