FEHBlog

• President Bush signed a joint resolution (H.R. Jt. Res. 52)yesterday funding the federal government, including the FEHB Program, through November 16, 2007. Of course, a new federal fiscal year starts tomorrow, October 1.
• On September 25, the President signed into law the Food and Drug Administration user fee reauthorization law (H.R. 3580). The law expands the FDA’s authority over prescription drug safety after initial marketing approval has been given in order to avoid the repeat of Vioxx type problems. The FDA currently is evaluating the impact of the new law.
• The State Children’s Health Insurance Program reauthorization battle should come to a head this week when President Bush is expected to receive and veto the compromise bill that Congress is in the process of adopting ($35 billion increase in SCHIP funding for Congress vs. $5 billion increase for the President.) The compromise bill is based on the Senate bill which, unlike the House bill, does not include major revisions to the Medicare program. Consequently, the SCHIP reauthorization battle, while interesting from a political perspective, does not affect the FEHB Program.
• Wal-Mart expanded its $4 generic drug program to seven new compounds. Also Wal-Mart announced that it will sell two popular female contraceptive bills for $9 for a month’s supply, which is a significant savings for a woman who does not have insurance coverage according to the New York Times. Obviously attracting young women customers is a plus for Wal-Mart.
• The full House Ways and Means Committee approved on September 27 the House version of the mental health parity bill (HR 1424). Like the SCHIP reauthorization, the likely outcome will be that Congress adopts the Senate version of this bill, which has bipartisan and industry support.

Dr. Howard Goldman has published an article in the American Journal of Psychiatry about the FEHB Program’s successful mental health parity policy. Ironically, also today, the House Ways and Means Committee approved a mental health parity bill (HR 1424) which goes far beyond the FEHB Program’s policy and the bill approved by the Senate (S. 558). The Ways and Means Committee’s version of the House bill differs from the version that the Education and Labor Committee previously approved. The House bill must also be considered by the Energy and Commerce Committee. The Rules Committee will then consolidate the three versions in consultation with the House leadership. I do expect that a mental health parity bill will be enacted this year.

• The House Federal Workforce and Postal Service Subcommittee held a business meeting on September 18 at which it approved a bill sponsored by Rep. Tom Davis (R Va) and others to allow federal retirees the opportunity to pay the FEHB plan premiums pre-tax. The House Ways and Means Committee has been an obstacle to passage of this bill because of its adverse impact on tax revenues.
• The Office of Management and Budget has updated its agency ratings on the ExpectMore.gov web site. OPM’s ratings are here. The FEHB Program is rated adequate.
• The OPM Inspector General’s oversight of the FEHB Program is rated effective at Expectmore.gov. This week the OPM Director submitted the agency’s response to the Inspector General’s most recent semi-annual report to Congress.
• The New York Times reported that prescription drug prices have increased only 1% on average over the past twelve months according to the U.S. Labor Department. According to the report, “Economists say the slowdown has come about because more people are turning to generics and because generic versions of some of the most common drugs have recently come on the market.” The article notes the inexpensive prices that retailer such as Wal-Mart and Target, charge for certain generic drugs. Also it notes that last month the Publix Supermarket chain started a promotion under which its Florida pharmacies provide seven commonly prescribed generic oral antibiotics for free with a valid prescription, even when the purchaser has health benefits.
• Today’s New York Times includes an interesting article about the return of physician house calls provided by companies such as Inn-House Doctor, Sickday Medical House Calls, and My Home Doctor. The fees run from $250 to $450 per visit.

The Leapfrog Group for patient safety released today its 2007 top hospital list, which is based on a safety and quality survey of hospitals nationwide. The only Washington DC hospital to make the list of 33 adult facilities and 8 children’s hospitals was Children’s Hospital. Two Baltimore hospital, Sinai Hospital and the University of Maryland Medical Center, also made the list.

Last night, the Senate passed its version of the enhanced mental health parity legislation (S. 558) by unanimous consent. Today, the Health Subcommittee of the House Ways and Means Committee cleared the more aggressive House version of this legislation by a 10-3 vote (HR 1424). The House Labor and Education Committee previously cleared H.R. 1424 and the full Ways and Means Committee and the Energy and Commerce Committee also must consider it. Business Insurance explains that

[The Senate bill] differs in several significant respects from legislation passed in July by the House Education and Labor Committee. Under the Senate bill, self-funded employers would decide which mental health care disorders they would cover. In the case of insured plans, the Senate bill would act as a floor and not pre-empt tougher state parity laws. By contrast, the House committee bill would tie the type of mental health care disorders that group health care plans must offer to coverage provided by health plans available to federal employees.

An interest group called Wellstone Action is urging the House speaker Nancy Pelosi to hold a vote on the House bill as soon as possible. According to the Associated Press, the Speaker is planning a mid-October vote.
The House of Representatives today passed a compromise version of the FDA Prescription Drug User Fee reauthorization bill by a 405 – 7 vote. The bill now goes to the Senate which is expected to give its prompt approval and the President has indicated that he will sign the bill. The compromise bill includes a number of new prescription drug safety measures, including post-market safety studies, but not a pathway to biogenerics. Crisis averted.

According to the Wall Street Journal, House and Senate conferees are in the process of essentially adopting the Senate version of the State Children’s Health Insurance Program reauthorization bill, which includes a $35 billion increase in SCHIP funding over 5 years but no Medicare changes. The President has threatened to veto the SCHIP funding increase greater than the $5 billion that he proposed, but the Senate passed its bill by a veto proof margin. The solons agreed to consider the Medicare changes later this year. I would not be surprised if the same result is achieved with the mental health parity legislation as the Senate bill has the most bipartisan support.

• Well, it has been a busy week due to OPM’s press release about the 2008 FEHB Program premiums.
• OPM also issued a notice in the Federal Register on Friday about the medically underserved states for 2008. The fee for service plans must provide certain extended benefits in those states under 5 U.S.C. § 8902(m)(2). According to the agency’s announcement,”for calendar year 2008, OPM’s calculations show that the following states are Medically Underserved Areas under the FEHB Program: Alabama, Arizona, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Montana, New Mexico, North Dakota, South Carolina, South Dakota, and Wyoming. For the 2008 calendar year Texas and West Virginia are being removed from the list, and no new states have been added.”
• Congress continues to debate the SCHIP and FDA Prescription Drug User Fee reauthorization bills. According to the Kaiser Capitol Hill Watch, a short extension of the SCHIP authorization is likely while the solons work out the funding level and whether to include Medicare changes in the bill. However, Senator Enzi (R Wyo) has announced his opposition to House Speaker Nancy Pelosi’s proposal for a three month extension of the FDA user fee reauthorization bill.
• The GAO released a report on the future of health care in the U.S.
• In the same vein, today’s New York Times featured another article on its series concerning the impact of new genetic technology on American life.

OPM has posted the 2008 FEHBP premiums on its website. Govexec.com and the Federal Times continue to report on the fallout from OPM’s announcement. NARFE and NTEU also posted press releases about OPM’s announcement. The Open Season will run from November 12 to December 10, 2007.

The U.S. Office of Personnel Management announced today that Federal Employees Health Benefit Plan premiums will increase on average about 2 percent for the second straight year. The Washington Post, FedNewsRadio.com and Govexec.com have reported on OPM’s press conference.

At 2 pm tomorrow, Sept. 13, OPM Director Linda Springer will hold a press conference to announce 2008 premiums for the Federal Employees Health Benefits Program and the Federal Employees Dental and Vision Program. As a point of reference, a Kaiser Family Foundation study released yesterday states that employer sponsored health insurance costs have increased 6.1% on average in 2007. The Wall Street Journal reports that

This is the fourth straight year premiums have decelerated since soaring nearly 14% in 2003.But after a decade of inflation-topping increases, the annual cost for family coverage through an employer plan is now more than $12,000, well over what a minimum-wage worker earns in a year. Workers now pay on average $3,281 a year to cover their share of that family policy, double what they did in 2000, the survey found.

• Congressional Quarterly reports that the Senate Republican leadership is delaying the naming of a Conference Committee with the House on the State Children’s Health Insurance Plan (SCHIP) reauthorization bills. It further reports that a brief extension of the SCHIP law, e.g., to November 15 may be in the offing. Absent such action, the SCHIP Program authorization will expire on September 30.
• Govexec.com reported this week on federal employee union and NARFE efforts to require FEHB plan carriers to purchase prescription drugs off the Federal Supply Schedule, just like VA and Defense Department health care facilities. Govexec.com also reported this reaction from OPM Associate Director Nancy Kichak:
  

  Nancy Kichak, associate director for strategic human resources policy at OPM, said the agency opposes such a bill. “We want our carriers to have the flexibility to offer a variety of products to encourage competition,” she said, adding that OPM would prefer making the supply schedule discounts optional for FEHBP carriers.Kichak added that while use of the FSS would lower drug costs, it could do away with valuable elements of some plans, such as encouraging the use of generic drugs and allowing employees to obtain prescriptions through mail order. Use of the supply schedule “would only help in one element of the drug purchase, which is cost, and only for those drugs on the schedule,” she said.

• Modern Healthcare.com reported on HHS’s September 5 forum on converting the American Health Information Community to a private sector organization.
• The September 2007 issue of AIS Health’s Report on Patient Privacy is freely available online to sample. My colleague Theresa Defino wrote the interesting front page article on how to handle security breaches and yours truly is quoted inside the publication.
• The Senate confirmed President Bush’s appointment of Jim Nussle to serve as Office of Management and Budget Director.