TGIF

Govexec.com and Federal News Radio also reported on yesterday’s Senate subcommittee hearing features OPM Director Dr. Jeff Pon and GSA Administrator Emily Murphy, if you are interested in their perspectives.

Employee Benefit News adds some details on the House of Representatives’ HSA bill passed earlier this week. To wit — the bill, if approved by the Senate, would

allow [High Deductible Health Plans} HDHPs to cover up to $250 (self-only) and $500 (family) annually for non-preventive services that currently may not be covered pre-deductible. This will allow pre-deductible coverage for chronic condition treatment and telehealth services, for example. 

The article describes administrative concerns about the provision but implementing the provision is optional. If not 2019, then 2020. More flexibility is a good thing.

The Centers for Medicare and Medicaid Services released proposed calendar year 2019 changes to Medicare’s outpatient hospital prospective pricing system and its ambulatory surgical center benefits.

CMS is moving toward site neutral payments for clinic visits (which are essentially check-ups with a clinician). Clinic visits are the most common service billed under the OPPS. Currently, CMS often pays more for the same type of clinic visit in the hospital outpatient setting than in the physician office setting. * * *

The proposed rule aims to address other payment differences between sites of service, so that patients can choose the setting that best meets their needs among safe and clinically appropriate options. For 2019, CMS is proposing to:

  • Expand the number of procedures payable at ASCs to include additional procedures that can safely be performed in that setting;
  • Ensure ASC payment for procedures involving certain high-cost devices parallels the payment amount provided to hospital outpatient departments for these devices; and
  • Help ensure that ASCs remain competitive by stabilizing the differential between ASC payment rates and hospital outpatient department payment rates.
This makes sense but assuming that CMS goes ahead with this approach, it could lead to a new wave of facility cost shifting to the private sector particularly if Medicare site neutrality favors one side over another. 
The FEHBlog from time to time has mentioned how blockchain, a secure transactional technology which gave rise to crytocurrencies like Bitcoin, is being tested in healthcare. The FEHBlog listened yesterday to a podcast called Conversations with Tyler in which a George Mason University economist Tyler Cowen spoke with a blockchain expert Vitalik Buterin. The transcript as well as the podcast are available here.

Finally, here’s a link to a Bloomberg article about a couple of innovative health plan startups that’s worth reading. 

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