Tuesday’s Tidbits

Yesterday, in the 24th ACA FAQ, the ACA regulators announced that while they do plan to issue a revised final rule on the summaries of benefits and coverage this year, they will hold off on requiring health plans to use new forms until the 2017 open season. In the proposed rule, the ACA regulators indicated the the new forms would be used for the 2016 open season, but the industry pushed back on that proposal.  The FEHBlog is not sure whether consumers actually use the summaries of benefits and coverage but if they do, then hospitals and doctors also should be required to disclose the health plans in which they participate, etc. That would be transparency.

Drug Channels and Reuters have interesting stories about the OptumRx (a unit of UnitedHealthcare) – Catamaran deal discussed in the most recent Weekend Update.  Reuters notes that stock analysts are suggesting that the deal may push Express Scripts and Walgreens into a merger and that if this deal goes through Humana would be the fourth largest PBM.

Ihealthbeat reports that a recent U.S Supreme Court decision exposing a North Carolina board regulating dental practices to antitrust liability could encourage state medical boards to liberalize their approaches to telemedicine. At the OPM AHIP carrier conference, the FEHBlog heard people complain about these state restrictions on telemedicine.  Right now, most of those medical boards generally require telemedicine doctors to be licensed in the state in which the online patient resides.  The Supreme Court decision allowed a restraint of trade lawsuit to proceed against the dental board based on its decision to restrict the practice of teeth whitening to dentists.  Time will tell.

Robert Pear of the New York Times has an interesting article about a provision of the House Medicare Part B doc fix bill that would prohibit states from imposing malpractice liability on doctors based on Medicare quality ratings.  The ingenuity of the FEHBlog’s profession may be unprecedented.  Congress is right not to limit the legal significance of these HEDIS and other quality measures.

Finally, the FEHBlog is very impressed by Aetna’s approach to cybersecurity as discussed in this Wall Street Journal article. Wikipedia informs the FEHBlog that there is an international treaty against hacking (the Budapest Convention) to which the U.S. and its allies are signatories but not the countries flying the pirate flag like Russia, China, North Korea, etc.  The WSJ article confirms that cybersecurity is a national security issue.

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