Tuesday’s Tidbits

The Wall Street Journal reports that the House of Representatives Congress sent to the President’s desk the Senate’s right to try bill (S.  204).  “The version of the legislation that passed Tuesday is broad and allows patients access to an investigational drug if the patient is diagnosed with a life-threatening disease or condition.”  Health plans generally do not cover investigational drugs as the manufacturer usually assumes that cost. The President is expect to sign the bill into law. 


Healthcare Dive informs us that the Government Accountability Office is recommending that the Centers for Medicare and Medicaid Services continue Medicare’s prior authorization programs because those programs save money. The American Medical Association has been on a holy war against insurer prior authorizations for the same reason, at least in the FEHBlog’s opinion. This GAO report has to be a shot in the arm for all prior authorization programs. 


Two worthy initiatives:


1. Fierce Healthcare reports on a fresh effort to improve patient safety.

Led by the Institute for Healthcare Improvement (IHI), a newly launched steering committee will seek to refocus the industry’s attention on safety and quality goals, such as finding ways to cut down on medical errors. In all, a collection of 24 groups including private organizations like the American Hospital Association and the ECRI Institute will be part of the new committee.

The steering committee held its inaugural meeting today, and

2.  Fierce Healthcare also reports that Kaiser Permanente, which is the carrier with the third largest enrollment in the FEHBP, is investing $200 million in urban housing initiatives through a partnership with the U.S. Mayors and CEOs for Housing Investment.

Finally, the Internal Revenue Service has announced the inflation adjusted percentage that applicable large employers will use to determine whether the minimum essential coverage offered to employees is affordable as required by the Affordable Care Act for plan years beginning after December 31, 2018. The specified percentage is 9.86%, up from 9.56% this year.

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