Both of Houses of Congress will be in session this week. The Hill’s Floor Watch blog sums it up this way — the two Houses will pursue “dueling agendas.” Meanwhile the March 1 sequestration implementation date gets ever closer without a compromise in sight. (Of course the sequestration itself was something of a compromise when Congress and the President created the deficit reduction approach in August 2011.) The sequestration would not adversely impact the FEHBP directly but doctors will not sit still for the 2% Medicare cut that would hit them.

Mark the tape. On Friday, health insurers officially became public utilities. As part of the great compromise to permit both the exercise religious freedom and the delivery of free contraception to women, the Administration is proposing to mandate that the health insurers provide free insurance.

With respect to insured group health plans, the eligible [religious employer] organization would provide the self-certification to the health insurance issuer, which in turn would automatically provide separate, individual market contraceptive coverage at no cost for plan participants.  Issuers generally would find that providing such contraceptive coverage is cost neutral because they would be they would be insuring the same set of individuals under both policies and would experience lower costs from improvements in women’s health and fewer childbirths.

With respect to self-insured group health plans, the eligible organization would notify the third party administrator, which in turn would automatically work with a health insurance issuer to provide separate, individual health insurance policies at no cost for participants.  The costs of both the health insurance issuer and third party administrator would be offset by adjustments in Federally-facilitated Exchange user fees that insurers pay.

The FEHBlog does not know where this compromise leaves faith based health plans. In FEHB appropriations laws, Congress has exempted those plans participating in the FEHBP from the FEHB’s contraception coverage mandate.

Also on Friday, America’s Health Insurance Plans issued a series of detailed state based reports about the problem of out of network providers who fly the pirate flag and charge exorbitant rates. The problem is nicely illustrated in this LA Times article. CMS issued a health care transparency rule on Friday about relationships between health care providers and drug manufacturer representatives. How about a professional ethics rule requiring providers to inform patients about the price of the care before it is rendered? Lawyers have to discuss that issue with their prospective clients. Dentists do it too because the insurance is limited.