On Friday, the Labor Department issued a set of new frequently asked questions about the regulations implementing the Affordable Care Act’s insurance market reform provisions. Most of the guidance concerns the circumstances under which a group health plan loses grandfathered status. That’s not a continuing issue for most FEHB plans because the initial regulatory guidance came out after the 2011 benefit and rate proposals had been submitted to OPM. The Q&A on rescissions confirmed the anti-rescission provision’s broad scope, while the Q&A on preventive health services provided useful guidance to FEHB plans.
The National Healthcare Anti-fraud Association, an excellent organization to which many FEHB plan carriers and the OPM Inspector General’s office belong, issued a white paper on combating health care fraud in the post-health care reform world. The organization’s press release explains “Health care fraud is both a multi-billion-dollar crime and an endangerment to public health. NHCAA’s white paper concludes that the fight against health care fraud will be enhanced if measures such as increased sharing of anti-fraud information, stronger auditing procedures and greater investment in fraud-fighting programs are adopted.”
The FEHBlog is hopeful that unlocking the human genome will lead to new, more effective treatments that over time will reduce health care costs. The Wall Street Journal posted an article by author Matt Ridley who writes on genomics and takes the opposite viewpoint. Mr. Ridley’s latest book is the Rational Optimist.