Tuesday’s Tidbits

The Department of Health and Human Services has finalized the Affordable Care Act 2019 benefit and payment parameter notice.  There is one item in this massive notice that applies to the FEHBP. On pages 332-334, HHS announced that it is finalizing as proposed the 2019 maximum annual limitations on cost-sharing for essential health benefit coverage at $7,900 for self only coverage and $15,800 for other than self-only coverage. This represents an approximately 7% increase above the current 2018 parameters of $7,350 for self only coverage and $14,700 for other than self only coverage.  The CMS press release provides other details on the notice, which loosens restrictions on insurers operating in the individual and small group markets.

Govexec.com reports that the Trump Administration is considering moving 25% of OPM’s responsibilities to other government agencies. “The White House * * * is reportedly weighing the option to move the entire [security] background investigations program to [the] Defense [Department].” What’s more,

“There’s another proposal to move OPM’s Human Resources Solutions, which provides HR services to agencies on a consulting basis, to the General Services Administration. The organization includes a federal staffing center and leadership development program, among other resources.”  

Finally, some actual tidbits

  •  The American Hospital Association is encouraging Congress to align a dated federal law (almost 25 yrs older than HIPAA which was enacted in 1996) that protects substance use diagnoses from disclosure (42 CFR Part 2) with the now customary treatment, payment, and health care operations uses and disclosures permitted by the HIPAA Privacy Rule. The AHA explains that  

“Clinicians treating patients for any condition need access to their complete medical histories, including information related to any substance use disorder (SUD), to ensure their patients’ safety, and delivery of the highest quality care. Partitioning a patient’s record to keep SUD diagnoses and treatments hidden from the clinicians entrusted to care for the patient, as required by 42 CFR Part 2, is dangerous for the patient, problematic for providers and contributes to the stigmatization of mental and behavioral health conditions”

  • The Alzheimer’s Association has proposed a new approach to drug research for that disease. Focus drug testing on patients who have been diagnosed with the disease using biomarkers rather than on patients with Alzheimer’s symptoms, such as cognitive impairment which can have many causes. The work stemming from mapping the human genome has lead to the discovery of many such biomarkers. ” The authors envision that defining Alzheimer’s disease as a biological construct will enable a more accurate understanding of the sequence of events that lead to the cognitive impairment associated with Alzheimer’s disease, as well as the multiple causes of the disease. This will enable a more precise approach to therapy trials including focusing more specific targets and including the appropriate people.” Evidently this approach has worked successfully with other complicated diseases.
  • Health IT Security has a useful article on how a new European Union privacy rule known as the GDPR which takes effect on May 25, 2018, impacts U.S. healthcare care providers and payers. 
  • The Wall Street Journal reports on Journal of the American Medical Association study on changes to premature death rates in the U.S. over the past twenty five years.  “The new analysis, published Tuesday in the JAMA, shows wide variation in where people ages 20 to 55 are at highest risk, and in what diseases or conditions afflict them. The risk of dying young declined in Minnesota, California and New York between 1990 and 2016, the study found. Yet it rose in 21 states, including West Virginia and New Mexico.”