Weekend update

The month of October starts this week. That means

  • A new federal fiscal year starts Thursday.  Congress is working on a continuing resolution to fund the federal government past Wednesday.  Here is a link to the Week in Congress’s report on last week’s activities on the Hill. 
  • The ICD-10 coding set compliance date also is October 1.  Government Health IT reports that according to GAO the implementation outcome is impossible to predict.  This is a big change for providers and payers. The FEHBlog expects that it will be a mess at least over the next six months despite best efforts.   
  • The U.S. Supreme Court returns to work this week. It’s first session of the new term will be a week from tomorrow. 
  • The 2016 FEHBP rates likely will be released this week. 
Late last week, The Segal Company, a large benefit consulting firm, issued its 19th annual survey on health care costs for the coming year 2016.  Segal’s key findings are as follows:
  • Trend rates for health maintenance organizations (HMOs) and open-access preferred provider organization (PPO)/point-of-service (POS) plans — the two most common medical plan types offered — are projected to differ by 1 percentage point: 6.8 percent for HMOs and 7.8 percent for PPO/POS plans.
  • Trend rates for prescription drug coverage are expected to be significantly higher in 2016: 11.3 percent for carve-out coverage for actives and retirees under age 65 and 10.9 percent for retirees age 65 and over. Both projections are roughly 3 percentage points greater than projections for 2015.
  • The projected specialty drug/biotech drug cost trend rate is expected to remain extremely high at 18.9 percent, but slightly lower than the projection for 2015.
  • Price inflation for prescription drugs and hospital stays are the overwhelming driver of cost increases, especially for prescription drugs, where trend is approaching double digits (9.8 percent), well above the current Consumer Price Index for all goods and services (0.1 percent).
Speaking of prescription drug price trends, get a load of this article on Kaiser Health News — 

Many doctors are choosing a better-safe-than-sorry approach to heading off heart trouble in very elderly patients. Inexpensive statin drugs are given to millions of people to reduce cholesterol, even many who do not show signs of heart disease. But a recent study has found that seniors with no history of heart trouble are now nearly four times more likely – from 9 percent to 34 percent – to get those drugs than they were in 1999.
Here’s the catch: For patients of that age, there is little research showing statins’ preventive heart benefits outweigh possible risks, which can include muscle pain and the onset of diabetes.  * * * With the average life expectancy at 76 for men and 81 for women in the U.S., drug companies haven’t funded such studies in people above 79. 

Also, the FEHBlog noticed this  thought-provoking article about electronic data encryption on the Federal News Radio site. The point of the article is that “data encryption should be done in such a way as to make it separate from the operating system or the application doing the encryption.”

HHS’s Office for Civil Rights has posted a lengthy FAQ on its even lengthier proposed rule on Public Health Service Act Section 1557, an ACA provision prohibiting various forms discrimination against individuals receiving services or coverage under federally funded programs such as the FEHBP.  The proposed rule applies only to HHS funded programs such as qualified health plans, Medicare, and Medicaid.

Enjoy the super moon eclipse / blood Moon tonight