It’s been a busy week for the FEHBlog so TGIF indeed.  The FEHBlog wishes to point out more tidbit from the 2016 Notice of Benefit and Payment Parameters. The notice set the 2016 in-network out-of-pocket limit for self-only coverage at $6,850 and for other than self-only coverage at $13,700. The notice’s preamble (80 Fed. Reg. at 10,824-25) advises that beginning with the 2016 plan year, HHS will require that whenever a member of a self and family group reaches the plan’s self only max for in-network care, the plan must cover that member’s in-network cost sharing (deductibles, coinsurance and copayments) for the remainder of the plan year.  Once the family in-network max is met, then the entire  family’s in-network cost sharing is waived. 

It’s a red letter day. The Washington Post reports that the Food and Drug Administration approved earlier today “the sale of the first-ever biosimilar drug in the United States, opening the door to a cheaper class of drugs that could expand patient access to life-saving treatments. The FDA approved Novartis AG’s copycat version of Neupogen, a biologic cancer drug that recorded $1.2 billion in worldwide sales last year.”  The article notes that the FDA has four other biosimilar applications on its plate. Also, the “FDA is expected to issue more guidance on “interchangeability,” which could mean greater take up of biosimilars. A product deemed interchangeable could be automatically substituted for the original biologic at the pharmacy, similar to how traditional generics replace their brand-name counterparts.”

I Health Beat reports that the AMA and a boatload of other medical groups are urging CMS to create ICD-10 contingency plans if things go awry on October 1. The FEHBlog bets that Congress mandates contingency planning in the near future.

Gallup reports that according to its surveys U.S. federal government workers are thriving in their financial well-being more than the rest of the workforce. The article explains that

Gallup research defines financial well-being as managing one’s economic life to reduce stress and increase security. Financial well-being is not necessarily related to absolute income, but rather to approaches to saving and spending and future expectations of job security, among other subjective factors. The survey data indicate that working for the federal government is associated with higher financial well-being when compared with other U.S. workers, holding across income and education levels. Federal workers reporting higher levels of financial well-being could mean good news for the U.S. government because financial well-being is a crucial aspect of overall well-being, which has a significant effect on healthcare costs and engagement on the job.

That’s interesting.

The FEHBlog is of course aware that the Supreme Court heard the King v. Burwell case this week. The FEHBlog long ago gave up predicting the outcome of Supreme Court cases and in any event this case while important does not have a direct impact on our beloved FEHBP.