Weekend Update

Congress remains in session this coming week.  The Federal Benefits Open Season starts a week from tomorrow so the OPM and FEHB plan Open Season websites, such as this one, should be up and running this week.  OPM has added a lot of information to its self plus one enrollment type website.

The FEHBlog noticed today this Fedsmith.com article which explains more angles on the Medicare Part B premium fix. The upshot is that the $104.90 monthly hold harmless premium for 2016 is only available to those Medicare beneficaries who currently pay their Medicare Part B premium from the Social Security check. People who become eligible for Medicare going forward will pay the new $123.70 monthly premium.  So will current CSRS annuitants who don’t receive Social Security benefits and high income seniors (who will see greater Medicare Part B premium increases.)

The Washington Post reports that about 100,000 federal employees (perhaps 5% of the workforce) will be eligible for new locality pay areas that were created under rules published last week.

Last week the FEHBlog noted many articles  in the press about a prescription drug manufacturer Valeant and a mail order pharmacy Philidor. It turns out that according to this Los Angeles Times article, Valeant is one of the business that snaps up, and then jacks up, the prices of single source generic drugs. According to this New York Times article, Philidor was in some sort of unholy alliance with Valeant to sell those drugs to consumers.  Valeant did not own Philidor, but it had an option to purchase Philidor.  The alliance became public recently and the major prescription benefit managers have terminated their contracts with Philidor, which is closing down.  The PBMs are also looking for similar unholy alliances.  What a mess.

The FEHBlog has been on a rampage about the lack of interoperability in electronic medical records (“EMR”). As this 2008 American Medical Association News article illustrates, the last Administration was pushing the idea of interoperable EMRs.

In 2004, President [George W.] Bush set a goal of most Americans using an electronic medical record by 2014. In his vision, doctors by then would be using EMR systems with interoperable standards that would allow them to share lab results, images, computerized orders and prescription information with hospitals and other health facilities.

The AMA News article explains that doctors were reluctant to shell out for EMRs. A 2009  law, the HITECH Act provided $30 billion of funding to give health care providers EMRs in return for the provider’s agreement to adhere to the government’s meaningful use standards. The EMR developers adhered to the meaningful use standards which mysteriously did not provide for interoperability.  So by 2014 most providers were usings EMRs which are not interoperable.  HHS does not expect widespread EMR interoperability to occur through retrofitting the EMRS until the 2021 to 2024 era in its recently issued roadmap to interoperability.

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