Today, OPM’s proposed rule to implement the multi-state plan program was released. The Affordable Care Act authorizes OPM to contract for at least two plans that eventually will participate in all of the state based health insurance exchanges beginning in 2014. According to the regulation, the plan carriers will have to adhere to both federal and state laws. In contrast FEHB plans generally adhere to federal laws. OPM also is asking the MSPs to offer a child only option.

The Health and Human Services Department released an even larger ACA rule today. The rule provides more guidance on the transitional reinsurance fee. The ACA requires all insurers and self funded health plan sponsors to contribute towards a reinsurance fund for plans participating in the health insurance exchanges, presumably including the multi-state plans. The assessment will be imposed in the years 2014 through 2016. The 2014 assessment will be $63 per “bellybutton” per year. Cost curve up.

On Wednesday, the prescription benefits manager Express Scripts issued its first Drug Trend Quarterly finding that the gap between the price of brand and generic drugs is growing and that the FDA needs to get off its butt and start approving biosimilars (as authorized by the ACA) in order to help control the skyrocketing costs of specialty drugs.

Also on Wednesday, the HHS Office of Civil Rights which enforces the HIPAA Privacy and Security Rules released guidance on the Privacy Rule’s provision governing de-identification of protected health information. This is important guidance because properly deidentified protected health information is not subject to the Privacy and Security Rules.  The guidance confirms my longstanding impression that de-identification is easier said than done.

Yesterday, the Congressional Budget Office released a report finding the greater prescription drug use by Medicare beneficiaries lowers Medicare’s spending on medical services. Needless to say the National Community Pharmacists Association was elated.