Thursday Miscellany

From Washington, DC,

  • The U.S. Office of Personnel Management released its Fiscal Year 2023 Agency Financial Report today. Worth reading is the OPM Director’s response to the OPM Inspector General’s Top Management Issues letter.
  • The Department of Health and Human Services (HHS) issued its proposed 2025 benefit and payment parameters notice. Here is the government’s fact sheet on the proposed rule. Published alongside the proposed rule is HHS’s final guidance on Maximum Annual Limitation on Cost Sharing for the 2025 Benefit Year, which does apply to FEHB plans.
    • “Under 45 CFR 156.130(a)(2), for the 2025 calendar year, cost sharing for self-only coverage may not exceed the dollar limit for calendar year 2014 increased by an amount equal to the product of that amount and the premium adjustment percentage for 2025. For other than self-only coverage, the limit is twice the dollar limit for self-only coverage. Under § 156.130(d), these amounts must be rounded down to the next lowest multiple of $50. Using the premium adjustment percentage for 2025 of 1.4519093322, and the 2014 maximum annual limitation on cost sharing of $6,350 for self-only coverage, which was published by the Internal Revenue Service on May 2, 2013, the 2025 maximum annual limitation on cost sharing is $9,200 for self-only coverage and $18,400 for other than self-only coverage. This represents an approximately 2.6 percent decrease from the 2024 parameters of $9,450 for self-only coverage and $18,900 for other than self-only coverage.”
  • Per MedTech Dive,
    • “Congress included a one-year delay to Medicare reimbursement cuts for clinical laboratory services in the short-term funding bill passed this week, granting a reprieve in targeted payment reductions of up to 15%.
    • “The stopgap bill to keep the government open, passed by the House on Tuesday and the Senate on Wednesday, provides a one-year reprieve from Medicare cuts that would have gone into effect in January for about 800 laboratory services.
    • “The American Clinical Laboratory Association (ACLA), a trade group whose members include Labcorp and Quest Diagnostics, called the delay “critically needed” to preserve patient access to many of the most commonly ordered lab tests.”
  • HHS also reminds us that
    • “Today [the agency] celebrates National Rural Health Day and recognizes the creativity and innovation of leaders across the country working to ensure access to high quality care for over 60 million Americans living in rural communities. National Rural Health Day is the third Thursday of every November and recognizes the efforts of rural providers, communities, organizations, state offices of rural health, and others dedicated to addressing the unique health care needs of rural America.” 

In FEHB Open Season news, Tammy Flanigan discusses Open Season and tax savings in Govexec.

From the public health and research front,

  • The New York Times points out the differences between Influenza A and Influenza B.
  • NCQA released its Quality Talks newsletter.
  • STAT News informs us,
    • “History just happened.
    • “For the first time, a regulator has cleared a treatment using CRISPR, the gene-editing technology, for patients. The regulator is the United Kingdom’s Medicines and Healthcare products Regulatory Agency. The product is Casgevy, a treatment for sickle cell disease and beta thalassemia, two blood disorders. It was developed by CRISPR Therapeutics, the Swiss company co-founded by Nobel laureate Emmanuelle Charpentier, and Vertex Pharmaceuticals, a large Boston-based biotech firm.”
    • The article covers questions and answers about this significant development.
  • Smileyscope has made history by becoming the first virtual reality (VR) device to receive FDA Class II clearance for acute pain. This approval recognizes Smileyscope’s innovative Procedural Choreography™ technique, which uses positive virtual stimuli to reduce pain and anxiety during medical procedures. With this milestone, Smileyscope aims to revolutionize pain and anxiety management, partnering with hospitals and clinicians globally to enhance patient experiences and improve clinical workflows.”