Congress is out of session now until November 14.  Here is a link to the Week in Congress’s report on last week’s activities.

In the lame duck session, Congress will have to address FY 2017 appropriations. Politico reports that the health insurance industry understandably will be pushing Congress to extend the suspension of, or repeal, the ACA’s onerous health insurance fee in the lame duck.  The FEHBlog expects that the big FEHB related activity in the lame duck session will be postal reform.  We are still waiting for the Congressional Budget Office to score the House Oversight and Government Reform Committee’s bipartisan postal reform bill (HR 5714).

The U.S. Supreme Court begins its October 2016 term on Tuesday following the Jewish New Year holiday. (L’shana tovah!)

Modern Healthcare reports that the Government Accoutability Office’s report on health care records security has been well received by experts.

Privacy and security gurus praised the GAO for taking an unflinching look at the dual role HHS plays as both a promoter of health information technology use and the primary enforcer of the Health Insurance Portability and Accountability Act, the federal privacy, security and breach notification law. The report, experts say, should come as one more warning to the healthcare industry to better protect sensitive patient information before Congress, the courts or their own patients take action.

The courts already are taking action as the article later notes.

Fierce Healthcare reports on the lack of transparency in hosital pricing.  But as Kramer observed in Seinfeld, “retail is for suckers.

Here is a link to OPM’s 2017 FEHBP and FEDVIP premiums press release and a link to the 2017 FEHBP premiums page.  Here’s the Washington Post’s article about the OPM announcement and NARFE’s press release.

Federal employee unions and NARFE engage in a lot of percentage comparisons at this time of year. Percentage comparisons are meaningless unless the base numbers are comparable, and these organizations make no effort to demonstrate comparability. It’s interesting to note that nearly 20 years ago, Congress changed the FEHBP Act to permit employee organizations, like AFGE for example, to rejoin the FEHBP.  No organization has taken up Congress on its offer. Being a health benefits carrier is not an easy business.

Blue Cross FEP has a press release on its 2017 benefit changes and GEHA has posted its 2017 brochures if you are interested. Other plans will be following suit.  

Federal News Radio reports that earlier today the President has signed into law the continuing resolution, which Congress enacted yesterday, funding the federal government through December 9, 2016.  The resolution also provides Zika funding and means that there will be a lame duck session of Congress following the federal election on November 8. Congress now leaves town for the campaign trail.

HHS yesterday announced the winners of the simplified medical billing contest as part of National Health IT Week. The winning designs and honorable mentions can be viewed at www.abillyoucanunderstand.com. Six large medical systems are working with the developers.

Govexec.com reports on OPM’s announcement of 2017 FEHBP premiums here. Federal News Radio explains 

On average, participants in the Federal Employee Health Benefit Program will pay 4.4 percent more on their premiums in 2017. The increase is slightly lower than what federal employees and annuitants saw this past year, when FEHBP increases went up 6.4 percent, the largest rate change in recent memory.

Congress suspended the Affordable Care Act’s health insurer fee for 2017. The health insurer fee generally applies to FEHB plans.  That change likely accounts for a good chunk of the decrease between the two years.

The press is reporting that as the FEHBlog expected Congress has reached an agreement in principle on funding the federal government past September 30. No government shutdown in sight, thankfully.

Congress unfortunately has not made evident progress toward adopting a continuing resolution funding the federal government past this Friday.  The Hill’s latest report is here.  The FEHBlog still expects the logjam to break.

Govexec.com reports that OPM will “unveil next year’s premium rates in the Federal Employees Health Benefits Program during a late-morning briefing Wednesday with reporters.”  The FEHBlog will post the news as soon as he sees it pop up.

Here’s a link to the live chat that the Washington Post had today on the controversial federal employee long term care insurance premium increase and a related Michelle Singletary column which concludes on the following note:

I get that you may be angry about the increases. But if you can’t save enough to self-insure and you wouldn’t qualify for Medicaid, choose an option that you can afford so that you at least have some level of coverage.

It’s hard to argue with that logic.

The GAO issued a report yesterday urging the Department of Health and Human Services to improve  the HIPAA Security Rule. That rule requires health plans, health care clearinghouses, most healthcare providers and their business associates to create and maintain administrative, physical and technical safeguards over electronic protected health information.

GAO is making five recommendations, including that HHS update its guidance for protecting electronic health information to address key security elements, improve technical assistance it provides to covered entities, follow up on corrective actions, and establish metrics for gauging the effectiveness of its audit program. HHS generally concurred with the recommendations and stated it would take actions to implement them.

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This Friday is the end of the current federal fiscal year.  The FEHBlog expects Congress and the White House to agree on a short continuing resolution which will lead to a lame duck session following the national election on November 8.

OPM’s once in a blue moon Federal Employee Group Life Insurance Program Open Season also ends this Friday.

The opportunity for Federal Employee Long Term Care Insurance Program enrollees to make decisions about premium increases ends on Friday as well.  Federal News Radio reports that OPM has rejected a request from several DC metro area members of Congress to extend this decision period until Congress could hold a hearing on the issue in November.  A Washington Post columnist began a series of articles on the issue today.  The FEHBlog thinks that there’s a problem with the program structure created by the statute.

The FEHBlog expects that OPM will make an announcement about 2017 FEHBP premiums this coming week. Last week, CMS made an announcement about 2017 Medicare Advantage premiums.

This coming week is National Health Information Technology Week.  Here is an official list of ten ways to celebrate. Health IT News reports on the Week’s activities here.

Health Data Management reports on the work of a healthcare cybersecurity task force that was created by a recent federal law.

According to Theresa Meadows, co-chair of the Health Care Industry Cybersecurity Task Force and CIO of Cook Children’s Health Care System, the panel’s 20 subject matter experts are drawn from a wide variety of organizations including providers, payers, pharmaceutical companies, medical device manufacturers, IT vendors, and government agencies. 

“We have representation from all the segments within healthcare so that we can have well-rounded discussions,” said Meadows. “There’s also a patient advocate on the task force.” 

Meadows said the task force has held several public and private meetings to date and will be “wrapping up its charge” early next year, after which it will report to Congress on its findings and recommendations. 

We are a week away now from the end of the current federal fiscal year.  Govexec.com reports that it’s likely that before the deadline passes, Congress will pass a continuing resolution funding the federal government’s operations through December 9.  The Wall Street Journal provides an amusing report on the history of the federal fiscal year here.

Modern Healthcare reports based on a recent study that “rapid adoption of bundled payments remains an act of faith.”  Bundled payments for orthopedic surgery was the only category of care that appeared to reduce costs and improve quality according to the study. Meanwhile according to another Modern Healthcare article, a survey reveals that changing reimbursement methods, among other factors, is causing low morale among doctors.

HHS’s Office for Civil Rights displayed another HIPAA scalp today. The covered entity failed to update its business associate agreements for the changes wrought by the 2009 amendments to HIPAA.

Health Day reports about the growing costs of treating falls suffered by elderly Americans —  $31 billion annually for Medicare. As the FEHBP’s demographics skew older, this should be a concern for FEHB plans too.

Finally, Harvard Medical School offers a helpful article on the proper consumer use of telemedicine which is a growing option in the FEHBP. It’s important for plans to educate their members on this topic. For example, the FEHBlog has noticed that his health coverage provider, Carefirst, offers such guidance on its website.

Govexec.com brings us up to date on the federal long term care premium increase controversy.  The decision period for affected enrollees ends on September 30, and the premium increase kicks in on November 1.

FCW.com reports that the President has nominated Elizabeth Field to be the new OPM Inspector General.  The nominate requires Senate confirmation and there’s not much time left in this Congress for that process to be completed.

OPM yesterday announced its Federal Employee Viewpoint Survey results. “The 2016 FEVS was administered to 407,789 employees representing 80 (38 large / 42 small) Federal agencies. These results provided through UnlockTalent.gov contain scores for two major indices — Employee Engagement and Global Job Satisfaction across the Federal government. OPM plans to release the more detailed 2016 FEVS results in digital and print formats in early October.”

Earlier this week, OPM issued guidance to federal agencies concerning flexibilities for federal employees affected by the Zika virus.

Finally, Health Data Management discusses a government task force report’s recommendations for improving the Blue Button connector which OPM endorsed for FEHBP carrier use a few years ago. is The connector is “designed to enable consumers to determine which healthcare providers offer electronic access to their health records.”

USA Today reports that a bipartisan group in the Senate and House have introduced a bill that would require drug manufacturers to permit regulators to review price increases of 10% or more.  As the FEHBlog has documented over the years, drug pricing is very complicated.  For example, Medicaid pricing effectively sets a floor for commericial pricing. Rebates also play a significant role in the bottom line to manufacturers.  Consequently, the FEHBlog does not think that this bill if enacted would have much of an impact but because the basic concept is already law for health insurers, the drug manufacturer pricing oversight law may happen.

Govinfosecurity.com reports that beginning next month HHS’s Office for Civil Rights will begin to conduct HIPAA Privacy and Security Rule compliance audits of the business associates of HIPAA covered entities.

Govexec.com reports that federal and postal retirees are about a month away from learning whether they will receive a cost of living adjustment in 2017.

The exact cost-of-living adjustment for next year won’t be known until October 18 when BLS releases the September CPI-W number, the final data point in the equation.
Still it’s not clear yet if retirees will receive a modest boost, or nothing, as was the case for 2016. But things look better now than they did at the same time last year.

2017 FEHB premiums should be announced by the end of this month if history is any guide.

The FEHBlog noticed two articles about the FEHBP — one concerns the self plus one option and the other concerns that Postal reform bill’s FEHB provisions. The FEHBlog’s role is to share information about the FEHBP so he is posting links to the articles even though his does not fully agree with the conclusions in either article.

With respect to self plus one, before this year, the average FEHBP self and family premium was about 2.4 times the average self only premium. If the FEHBlog were king, he would not have added the self plus one option because it had to be squeezed in.  Contrast the FEHBP with FEDVIP which always has had self plus one.  FEDVIP has annual benefit maximums for each individual. In contrast FEHBP has a maximum out of pocket limit for self only and other than self only which once met relieves the individual of in-network cost sharing until the end of that year. In contrast to dental insurance, there is a substantial financial risk associated with providing health insurance coverage.  In sum the FEHBlog never expected the FEHBP self plus one to be two times self only.  There were some outliers for 2016 but give it time for bumps to smooth out somewhat.

With respect to the Postal Service reform article, the Postal Service wants to obtain the full benefit of the Medicare taxes paid for its employees. For that reason, the Postal Service has been pressing for fully FEHBP integration with Medicare.  That’s reasonable particularly in view of the retiree healthcare pre-funding burden that Congress has placed on the Postal Service. The author, who is a recognized FEHBP expert, nevertheless makes some points worth discussing.

OPM Acting Director Beth Cobert announced today that “OPM is happy to announce that the all-new FSAFEDS.com is open for business to serve our current FSAFEDS participants. We’re excited about the new tools and flexibilities that will help you to easily manage your Flexible Spending Accounts.” Best of luck to the new FSA contractor WageWorks.

Also today the Health Subcommittee of the House Ways and Means Committee held a hearing on ways to improve healthcare through technology.  The FEHBlog agrees with the approach but let the private sector lead the way.

The Kaiser Family Foundation released its 18th annual employer health benefits survey.  “The 2016 survey included almost 1,900 interviews with non-federal public and private firms.  Annual premiums for employer-sponsored family health coverage reached $18,142 this year, up 3 percent from last year, with workers on average paying $5,277 towards the cost of their coverage.” A lot of information is available at the provided link.

American Hospital News reports that according to CMS unnecessary hospital readmissions have been dropping. “While hospitals have reduced readmissions by 565,000 since 2010, the [Medicare readmissions control] program has penalized them by $1.9 billion, a new AHA infographic notes.”  And of course where do those additional costs wind up? Being imposed on FEHB and private sector plans.

Drug Channels has an interesting take on the Epipen pricing controversy. Drug Channels observes that “IMS Health has done a great job documenting the growing divergence between gross sales and net sales. As the chart [at the link] shows, manufacturers retain a smaller share of their price increases. In 2015, list prices grew by 12.4%, but net prices after rebates grew by only 2.8%.”  The difference is largely attributable to prescription benefit manager negotiated discounts and rebates.  The rub is there according to Drug Channels.