Congress remains in its district work session / recess this week.
On Friday. OPM published its annual notice implementing the medically underserved area (“MUA”) provision of the FEHBA, 5 USC § 8902(m)(2). That provision requires fee for service FEHB plans to reimburse all State licensed provider for covered services rendered within the scope of their respective licenses in medically underserved states annually designated by OPM. The provision expands the provider pool in medically underserved states.
Govexec.com reports that “Federal employees in Montana and South Dakota will no longer receive
special treatment for their health benefits coverage in 2014, the Office
of Personnel Management has announced” because those States are on the 2013 MUA list but are not on the 2014 MUA list. But surprise! The Affordable Care Act has its own version of § 8902(m)(2) which applies nationwide. As the previously FEHBlog noted, in ACA FAQs XV, the ACA regulators discussed new Public Health Service Act § 2706 as follows:
[Under § 2706], to the extent an item or service is a covered benefit under the plan or coverage, and consistent with reasonable medical management techniques specified under the plan with respect to the frequency, method, treatment or setting for an item or service, a plan or issuer shall not discriminate based on a provider’s license or certification, to the extent the provider is acting within the scope of the provider’s license or certification under applicable state law. This provision does not require plans or issuers to accept all types of providers into a network. This provision also does not govern provider reimbursement rates, which may be subject to quality, performance, or market standards and considerations.
Cavest: § 2706 technically does not apply to non-grandfathered plans but OPM in othe cases has applied these reforms, such as the “free” preventive care to all FEHB plans regardless of their grandfathered plan status (which is entirely within OPM’s discretion in the FEHBlog’s view.)
The main purpose of the survey is to measure the importance, adequacy and value of employee benefits to ensure that available benefits align with best practices and employee needs. The FEBS will also help to evaluate whether or not Federal employees understand the flexibilities and benefits available to them. Additionally, based on the ongoing focus on health and wellness programs across all Federal agencies, the survey will capture information regarding employee perceptions of health status and healthy living. As was the case in 2011, the 2013 FEBS will contain a section about the fully covered tobacco cessation benefit offered by all Federal Employees Health Benefit (FEHB) Plans.
The 2013 FEBS will be administered confidentially via e-mail to a random sample of Federal Government employees. Agency supervisors should be advised that employees may complete the approximately 15-minute survey during work hours. The survey will be available online for a period of four weeks with periodic reminders e-mailed to respondents. As with previous administrations of the FEBS, the results will be reported Governmentwide and will be used in the development of benefits policy and educational programs.
Fedsmith.com recently conducted its own benefits survey which found the FEHBP to be quite popular.
Finally, the IRS now has a sporty new ACA website.