Thursday update

Following up on Tuesday’s post on Hurricane Harvey, the Washington Post reports that Houston’s medical world mostly has withstood the hurricane due to significant disaster preparatory steps taken in the wake of a strong tropical storm in 2000.

Tuesday’s post also noted that Gilead Sciences had acquired a company called Kite which specializes in develop CAR-T cancer treatments. Stat News reports that yesterday the Food and Drug Administration approved a Novartis CAR-T treatment called Kymriah for marketing. “Novartis’s product is the first CAR-T therapy to come before the FDA, leading a pack of novel treatments that promise to change the standard of care for certain aggressive blood cancers.”  Novartis plans to charge $475,000 for a course of treatment which is lower than the $700,000 charge approved by the British health system.

How about some FEHB plan news?

  • The Kansas City Star tells the impressive story of the largest employee organization carrier in the FEHBP, GEHA
  • Blue Cross FEP announced that its rolling out telehealth services to its FEHB plan members next year under a contract with Teladoc. In a related story, Healthcare Dive reports that utilization of  telehealth services is building in the Medicare program.

And let’s wrap it up with some tidbits

  • Take a look at Healthcare Dive’s article on what’s happening with the 21st Century Cures Act which Congress passed late last year. 
  • Healthcare Finance News informs us that “Healthcare spending growth slowed in 2016, and the trend appears to be continuing, according to the August 2017 Altarum Institute Center Health Sector Trend report.”
  • The ACA’s employer mandate requires that a large employer offer coverage with a minimum actuarial value of 60% and an affordable employee contribution not to exceed 9.5% of W-2 income which percentage is annually adjusted. Since the mandate was implemented in 2015, the percentage has crept up slightly. However, Accord consultants tells us that 

In 2015 the affordability threshold was adjusted to 9.56 percent. Then in 2016 the affordability threshold increased again to 9.66 percent and again in 2017 to 9.69 percent. However, for the first time, the affordability threshold has decreased in 2018 all the way back to 9.56 percent. The significant drop in the affordability threshold compared to 2017 places employers who are toeing the line of the affordability threshold in danger of being subject to a potential section 4980H(b) penalty if the price of coverage is not reduced for self-only coverage.

In programs like the FEHBP the employer can select a benchmark plan that is open to all employees for compliance purposes, instead of testing each plan offered to employees. 

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