Weekend Update

Congress is out of town this week for the Thanksgiving holiday.

The trial of federal government’s antitrust case against the Anthem-Cigna merger begins tomorrow before U.S. District Judge Amy Berman Jackson here in Washington, D.C.  Modern Healthcare explains that

In the first portion of the trial, expected to last through Dec. 2, U.S. District Judge Amy Berman Jackson will hear arguments on the national implications of the deal. The companies compete for business from large, self-insured employers to handle functions such as claims administration and designing provider networks. A second portion of the trial—unless Jackson decides there’s already enough cause to spike the deal after the first—will address regional markets.  Jackson has said she plans to rule on the case by late January. 

The Wall Street Journal adds some color:

The first few days of the trial could be crucial in setting the tone. The Justice Department is expected to start its case by summoning as witnesses Anthem CEO Joseph R. Swedish and Cigna CEO David Cordani.

The Journal adds that “A negative decision almost surely means the end of the Anthem deal, given its tensions with Cigna. Companies rarely keep litigating merger cases if they lose at trial because it is very difficult to keep a deal together for another year or two of litigation.”

The trial of the government’s antitrust case against the Aetna-Humana merger begins soon after the Thanksgiving holiday before U.S. District Judge John Bates, also in Washington, D.C.  The Journal explains that

The Aetna case, in contrast [to the Anthem-Cigna case], focuses heavily on the market for private Medicare plans, Humana’s main line of business. The government says the merger would eliminate aggressive competition between the companies to enroll seniors in so-called Medicare Advantage plans. The insurers say their transaction would combine two complementary companies that would offer better, more cost-effective insurance products.

All four insurers participate in the FEHBP in various capacities.

FCW reports that on Friday the U.S. Office of Personnel Management’s Inspector General issued a report on the state of the agency’s compliance with the federal information security law for federal government information technology systems, FISMA.  “More than a year after the massive data breach at the Office of Personnel Management was revealed to the public, the agency still has a litany of IT weaknesses and deficiencies, according to a new inspector general report.” Meanwhile the Federal Times reports about a speech that the acting OPM Director Beth Cobert recently made to a contractors’ association.

One of the more intriguing of issues Cobert spoke on was the dearth of not only new talent coming into the federal government, but also the trickle of cybersecurity expertise.
“Both the government and the private sector fundamentally need more help with cybersecurity expertise working for us than exists today in the country,” she said.
She said that while estimates vary, some speculate that the cybersecurity talent shortfall could be as high as a million positions needed, prompting OPM, the departments of Defense, Homeland Security and others to develop a cyber recruitment strategy for new professionals, while navigating the issues of retaining them. 

Not a good situation.

OPM is asking FEHBP plan carriers to call their members attention to a new government website, healthfinder.gov  OPM explains that the websit

provides personalized recommendations for – and plain language information about – clinical preventive services based on age, sex, and pregnancy status.  Once users enter this information, the tool generates a list of evidence-based preventive services along with actionable guidance to help them stay healthy.  The recommendations come from the U.S. Preventive Services Task Force (USPSTF), the CDC Advisory Committee on Immunization Practices (ACIP), and the Health Resources and Services Administration (HRSA)—the same authorities that guide preventive services covered by FEHB plans.  Importantly, HHS is committed to refreshing this tool as new preventive service recommendations are implemented.

All that you have to do is type in your gender and age. Check it out.

In April 2016, the FEHBlog attended portions of the HCP/LAN spring conference in lovely Reston Virginia.   This is a government / private sector collabotative intended to boost the use of value based payments by health plans. The FEHBlog was struck by the fact that the meeting was heavily attended.  The FEHBlog must have overlooked the invitation to the fall conference which occurred last month. Here is a press release on that conference.