Weekend Update

The House and the Senate will be in session this week according to the Hill’s Floor Action blog. On Tuesday morning, the House Ways and Means Committee’s oversight subcommittee will hold a hearing on the plethora of taxes created by the Affordable Care Act.

The Wall Street Journal published an article about OPM’s multi-state plan regulation in its weekend paper (in the FEHBlog’s view the best newspaper issue from week to week). Here’s the skinny:

Cigna Corp. said it has opted not to apply to be one of the national-plan carriers, saying it “does not align with our focused approach,” according to a spokesman.

Spokesmen for UnitedHealth Group Inc. and Aetna Inc. both said this past week that their companies were still reviewing the multistate plan opportunity. A spokeswoman for the Blue Cross Blue Shield Association said that Blues plans in the states were interested in banding together to try to become the nonprofit plan, with some coordination from the association.

OPM posted a notice explaining how to apply to become a multi-state plan carriers on the fedbizopps.gov website about six weeks ago. OPM also has an MSPP website here.

The Wall Street Journal also published an article about ongoing negotiations between insurers planning to participate in the exchanges / marketplaces and health care providers. Shockingly, the article reports that consumers are sensitive to premiums and for that reason the insurers are looking for deeper discounts in return for offering narrow provider networks.   “Plans with smaller choices of health-care providers are a big focus for insurers, partly because many other aspects of exchange plans, including benefits and out-of-pocket charges that consumers pay, are largely prescribed by the law, giving them few levers to push to reduce premiums.”  The FEHBlog expects this trend to pop up in the FEHBP as the ACA continues to roll out.

The FEHBlog was intrigued by a Wall Street Journal article about innovative pharmacy chain practices designed to make healthcare more widely available. For example,

Rite Aid Corp. will open 58 stores, across four markets, which contain in-store clinics providing virtual doctor visits conducted via Web camera. The walk-in clinics—which charge patients $45 for a 10-minute chat with a doctor on a computer monitor—will be rolled out Friday in Baltimore, Boston, Philadelphia and Pittsburgh. Previously, Rite Aid had piloted the virtual clinics in nine stores in the Detroit area.

No doubt health plans will be covering these virtual office visits.

Finally Kaiser Health News reports on “a study, published Thursday by the National Institute for Health Care Reform, researchers found that while so-called “scope of practice” laws did not appear to restrict the primary care services nurse practitioners can provide to patients, they do affect how the advanced nurses are paid.”  In a nutshell, health plans pay less to nurse practitioners in states which effectively require the plan also to pay a doctor for supervisory services.

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