Thursday Miscellany

COVID-19

Thursday Miscellany

David Ermer–COVID-19 vaccine, OPM, Rx coverage, SCOTUS–
Photo by Juliane Liebermann on Unsplash

OPM has posted an announcement about the beginning of the Federal Benefits Open Season which kicked off last Monday and the NIH Director Dr. Francis Collins offers guidance on how to celebrate the upcoming holidays with exposing yourself to COVID-19.

To illustrate that the Pfizer COVID-19 game in town vaccine is not the only game, Fierce Healthcare offers articles on two candidate which offer greater pre-administration stability, one by CureVac and the other by Johnson & Johnson.

Leaning on its years of experience, the drugmaker is well on its way to producing 1 billion doses of its COVID-19 vaccine in 2021 and is looking ahead to 2022, said Paul Lefebvre, VP of strategic initiatives and COVID-19 vaccine supply chain at J&J’s Janssen unit, in an interview. 

J&J’s shot could have a storage and distribution edge over the likes of those from Pfizer and BioNTech, Lefebvre thinks. 

“In our plans, we will bring our product at -20° C into the J&J warehouses around the world,” he said.

J&J’s shot is expected to remain stable for up to two years at that temperature, about -4° Fahrenheit. Once it goes out to distributors and customers, it can be kept stable at 2 to 8° Celcius (a range of about 35.6° to 46.4° Fahrenheit) for up to three months, not much colder than your average refrigerator, Lefebvre said. 

As previously noted, the COVID vaccine manufacturers will seek emergency use authorization (“EUA”) from the Food and Drug Administration follow the completion of the phase III trial. Phrma, the drug manufacturer trade association, provides readers with an understanding of FDA EUA.

The FDA may issue an EUA, when, among other things, the agency determines that based on all of the available scientific evidence, the known and potential benefits of the vaccine outweigh the known and potential risks. To underscore this, FDA Commissioner Stephen Hahn has said repeatedly in recent weeks and months that the agency would only consider an EUA if it felt the risks associated with the vaccine were “much lower than the risks of not having a vaccine and the potential benefit of having a vaccine.”

The agency has further taken steps to ensure the robust vaccine candidate review process by engaging the Vaccines & Related Biological Products Advisory Committee (VRBPAC) to discuss the development and potential authorization of vaccines to prevent COVID-19 after issuing guidance on FDA’s recommendations for an EUA submission for a COVID-19 vaccine.­

The Department of Health and Human Services announced today its partnerships with chain and independent pharmacies to administer the COVID vaccines as the vaccines received EUA and are made available to the public under the government allocation plan, which kicks off with first responders.

In prescription drug benefit news,

  • Drug Channels is offering its “annual deep dive into employer-sponsored coverage for prescription drugs,” and
  • Good Rx unveils the 2021 changes in popular CVS Health and Express Script formularies.

Finally, the FEHBlog wants to call attention to Katie Keith’s excellent analysis of last Tuesday’s Supreme Court argument in the California v. Texas case. Although Ms. Keith does not project an outcome, the FEHBlog is comfortable stating that the Supreme Court will preserve the Affordable Care Act for the third time, except perhaps for the zeroed out individual shared responsibility provision, which already is a dead letter.

Happy Veterans Day

David Ermer–COVID-19, OPM, U.S. Healthcare–
Thanks to Aaron Burden for sharing their work on Unsplash.

Fedweek reminds us that “With just about a third of federal employees having also served in [the U.S. military], today is an especially important day in our community. Thanks for your service.

Healthcare Dive cumulates its reporting on health insurer third quarter 2020 financial results.

In the third quarter, insurers saw a slight dampening from the record-high profits [which of course are constrained by the ACA MLR and OPM’s even stricter FEHB MLR] recorded in the previous quarter as medical utilization rebounded to about 95% of normal volumes for most major payers.

They warned, however, that tailwinds may not last as people seek previously deferred care in the fourth quarter and into next year. Another widespread halting of elective procedures is unlikely as providers have learned more about safely carrying out routine care despite COVID-19 surges.

But novel coronavirus case rates and hospitalizations have reached record levels nationwide this week and it’s unclear how safe people will feel returning to hospitals and doctor’s offices for non-emergent treatments.

Good point.

The Wall Street Journal warns that

Hospitals across the nation face an even bigger capacity problem from the resurgent spread of Covid-19 than they did during the virus’s earlier surges this year, pandemic preparedness experts said, as the number of U.S. hospitalizations reached a new high.

The number of hospitalized Covid-19 patients Tuesday reached 61,964, according to the Covid Tracking Project, passing the prior record of nearly 60,000 in April as the virus surged in the northeast. Hospitalizations hit a nearly identical peak again in late July, as the pandemic’s grip spread across the South and West.

Epidemiologists said the record is likely to be swiftly replaced by another as Covid-19 cases soar nationally. “We already know this is going to go far north,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Fierce Healthcare adds that

Health IT giant Epic has rolled out a new tool for hospitals that helps predict patients’ likelihood of testing positive for COVID-19. The COVID-19 risk prediction model was designed by Cleveland Clinic researchers and was developed and tested using clinical data from more than 11,000 patients. The model uses information from patients’ comprehensive health records combined with patient-entered information in Epic’s patient-facing app, MyChart, to show an individual’s likelihood of testing positive for COVID-19.

Finally on the FEHBP front, FEDWeek reports that

OPM has issued guidance on removing ineligible family members from coverage under the FEHB program, stressing that under its rules, either an employing agency, OPM or an FEHB carrier may “request proof of family member eligibility from an employee at any time for existing enrollments.”

In a pair of similar messages to agencies and to carriers, OPM set the process for requesting proof of family member’s eligibility for existing enrollments, what documents may be used as proof, what actions can be taken based on the response, and the process for reconsidering a decision to remove someone from coverage. Carriers are to inform employing offices in order to avoid duplicate requests for verification, it added, and carriers are to be “judicious in exercising this authority.”

Honestly, it is the employer’s responsibility to police its eligibility rolls. Around five years ago, OPM added a provision to the FEHBP standard contract requiring carriers to pay the freight for an OPM contractor to audit eligibility rolls for ineligible family members. However, OPM has not implemented this clause to date.

Tuesday Tidbits

David Ermer–AHRQ, Congress, COVID-19, COVID-19 vaccine, OPM, U.S. Healthcare–
Photo by Patrick Fore on Unsplash

The FEHBlog spent two hours this morning listening to the oral argument in the latest Affordable Care Act (“ACA”) constitutionality case to reach the U.S. Supreme Court, California v. Texas (No. 19-840). This activity resulted in the FEHBlog learning a new word hortatory and receiving confirmation that his hunch is correct, to wit, There is no chance that the Supreme Court will disrupt the ACA status quo as a result of this case. Indeed the Supreme Court clearly took the case to preserve, not disrupt, the status quo. If you are interested, Amy Howe from the SCOTUSblog has written a legal analysis of the oral argument.

Following up on yesterday’s good news about Pfizer’s COVID-19 vaccine, the Wall Street Journal informs us that

In Kalamazoo, Mich., Pfizer has turned a stretch of land the size of a football field into a staging ground outfitted with 350 large freezers, ready to take delivery of millions of doses of Covid-19 vaccine before they can be shipped around the world.

To make sure its Covid-19 vaccine doses arrive at hospitals and clinics frozen and potent, Pfizer created its own container to ship them.
The temperature-controlled container can store between 1,000 and 5,000 doses for 10 days at minus 70 degrees Celsius before requiring re-icing.

From that site, and another in Puurs, Belgium, the pharmaceutical giant said it wants to deliver up to 100 million doses this year and another 1.3 billion in 2021.

One person needs two doses of the vaccine in order to be protected, again assuming that the phase III study of the vaccine remains on its currently successful course.

The Journal further reports that

U.S. health officials on Monday authorized use of the first treatment for people with earlier-stage Covid-19 who aren’t hospitalized, filling a gap in treatment.

The U.S. Food and Drug Administration said Eli Lilly LLY 2.97% & Co.’s antibody drug should be used for patients ages 12 and up with mild to moderate Covid-19, based on a study showing it helped improve symptoms and kept many patients out of the hospital.

The drug is named bamlanivimab [and it is infused into the patient]. Lilly said it will begin shipping the drug immediately to AmerisourceBergen Corp. ABC 3.59% , a national drug distributor, to distribute it as directed by a federal allocation program [which is described in this HHS announcement issued today].

The Journal also discusses ongoing U.S. problems with COVID-19 testing

The U.S. is running more Covid-19 tests each day than at any other point during the pandemic, but the increased testing doesn’t fully explain recent case surges across the nation, data show. Altogether, testing data suggest Covid-19 diagnostic tests are still severely underused in the U.S. And inconsistencies in data collection and reporting systems are hampering efforts to understand and contain the virus’s spread as the holidays approach, public health and testing executives say.

Because the FEHBP covers a large cadre of senior citizens, it is worth pointing out this AHRQ funded report finding that

Healthcare costs for seniors who needed emergency services after a fall averaged $26,143 in the year following the event, according to an AHRQ-funded study published in The Journal of the American Geriatrics Society. Those costs significantly exceeded the average $8,642 in healthcare costs in the year prior to the event

In civil service news,

Federal employees would not receive an across-the-board increase in pay next year under provisions outlined in a series of fiscal year 2021 funding bills released by the Senate Appropriations Committee Nov. 10. Unlike FY2021 funding passed in the House earlier this year — which simply did not include any provision addressing federal pay — the Senate bill actively sets 2021 pay levels at the same rate as 2020. That difference would override any planned pay increase out of the White House, which was set at 1 percent in President Donald Trump’s February budget proposal.

The Senate is pushing through these measures in order to create a baseline for negotiating an omnibus continuing resolution with the House, which has completed its appropriations bills work, before the current continuing resolution expires on December 11.

  • Federal News Network reports on the Biden Administration’s transition team. Of note,

Kiran Ahuja, a former chief of staff at the agency, will lead the OPM team. Ahuja served at OPM during the aftermath of the agency’s cybersecurity breaches. Prior to her OPM service, she led the Obama administration’s White House Initiative on Asian Americans and Pacific Islanders. Today, she’s the CEO of Philanthropy Northwest, a non-profit organization. The rest of the team is filled with OPM alums who served at the agency as senior advisors during the Obama administration.

Monday Roundup

David Ermer–ACA, CDC, COVID-19, COVID-19 vaccine, SCOTUS–
Photo by Sven Read on Unsplash

Perhaps at last we are beginning to see the light at the end of the COVID-19 tunnel. Pfizer announced positive initial results from the phase three trial of its two dose COVID-19 vaccine.

“Today is a great day for science and humanity. The first set of results from our Phase 3 COVID-19 vaccine trial provides the initial evidence of our vaccine’s ability to prevent COVID-19,” said Dr. Albert Bourla, Pfizer Chairman and CEO. “We are reaching this critical milestone in our vaccine development program at a time when the world needs it most with infection rates setting new records, hospitals nearing over-capacity and economies struggling to reopen. With today’s news, we are a significant step closer to providing people around the world with a much-needed breakthrough to help bring an end to this global health crisis. We look forward to sharing additional efficacy and safety data generated from thousands of participants in the coming weeks.”

The Wall Street Journal explains (in part) that ‘

“When will the Pfizer vaccine be ready for [emergency use] authorization?

“It will be several more weeks at the earliest, because researchers and regulators still need to make sure the shot is safe. The U.S. Food and Drug Administration has said it wants to see two months’ worth of safety outcomes after vaccination for at least half of the people participating in any large, final-stage clinical trial before it considers authorizing a Covid-19 vaccine. The FDA says this will allow identification of any side effects, such as neurological or heart conditions, that weren’t apparent immediately after vaccination. So far, no serious safety issues have been found, Pfizer says. It expects the two months of safety data later this month, and can ask the FDA to authorize the vaccine soon thereafter. It isn’t yet clear how long the FDA will take to make a decision.

“When will people start getting vaccinated?

“Shots from Pfizer and BioNTech could start becoming available before the end of the year, as production has already begun, but initial supplies will be limited. Pfizer says it expects to produce up to 50 million doses globally in 2020—enough for 25 million people because the vaccine is given in two doses—and up to 1.3 billion doses in 2021. This means only the highest risk groups, such as front-line health care workers, could be inoculated this year. Many more doses would be needed to cover the U.S. and global population. Other Covid-19 vaccines in development will likely be needed for everyone to get vaccinated. Their makers have projected they could produce billions of doses next year if their vaccines are successful in clinical testing.”

The Centers for Disease Control released a study of hospital readmissions of COVID-19 patients from March through July 2021.

Among 126,137 unique patients with an index COVID-19 admission during March–July 2020, 15% died during the index hospitalization. Among the 106,543 (85%) surviving patients, 9% (9,504) were readmitted to the same hospital within 2 months of discharge through August 2020. More than a single readmission occurred among 1.6% of patients discharged after the index hospitalization.

The CDC also offered us guidance on avoiding COVID-19 during the Thanksgiving holidays.

The Centers for Medicare and Medicaid Services (“CMS”) released Affordable Care Act medical loss ratio rebate data from the latest health insurer reports for the three year period ending in 2019. The medical loss ratio data is broken out into three cohorts — individual insurance (minimum MLR 80%), small group insurance (minimum MLR 80%), and large group insurance (minimum MLR 85%). Each cohort then is further broken down state by state which no doubt increase the rebates. FEHB plan insurer rebates sensibly are paid to the the carrier’s contingency reserve, which is FEHB lingo for a premium stabilization fund.

Katie Keith in the Health Affairs blog offers her insights into tomorrow’s California v. Texas oral argument before the U.S. Supreme Court. C-SPAN will play the audio live on radio and the internet.

“The main issues to listen for are:

  • “Do the challengers—a coalition of states led by Texas and two individuals—have standing to challenge the ACA?
  • “Is the individual mandate, with a $0 penalty, unconstitutional?
  • “If the mandate is unconstitutional, is it severable from the rest of the ACA? If not, which other ACA provisions should be struck down alongside the mandate?”

Weekend Update

David Ermer–Congress, COVID-19, OPM, SCOTUS, U.S. Healthcare–

The House and the Senate are resuming some Committee work this coming week. The Senate may be conducting floor votes but the House will not resume floor voting until next week. Wednesday November 11 is a federal holiday for Veterans’ Day.

Tuesday morning will feature the oral argument in the latest Affordable Care Act constitutionality case, California v. Texas (No. 19-840). The argument will proceed as follows beginning at 10 am:

  • 30 minutes for California, et al.,
  • 10 minutes for the U.S. House of Representatives,
  • 20 minutes for the Solicitor General, and
  • 20 minutes for Texas, et al. 

Of course, the FEHBlog will be listening to the oral argument and he will report his observations on Tuesday. The FEHBlog enjoys the live audio version of the Supreme Court’s oral arguments because the Justices ask questions in order of seniority following the Chief Justice. If you want to listen in too, here’s a link to C-SPAN website which will send you a reminder if you share your email address.

The Centers for Medicare and Medicaid Services did fix their broken link to the 2021 Medicare premium and cost-sharing changes fact sheet over the weekend. Here’s an active link for your information.

Of course, the Federal Benefits Open Season begins tomorrow and runs through December 14. Good luck to all.

Kaiser Permanente released its third quarter 2020 financial results last Friday.

“Although the pandemic continues to have an impact on Kaiser Permanente, during the third quarter we safely resumed in-person preventive and elective care, started to address the backlog of deferred procedures that were put on hold due to COVID-19, and continued to leverage and grow virtual care for members’ safety and convenience,” said executive vice president and chief financial officer Kathy Lancaster.

NPR Shots offers a useful overview of COVID-19 cases and deaths similar to the CDC and it offers a preview of the Biden Administration’s approach to the pandemic.

On Monday, I will name a group of leading scientists and experts as transition advisers to help take the Biden-Harris COVID plan and convert it into an action blueprint that starts on Jan. 20, 2021,” Mr Biden said last night in a public address.

A Biden spokesperson told NBC’s Meet The Press Sunday that the coronavirus task force will be led by former Surgeon General Dr. Vivek Murthy and Dr. David Kessler, who led the Food and Drug Administration during the 1990s.

“We have to function as one nation. That means having a national plan,” Dr. Murthy, a key adviser to the Biden campaign, told NPR recently.

Friday Stats and More

David Ermer–COVID-19, Medicare, Rx coverage, U.S. Healthcare–

Based on the CDC’s Cases in the U.S. website, here is the FEHBlog’s chart of new weekly COVID-19 cases and deaths over the 20th through 44th weeks of this year (beginning May 14 and ending November 4; using Thursday as the first day of the week in order to facilitate this weekly update):

and here is the CDC’s latest overall weekly hospitalization rate chart for COVID-19:

The FEHBlog has noted that the new cases and deaths chart shows a flat line for new weekly deaths  because new cases greatly exceed new deaths. Accordingly here is a chart of new COVID-19 deaths over the same period (May 14 through November 4).

On the flip side, also according to the CDC, “seasonal influenza activity in the United States remains low.”

Fierce Biotech discusses the progress of a Humanigen investigation new drug called lenzilumab which is undergoing a phase 3 trial.

If the trial succeeds, lenzilumab could emerge as part of the arsenal for treating some of the sickest COVID-19 patients. Lenzilumab may stop cytokine storms, the severe hyperimmune responses that drive organ damage in some COVID-19 patients. Currently, physicians treat such severe patients with steroids and Gilead’s remdesivir, but there remains a need for more efficacious therapies. 

The chances of anti-SARS-CoV-2 antibodies meeting that need have diminished in recent weeks as prospects in development at Eli Lilly and Regeneron have failed in severe COVID-19 patients. Efforts to use existing drugs, notably anti-IL-6 antibodies such as Sanofi’s Kevzara, to stop cytokine storms in COVID-19 patients have also failed. 

In other investigational drug news, the Boston Globe reports that

Biogen Inc.’s experimental Alzheimer’s disease therapy [mentioned in the FEHBlog earlier this week] failed to gain support from a panel of US Food and Drug Administration advisers on Friday, putting the drug at a crossroads as the agency weighs approval.

The outside experts voted 8 to 1, with 2 undecided, that data from a single clinical trial with positive results was insufficient to show Biogen’s drug works. The vote contradicts a report FDA reviewers prepared ahead of the meeting that supported the efficacy of the drug, called aducanumab, though there was dissent in the agency. * * *

The advisory committee’s recommendations aren’t binding. The FDA often calls on panels of experts, including researchers, medical professionals and patient representatives, when it is considering whether to approve a new drug. Wall Street analysts said the FDA seemed set on viewing the drug positively.

“This will be a test for the FDA on what happens when the FDA is on one extreme and the panel is seemingly on the other, with science and evidence or the lack thereof being at the core of discussion,” Mizuho analyst Salim Syed said in an email to Bloomberg News.

At long last (given the fact that the Medicare Open Season stated on October 15), the Centers for Medicare and Medicaid Services this afternoon announced Medicare Part B premiums and Parts A and B cost sharing changes for 2021:

  • The standard monthly premium for Medicare Part B enrollees will be $148.50 in 2021, an increase of $3.90 from $144.60 in 2020.  The fact sheet that would show income adjusted premiums for high earners was unavailable online this evening. Check again here on Sunday.
  • The Medicare Part A inpatient deductible that beneficiaries will pay when admitted to the hospital is $1,484 in 2021, an increase of $76 from $1,408 in 2020. 
  • The annual deductible for Medicare Part B beneficiaries is $203 in 2021, an increase of $5 from $198 in 2020.

CVS Health not only announced third quarter earnings today; it also disclosed that its current CEO Larry Merlo is retiring and Karen Lynch, who currently heads the Aetna business unit, will replace him. Congratulations to both of them. Healthcare Dive adds

CVS’ medical loss ratio was 84%. That’s compared to just 70.3% in the second quarter as consumers deferred non-essential care amid COVID-19.

CVS has now administered more than 6 million COVID-19 diagnostic tests across 4,000 testing sites, representing 70% of all testing done in retail settings, Merlo said.

Health Payer Intelligence discusses how “Blue Cross and Blue Shield of Illinois (BCBSIL) has partnered with hospitals across the state in a new program that seeks to pursue health equity by focusing on mitigating health disparities for racial and ethnic minorities.” Well done.

Thursday Miscellany

David Ermer–ACA, COVID-19, OPM–
Photo by Juliane Liebermann on Unsplash

Not without cause, Katie Keith in the Health Affairs blog provides her thoughts on how Biden’s election will impact the Affordable Care Act “in what otherwise appears to be a status quo election.” Compare your thoughts with hers. Remember that the ACA puts a lot authority in the hands of the Secretary of Health and Human Services often together with the Labor and Treasury Secretaries.

On the COVID-19 front, Healthcare Dive reminds us, not surprisingly, that

Patients overwhelmingly turned to telehealth visits early in the COVID-19 pandemic but skipped out on diagnostic procedures and other preventive and elective care that can only be done in-person, according to a study published Thursday [today] in JAMA Network Open. The number of mammograms and colonoscopies performed in March and April dropped more than 65% compared to the year prior, according to the analysis of more than 5 million commercially insured patients. Overall, healthcare utilization dropped 23% in March and 52% in April. * * *

Researchers looked at insurance claims data from 2018 to 2020 from about 200 employers. Beyond major declines for mammograms and colonoscopies, they found other procedures like musculoskeletal surgery, cataract surgery and MRIs all dropped by 45% or more.

In-person visits to manage chronic conditions dropped too, including blood sugar tests for patients with diabetes, which fell more than 50% in March and April. Chemotherapy treatments dropped 4%. And among children under 2 years old, vaccinations dropped 22%.

Utilization did increase in the third quarter. Fierce Healthcare reports that

Major insurer Cigna reported a rebound in healthcare utilization in the third quarter from massive declines in the second quarter due to COVID-19. Cigna, which posted a $1.39 billion profit in the third quarter, said that healthcare use remains slightly below average when not taking into account costs for COVID-19. The insurer’s performance in the quarter was bolstered by its newly rebranded Evernorth subsidiary.  Cigna executives said that utilization was 95% below normal levels without factoring COVID-19 costs. 

Nevertheless, given the current upswing in COVID-19 cases, it’s unlikely that a lot of catch up preventive care will happen this year. It is incumbent on health plans to help members catch up, in the FEHBlog’s opinion.

In sobering news, the Robert Wood Johnson Foundation helps us look at the impact of COVID-19 on households across our country.

Finally, FedWeek offers upcoming Open Season advice to federal employees and annuitants

Tuesday Tidbits

David Ermer–ACA, COVID-19, Mental health care, U.S. Healthcare–
Thanks to Aaron Burden for sharing their work on Unsplash.

Happy Election Day!

The FEHBlog enjoyed reading this American Medical Association article about the five things that doctors should tell their patients about the COVID-19 vaccines currently under development. This could be good information for health plans to share with their members.

Fierce Healthcare reports that

Nearly half the nation’s hospitals, many of which are still wrestling with the financial fallout of the unexpected coronavirus, will get lower payments for all Medicare patients because of their history of readmitting patients, federal records show.

The penalties are the ninth annual round of the Hospital Readmissions Reduction Program created as part of the Affordable Care Act’s broader effort to improve quality and lower costs. The latest penalties are calculated using each hospital case history between July 2016 and June 2019, so the flood of coronavirus patients who have swamped hospitals this year were not included.

The number and severity of penalties were comparable to those of recent years, although the number of hospitals receiving the maximum penalty of 3% dropped from 56 to 39.

Beckers Hospital Review provides a list of those 39 hospitals here.

Healthcare Dive informs us that

Humana bested Wall Street expectations as it gained more members during the third quarter, generated higher revenue and beat earnings estimates, according to its quarterly results released Tuesday morning.

The payer’s medical utilization continued to trend slightly below pre-COVID levels during the third quarter, though still well above the severe dip in March and April. The lower levels of utilization were partially offset by higher COVID-19 testing and treatment costs as cases began to tick back up.

Executives warned during Tuesday’s call with investors that they expect a loss in the fourth quarter due to a number of issues, including COVID-19 testing and treatment and rebounding utilization.

It’s the last bullet that caught the FEHBlog’s attention.

Finally, Kaiser Health News offers a nice story about seniors forming friendship pods to ward off the loneliness of the great hunkering down.

Monday Roundup

David Ermer–COVID-19, Federal employment benefits, OPM, Uncategorized–
Photo by Sven Read on Unsplash

Well, the 2020 Federal Benefits Open Season starts next Monday, November 9. The FEHBlog has noticed that OPM has launched its Open Season 2020 website and Fedsmith.com has made available the FEHBlog favorite annual benefits administration letter, the description of significant FEHBP changes for 2021. There are a lot of interesting HMO plan changes to review.

The FEHBlog was looking for information about the virtual health fairs that OPM and FedPoint are sponsoring this year for federal employees and annuitants. It turns out that FedPoint is new name for Long Term Care Partners. FedPoint p/k/a LTCP administers the Federal Long Term Care Insurance Program. The company’s press release explains

FedPoint, which has more than 400 full-time employees and many part-time and contracted employees around the country, is a division of John Hancock Life & Health Insurance Company. The new name was chosen in part to reflect the platforms and service centers the company builds and manages, which function as key points where multiple stakeholders converge, interact, and transact business. Perhaps the most notable example is BENEFEDS, a proprietary online platform and call center built under the auspices of the U.S. Office of Personnel Management (OPM). Through BENEFEDS the company handles enrollment, billing, and customer support functions for enrollees in the large Federal Employees Dental and Vision Insurance Program (FEDVIP).

BENFEDS offers a website with information about 2020 Open Season virtual information offerings for FEDVIP and FEHBP customers. (BENFEDS understandably focuses on FEDVIP but if you click on any of the registration tabs you see that the information concerns the FEHBP, FEDVIP, and FSAFeds. NARFE’s Federal Benefits Institute also offers useful benefit webinars for active and retired Feds.

As tomorrow is the big day, the Centers for Disease Control is offering advice to voters on how to control the risk of contracting COVID-19 at polling places. The FEHBlog voted at a Montgomery County, Maryland, early voting center last Thursday and he found the process to be a well-oiled machine. Kudos.

Weekend update

David Ermer–ACA, Congress, COVID-19, Telehealth–

In view of the impending national election on Tuesday, Congress is out of session for the next two weeks except for one Committee hearing on November 10.

On the COVID-19 front –

  • The Wall Street Journal reports about research and medical efforts to address the health problems of so-called COVID-19 long haulers.

Nearly a year into the global coronavirus pandemic, scientists, doctors and patients are beginning to unlock a puzzling phenomenon: For many patients, including young ones who never required hospitalization, Covid-19 has a devastating second act.

Many are dealing with symptoms weeks or months after they were expected to recover, often with puzzling new complications that can affect the entire body—severe fatigue, cognitive issues and memory lapses, digestive problems, erratic heart rates, headaches, dizziness, fluctuating blood pressure, even hair loss.

What is surprising to doctors is that many such cases involve people whose original cases weren’t the most serious, undermining the assumption that patients with mild Covid-19 recover within two weeks. Doctors call the condition “post-acute Covid” or “chronic Covid,” and sufferers often refer to themselves as “long haulers” or “long-Covid” patients.

According to the article, the estimated numbers of long haulers varies “widely.” Nevertheless, [w]ith more than 46 million cases world-wide, even the lower estimates would translate into millions living with long-term, sometimes disabling conditions, increasing the urgency to study this patient population, researchers said. What they find could have implications for how clinicians define recovery and what therapies they prescribe, doctors said.” What’s more, “[o]ther viral outbreaks, including the original SARS, MERS, Ebola, H1N1 and the Spanish flu, have been associated with long-term symptoms.”

  • Last Friday, ” the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Defense (DOD) jointly announced a $12.7 million contract with InBios International Inc., of Seattle, to expand domestic production capacity for two rapid point-of-care tests for SARS-CoV-2, the virus that causes COVID-19. The first, called the SCoV-2 Ag Detect Kit, detects current infections by identifying antigens – genetic material – of the virus in a nose swab sample. The second test, called the SCoV-2 Detect IgM/IgG Kit, detects antibodies for the virus in a finger prick of blood, indicating whether the person had a previous COVID-19 infection. The contract enables InBios to ramp up production of either or both tests to 400,000 units per week – 20 times the facility’s current output – by May 2021, significantly expanding the nation’s testing capacity.

Fierce Healthcare informs us

According to UnitedHealth Group’s fifth annual UnitedHealthcare Consumer Sentiment Survey, which examines Americans’ opinions about multiple areas of healthcare, a survey-record 56% said it is likely they would use virtual care for medical services.  More than a quarter of respondents (26%) said they would prefer a virtual relationship with a primary care physician, the survey found. And when comparison shopping for care, 55% of respondents said they had used the internet or mobile apps to comparison shop for healthcare during the past year, with 1 in 4 patients saying that online or mobile resources were their first option for evaluating health issues.

Follow up on a couple of stories that the FEHBlog has been following:

  • Health Payer Intelligence discusses various angles on the payer transparency rule that the ACA regulators issued last week. That rule is applicable to the FEHBP.
  • A friend of the FEHBlog related that the federal government has noticed an appeal to the D.C. Circuit of District Judge James Boasberg’s September 2, 2020, decision preliminarily enjoining certain provisions of the Trump Administration’s revised ACA Section 1557 rule that adversely affected transgendered people. The government’s 60 day period to notice such an interlocutory appeal would have expired tomorrow.