Weekend update

Weekend update

Photo by Dane Deaner on Unsplash

Greetings from North Beach, NJ. The FEHBlog will be writing from outside the Beltway for the coming week.

Both Houses of Congress are is session for committee and legislative business this coming week. The House Rules Committee will consider the FY 2021 continuing resolution tomorrow.

The FEHBlog noticed that last week the President nominated OPM’s Acting / Deputy Director Michael Rigas to fill permanently fill his other and more important acting position, Deputy Director for Management at the Office of Management and Budget. It’s too bad that Mr. Rigas was not nominated for OPM Director back in 2017. He certainly has impressed people in the Trump Administration.

The Federal News Network reports that

“Due to the ongoing management challenges that the COVID-19 pandemic presents for our workforce, the Government Managers Coalition believes the federal government would benefit from the establishment of a [permanent] emergency leave transfer program (ELTP) both as a management tool and as a means by which to support our workforce,” the organizations said in a recent letter to Michael Rigas, acting director of the Office of Personnel Management. “An ELTP would be a novel solution, especially for employees with caregiving responsibilities affected by school and daycare closures.” Under an emergency leave transfer program, federal employees can donate unused annual leave to their colleagues who are adversely impacted by a major disaster. Employees who are impacted by a national emergency can apply in writing to become recipients of the donated leave.

This is a good idea for other large and even mid-sized employers.

In other news

  • The Wall Street Journal reports that

When enough people become immune such that the whole community is protected, it’s called herd immunity. Herd immunity can sometimes occur naturally from survivors of the disease within a population, but often not without many deaths. Covid-19 has so far killed close to 200,000 people in the U.S. Epidemiologists believe only a small percentage of the nation has been infected and developed some level of immunity. The introduction of a vaccine can be the quickest, safest way of creating herd immunity, since people can develop immunity without getting the disease.

According to the Great Influenza, the world’s population eventually achieved herd immunity from the 1918 influenza, by a mild first wave of the virus and millions upon millions of deaths from the second wave. Of course, there was no vaccine for the great influenza one hundred years ago.

  • Healthcare Dive informs us that “One year after the first Walmart Health location opened in Dallas, Georgia, the retail giant is moving forward with nationwide expansion of its health superstores.” The FEHBlog is intrigued by Walmart’s healthcare actions.
  • Last week, the Centers for Medicare and Medicaid Services announced that “it has finalized the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model (fact sheet), to improve or maintain the quality of care and reduce Medicare expenditures for patients with chronic kidney disease. The ETC Model delivers on President Trump’s Advancing Kidney Health Executive Order and encourages an increased use of home dialysis and kidney transplants to help improve the quality of life of Medicare beneficiaries with ESRD. The ETC Model will impact approximately 30 percent of kidney care providers and will be implemented on January 1, 2021 at an estimated savings of $23 million over five and a half years.”

Midweek update

OPM Director Nominee John Gibbs (Senate video / Federal Times)

The Senate Homeland Security and Governmental Affairs Committee held a confirmation hearing for OPM Director nominee John Gibbs this afternoon. Here’s are links to Mr. Gibbs’ testimony and a Federal News Network article on the hearing. The Committee will vote on whether to advance Mr. Gibbs’ nomination to the full Senate at a business meeting scheduled for next Wednesday October 16.

The Senate Health Education Labor and Pensions Committee heard testimony today from the NIH Director Dr. Francis Collins and the U.S. Surgeon General Vice Admiral Jerome Adams on the topic of vaccines. U.S. News and World Report highlights an important segment of Dr. Collins’s appearance before the Committee.

AstraZeneca announced on Tuesday that its late-stage [COVID-19] vaccine study was being put on hold due to a “potentially unexplained illness” in one of the participants.

“With an abundance of caution at a time like this, you put a clinical hold, you investigate carefully to see if anybody else who received that vaccine, or any other vaccines, might have had a similar finding of a spinal cord problem,” Collins said.

Those who are concerned about the safety of the approval process should be reassured by the development, Collins said. “If it turns out that that is a real consequence of this vaccine and can be shown to be cause and effect then all the doses that are currently being manufactured for that will be thrown away because we do not want to issue something that is not safe,” Collins said. He added that the U.S. is investing in six vaccine candidates “because of the expectation that they won’t all work, although it would be lovely if they did.”

AstraZeneca was one of the nine drugmakers to pledge on Tuesday to uphold standards for science and safety in their pursuit of a coronavirus vaccine.

Healthcare Finance reports on America’s Health Insurance Plan comments on how health insurers can aid the COVID-19 vaccine distribution process. For example,

Insurers can use their member data to help identify which people meet the criteria to be eligible for the vaccine, according to the best available evidence. Outreach efforts must adhere to patient privacy requirements, AHIP said.

Insurers can coordinate across partners such as public health officials for data sharing regarding their members’ vaccine status, encouraging data to be shared with state or regional databases (Immunization Information Systems).

“Health insurance providers play an important role ensuring that people receive the vaccines that are recommended for them, and have experience conducting outreach to their members to inform them of the vaccines that are recommended for them and how they can get them,” AHIP said. This may include reminders to ensure they receive multiple doses of a vaccine when needed.”

The Health Affairs Blog experts offer five recommendations on how to better integrate telehealth with primary care.

RecommendationsRepresentative Open-Text Survey Responses
Harmonize the reimbursement criteria “Some insurance companies are paying less than in-person visits for telehealth visits from Day 1. Small practices, like usual, have been left to themselves for the most part.”“Primary care is extremely challenging with the constant change in protocols, the uncertainty and enormously confusing insurance schemes.”
Create billing codes or payment models for the additional work required to offer telehealth “Insurance companies not reimbursing telephone visits at a rate that supports the level of work done on a telephone visit.”“Elderly patients have no access or are unable to access virtual – more work, have to teach them how to take BP, some hard of hearing, etc.”“I am more stressed out doing telehealth, as we spend time to fix internet, video, and voice. There are calling issues, so it’s more time consuming.”
Provide coverage for at-home monitoring devices “I need blood pressure cuffs and glucometers covered by insurance for home monitoring.” “I will do tele health… provided patients have equipment.”“Patients lack thermometers, blood pressure cuffs, and pulse oximeters.”
Incentivize the development of and access to, patient- and provider-centered telehealth technology “Telehealth information technology platform is NOT user friendly.”“Difficult to properly diagnose with telehealth. Have been using photos from patients to supplement but still not really sufficient.”“Our patients are low-income with language barriers. Requiring third party interpreter by speaker phone takes extra time and reduces quality of care.”
Review, revise, and communicate telehealth malpractice policies  “I am not going to practice telehealth; it is not reliable and may increase malpractice cases.”“I’m very concerned about being sued for managing the patients over telehealth especially since many are requesting opioids.”“Malpractice premiums are a major barrier for telehealth.”

Source: Authors’ analyses of data from surveys administered to primary care providers in New York City from April to July 2020.

Tuesday Tidbits

The U.S. Office of Personnel Management released its first of four Benefit Administration letters for the upcoming Federal Benefits Open Season which which will run from Monday, November 9, 2020 through Monday, December 14, 2020. Here are links to the BAL, a sample email to employees and a Venn diagram displaying the interlocking aspects of the health, dental, vision, and flexible benefits programs that participate in this Open Season. The FEHBlog expects that COVID-19 public health emergency will tamp down the traditional Open Season health fairs. It will be an interesting experiment to see whether this change impacts the volume of plan changes one way or the other.

In anticipation of FDA approval of COVID-19 vaccine(s), an expert panel formed by the National Academies of Science has issued for public comment draft recommendations for staging an equitable distribution of the vaccines according to a STAT News report. A public hearing on the draft recommendations is scheduled for tomorrow. This report then goes to the Centers for Disease Control which has an Advisory Committee on Immunization Practices. The staging offered in the recommendations makes sense to the FEHBlog, e.g., first responders first etc.

The Wall Street Journal reports that Americans should add strong ventiliation to the Covid-19 prevention toolbox along with mask, social distancing, etc.

After urging steps like handwashing, masking and social distancing, researchers say proper ventilation indoors should join the list of necessary measures. Health scientists and mechanical engineers have started issuing recommendations to schools and businesses that wish to reopen for how often indoor air needs to be replaced, as well as guidelines for the fans, filters and other equipment needed to meet the goals.

There’s a recently renovated office building near the FEHBlog’s offices in downtown DC that has a big outside sign stating that its ventilation services are tops and known to be anti-COVID. The FEHBlog will retry to remember to post a picture of the sign later this week.

Becker’s Health IT discusses a Centers for Medicare and Medicaid Services proposed rule issued yesterday. “The Medicare Coverage of Innovative Technology proposed rule would speed up the FDA approval process for Medicare coverage of new medical technologies. * * * Often referred to as the “valley of death,” for innovative medical tech products, the lag time between the FDA’s approval and Medicare establishing coverage prevents seniors from accessing these new technologies during the coverage determination process.” Ouch.

Speaking of innovation, Econtalk podcast host and economist Russ Roberts speaks this week with author Matt Ridley about his fascinating book titled “How Innovation Works.” Check it out.

In other news

  • EHR Intelligence reports “Following vote in the House of Representatives to remove the bill prohibiting the use of federal funds for the adoption of a national patient identifier (NPI), the Premier Healthcare Alliance and the Patient ID Coalition call on the US Senate to also lift the ban.” Good luck.
  • FYI, here’s a link to Treasury Secretary’s Steven Mnuchin’s testimony before the COVID-19 subcommittee of the House Oversight and Reform Committee. The federal employee press does not suggest that fireworks exploded at the hearing.
  • The Department of Health and Human Services announced today that “The Federal Communications Commission (FCC), HHS, and U.S. Department of Agriculture (USDA) today announced that they have signed a Memorandum of Understanding to work together on the Rural Telehealth Initiative, a joint effort to collaborate and share information to address health disparities, resolve service provider challenges, and promote broadband services and technology to rural areas in America.” Perhaps another silver lining in the COVID-19 cloud.
  • And then another. The HHS Agency for Healthcare Research and Quality explains that

There is evidence that people who receive longer-term treatment with medications for addiction treatment (MAT) have better outcomes. But, keeping people with OUD on MAT is challenging. Now, the COVID-19 pandemic may be making retention of patients in MAT even more difficult.

Fortunately, we can report some good news that should help us fight the opioids epidemic even as we try to maintain safe distance. It appears that people with OUD will stay in treatment when given support remotely as they do in person—a major benefit that appears to be emerging during the COVID pandemic.

Monday Roundup

The Wall Street Journal provides a roundup on the status of the front runners in the race for a safe and effective COVID-19 vaccine. “Nine of these have advanced into Phase 3, which tests whether the dose that would be given to the public works safely.” The Phase 3 candidates fall into one of the following three vaccine approaches

Genetic-code vaccines deliver specific genetic instructions teaching the body’s cells to make a protein from the targeted virus, which in turn induces an immune response. One type incorporates a synthetic, engineered version of messenger RNA, or mRNA. These are molecules in the body that ferry DNA instructions for making immune-inducing proteins. Other gene-based vaccines use DNA itself.

A virus-based vaccine uses a killed or weakened form of the targeted virus to induce an immune response.

Viral vector vaccines use a modified virus different from the targeted virus to serve as a carrier of the vaccine teaching the body’s cells to make a protein from the targeted virus.

Candidates at the Phase 2 trial level are also using a protein-based approach that “incorporates a protein from the virus, or something resembling it, that will trigger an immune response.” The more, the merrier, right?

With respect to other COVID-19 ramifications:

  • Healthcare Dive discusses CDC surveys on the estimated 40% of Americans experienced a reduction in access to healthcare during the great hunkering down while Fierce Healthcare discusses how hospital systems are reacting to the drop.
  • The Healthcare Dive article also points out a “”separate CDC RANDS survey found that nearly 37% of people said their provider now offers a form of telehealth, compared to about 14% who said it was offered before the pandemic” while Health Payer Intelligence discusses what it takes to for health plans to build upon the uptick in virtual care.

In other healthcare news:

  • Fierce Healthcare reports on a new Aetna plan design for mid-sized and large employers in the Kansas City metropolitan area. “While the PPO plan will offer access to many regional providers, CVS’ HealthHubs and MinuteClinics are deeply embedded in the plan design, Aetna said.”
  • The Health Care Cost Institute released a study of its voluminous health plan claims data finding that “commercial [health plan] prices paid for the average professional service were 122% of what would have been paid under the Medicare Physician-Fee-Schedule.” The report looks at this comparison from several different angles.
  • Drug Channel analyzes GoodRx’s decision to make public stock offering. GoodRx offers prescription drug savings to consumers.

In follow up news:

  • Federal News Network reports on another National Finance Center announcement hitting the brakes on its earlier announced plan to implement the President’s August 8 executive order permitting employers to defer payroll taxes for certain employees as early as the first paycheck in September.
  • A Delaware Chancery Court judge, according to Fierce Healthcare, has decided that neither Anthem nor Cigna should receive damages as a result of the 2017 breakup of their planned merger. Hopefully that’s the end of this saga.

Friday Stats and More

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 34th weeks of this year (beginning May 14 and ending August 26; 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:

Note that today, the CDC revamped its COVID-19 websites. Sharp eyed readers will notice the CDC changed the scale on this hospitalization chart since last Friday. In any event, both charts continue to move in the preferred downward direction.

The CDC added a webpage on how regular folks should select, wear and clean their protective masks. It should be helpful for health plans to share this CDC webpage on their own sites.

Also, Medpage Today interviewed Dr. Anthony Fauci about the ongoing development of monoclonal antibodies to treat COVID-19.

Fauci explained how the mechanism of monoclonal antibodies “is really one of a direct antiviral.” “It’s like getting a neutralizing antibody that’s highly, highly concentrated and highly, highly specific. So, the mechanism involved is blocking of the virus from essentially entering its target cell in the body and essentially interrupting the course of infection,” he said. While Fauci noted the success of monoclonal antibodies to treat Ebola, he added that they are not practical for other viruses that only last a day or two, where the virus may already be cleared once the patient receives the treatment. “If you have a disease that’s serious enough and prolonged enough, such as what we saw with Ebola, and what we are currently seeing with COVID-19, then you have enough opportunities to get the monoclonal antibody to actually work,” he added.

The article notes that work also is underway to develop these antibodies as an HIV treatment.

Managed Healthcare Executive News reports on issues that providers are encountering with electronic prior authorization and efforts to resolve those issues. For example,

[Rose] Moore says one of the obstacles to a more streamlined approach to prior authorizations is the lack of uniformity. “There must be greater collaboration between payers and providers to set universal guidelines on requirements, starting with the high-volume, low-complexity procedure types that consume the greatest administrative cost across the healthcare continuum,” says Moore.

That should be resolvable.

Finally, Govexec.com reports that “The government will begin deferring withholding payroll taxes for federal employees [beginning September 1] to fulfill a memorandum President Trump issued earlier this month, according to a notice from one of its payroll processors.” Because the executive order cannot and does not waive these taxes permanently, this action will get Congressional attention.

Thursday Miscellany

The Wall Street Journal reports “The Trump administration unveiled Thursday a $750 million deal to buy 150 million rapid Covid-19 tests from Abbott Laboratories, a move that would substantially expand the nation’s capacity for rapid testing.” As noted in yesterday’s post, this $5 antigen test, which received Food and Drug Administration emergency use authorization on Wednesday, ” is roughly the size of a credit card. The test could be administered in a doctor’s or school nurse’s office and uses technology similar to home pregnancy tests. It returns results in about 15 minutes.”

While on the subject of COVID-19 testing, Fierce Healthcare informs us that

Out-of-network costs for COVID-19 testing far outpace the costs for in-network tests, according to a new report from America’s Health Insurance Plans. The results suggest that price gouging is a significant problem under the pandemic, the group argues. The AHIP analysis finds that a test for the novel coronavirus costs on average $130 for commercial insurers. However, out-of-network providers charged more than $185 for 40% of diagnostic test and 25% of antibody tests, the lobby organization found.

Shameful. Congress should step in on this one.

In encouraging developments,

Fierce Biotech lets us know that

As the world scrambles to develop diagnostics, treatments and vaccines for COVID-19, one big question looms: How will we face the next pandemic? Johnson & Johnson and the U.S. Biomedical Advanced Research and Development Authority (BARDA) are teaming up once again to answer that.

Through a joint effort dubbed Blue Knight, the duo aims to boost innovation and “amplify” scientific and technological advancements to prepare for potential health threats—starting with COVID-19. They’ve picked seven startups from J&J’s global JLABS network to participate. The startups will receive up to $500,000 in support, as well as mentorship from BARDA and J&J to help them navigate R&D challenges and regulatory pathways and get medicines and tools to patients and healthcare workers as soon as possible.

and Healthcare Dive reports that

Aetna is partnering with WellBe Senior Medical, a relative newcomer, to deliver primary care services to about 10,000 high-risk seniors in their homes, according to WellBe CEO Jeff Kang, who is also a physician. The program launched in Atlanta last month and is now available for certain seniors in the Chicagoland area. For eligible seniors, this means access to at-home care 24 hours, seven days a week, lessening the burden of getting a ride to an appointment or venturing to a medical facility amid the pandemic. Even COVID-19 testing can be done in their homes. Aetna assigns eligible high-risk patients to WellBe, which is then responsible for managing their care and receives capitated payments from Aetna. Those eligible are typically seniors in their 80s with multiple chronic conditions, including diabetes, heart failure, osteoarthritis and dementia, Kang said in an interview with Healthcare Dive.

There are plenty of elderly annuitants in the FEHBP although most of them have primary Medicare coverage.

Finally in Office of Personnel Management new:

Office of Personnel Management acting Director Michael Rigas [considerately] has issued a new memorandum to agency heads Aug. 27 informing them that [under a new regulation] employees will no longer have to pre-schedule their annual leave prior to the third pay period before the end of the year, so that the agency can then cancel and restore it. [A]ny leave that is forfeited at the end of the year due to a national emergency where the employee was deemed essential and not able to take leave would automatically be considered “scheduled in advance” and restored into a separate leave account for later employee use.

and Govexec.com updates us on the upcoming Combined Federal Campaign. This annual charity drive for federal employees runs from Sept. 21 through Jan. 15, 2021.

Thursday Miscellany

The FEHBlog generally writes his posts at home in the evening, and he has been noting when it has been raining in Bethesda as it has been quite a rainy summer. This evening features blue skies (although it did rain this morning.)

On the COVID-19 front, the Department of Health and Human Services announced today

combined investments of $6.5 million in two commercial diagnostic laboratories to expand capacity to conduct up to 4 million additional SARS-CoV-2 per month. SARS-CoV-2 is the virus that causes COVID-19. The investments in Aegis Sciences Corporation and in Sonic Healthcare USA will provide critical laboratory equipment supplied by Beckman Coulter Life Sciences and Thermo Fisher Scientific and increase staffing and infrastructure to allow the U.S. to perform an additional 1 million tests each week by early October.

The American Hospital Association, the American College of Surgeons, and other major provider organizations have updated their roadmap for performing essential surgeries during the COVID-19 emergency. This may be helpful to health plan utilization review units.

A Wall Street Journal op-ed piece points out that

More than 500 clinical trials are under way world-wide in the race to find an effective treatment for Covid-19. Everybody wants it; nobody has it—yet. But one of the most promising therapies for Covid-19 patients uses “medicinal signaling cells,” or MSCs, which are found on blood vessels throughout the body.

In preliminary studies, these cells cut the death rate significantly, particularly in the sickest patients. With a powerful 1-2-3 punch, these cells eliminate the virus, calm the immune overreaction known as a cytokine storm, and repair damaged lung tissue—a combination offered by no other drug. This type of regenerative medicine could be as revolutionary as Jonas Salk’s polio vaccine.

Here’s a link to a STAT News report on newly released information on a study of convalescent plasma to treat COVID-19. Something has to pay off soon, right?

In general prescription drug news, GoodRx lists the twenty most expensive medicines in the U.S. The list identifies the manufacturer assistance program associated with each drug.

In other healthcare news —

  • Becker’s Hospital Review reports that UnitedHealthcare is resuming its COVID-19 delay effort to stop sending paper benefit checks to network providers. UHC plans to rely entirely on electronic payments. Smart move.
  • The Affordable Care Act provided government funding to create new CO-OP health plans. The FEHBlog criticized the decision as unnecessary. At on point there were 23 CO-OP plans and OPM was enlisting them for their ACA create Multi-State Program (“MSP”). ThinkAdvisor informs us that the New Mexico Co-op plan is shutting down at the end of this year which will leave three Co-ops operating in Maine and the Midwest. The MSP similarly failed because it was over-complicated and unnecessary.

Midweek Update

FCW.com reports that “The Senior Executives Association, which represents members of the Senior Executive Service and other federal mangers, is looking for sweeping change to the government’s human resources organization and practice.” Here’s a link to a the SEA’s report titled “Transforming the Governance of Federal Human Capital Management.” Of note, check out their recommendation for the OPM group that manages our beloved FEHBP:

The Healthcare and Insurance enrollment function should be assessed to determine if there would be benefits to reengineering and/or outsourcing. The federal government already does this with its vision and dental program (FEDVIP), which is administered by BENEFEDS. Reengineering should, as needed, focus on customer service and cost savings through efficiency. The nation’s largest employers, such as Walmart, outsource their benefits administration, as do most private-sector organizations. Once reengineering is complete, service level agreement and transactional cost ratios should be established. OPM could then explore if it is an appropriate candidate for outsourcing. If it is determined that outsourcing is more effective, OPM should maintain policy oversight and HC data ownership and control.

It’s not the first time that the FEHBlog has heard this recommendation made.

On the innovation front —

  • The FEHBlog was wondering today what was going on with his preferred candidate for COVID-19 treatment, convalescent plasma. Wonder and you shall receive for the Wall Street Journal advises tonight that

The Food and Drug Administration is nearing a decision to authorize emergency use of antibody-rich blood plasma from recovered Covid-19 patients for treating people infected with the coronavirus, people familiar with the matter said. The authorization could come as soon as next week, according to the people, though the agency could also decide to delay a decision. The designation could open the way for faster and wider access to one of the most promising treatments for Covid-19 patients. Only a Gilead Sciences Inc. antiviral drug known as remdesivir [currently] carries the designation.

  • Employee Benefit News informs us that

CVS Health is expanding their voluntary benefits to tackle mental health and anxiety treatment with a new digital offering.

The company added Daylight, an app that uses cognitive behavioral therapy techniques to combat anxiety, to its Point Solutions Management lineup. Both employer clients and CVS employees will have access to the app.

CVS looked to one of its existing partners — Big Health, the makers of the digital sleep benefit, Sleepio — for its newest offering. Daylight uses AI to make personalized recommendations on therapy exercises for users experiencing anxiety and stress.

On the Medicare front —

  • The Centers for Medicare and Medicaid Services announced today that “The average basic Medicare Part D premium will be $30.50 in 2021. The 2021 and 2020 average basic premiums are the second lowest and lowest, respectively, average basic premiums in Part D since 2013. This trend of lower Part D premiums, which have decreased by 12 percent since 2017.” Of course, Medicare Part D covers outpatient prescription drugs.
  • Forbes reports that

Americans who depend on Medicare Part B are accustomed to a yearly cost increase for their coverage. The Senate Republican proposals for a second stimulus package would freeze 2021 Medicare Part B premiums at 2020 levels. Negotiations between Republican and Democratic leaders continue in Congress, with multiple potential provisions for a second stimulus package on the table. Both sides have indicated they would like to pass a new stimulus bill before Congress departs for a month-long break on Aug 7.

In other news —

  • The Department of Health and Human Services (“HHS”) released today the HHS Secretary’s Report on Addressing Surprise Billing. Here’s Healthcare Dive’s take on the report. “HHS on Wednesday prodded Congress to pass legislation that bans surprise medical billing but did not take on stance on the best method to do so or endorse any particular bill.”
  • HHS also released “a new report showing the dramatic utilization trends of telehealth services for primary care delivery in Fee-for-Service (FFS) Medicare in the early days of the coronavirus disease 2019 (COVID-19) pandemic. The report analyzes claims data from January through early June.” Here’s is Healthcare Dive’s take on that report. “Almost half — 43.5% — of all Medicare primary care visits were being conducted through telehealth in April. That’s up from just 0.1% in February.” Wow.
  • Finally, Federal News Network informs us that

Four months after Congress approved a $10 billion loan for the Postal Service under the CARES Act, the Treasury Department and USPS leadership have struck a deal on the terms of that loan. According to the terms of the loan, released by top Democrats in the House and Senate, USPS has agreed to give Treasury access to its biggest negotiated service agreements with industry partners. The Postal Service will have access to the loan to fund operating expenses until March 27, 2022, but Treasury won’t advance any of the funds if USPS has a cash balance of more than $8 billion. In addition, USPS has agreed to give Treasury monthly reports on its cash flow and year-over-year changes in volume for its major lines of business, as well as changes in revenue and expenses.

Friday Stats and More

For the third week in a row, new COVID-19 cases have topped 300,000 (nearly 1 million in total) while the number of new deaths remains relatively low and stable (12,000 in sum over the past three weeks) according to the CDC’s cases in the U.S. website which the FEHBlog tracks.

Axios echos the FEHBlog’s sentiment that the medical profession to its credit has learned how to treat COVID-19. That is what you would expect in 2020. Hopefully the government is doing a good job providing healthcare resources to hot spot areas in order to facilitate treatment. In that regard, HHS announced today that “it will begin distributing $10 billion in a second round of high impact COVID-19 area funding to hospitals starting next week.”

In our FEHBP world —

  • Federal News Network reports that OPM has issued new proposed rules to address enrollment problems that arose during the long government shutdown in the winter of 2018-19. Hopefully we won’t encounter another one of those unfortunate events again, but it is better to be safe than sorry. Several of the new flexibilities are already law thanks to a law that Congress passed in 2019.
  • OPM also released today a revised SF 2809 FEHB enrollment form. The form is a handy reference for FEHB enrollment rules. It’s not used as often as it was pre-internet and smart phones.

Finally, the Trump Administration enjoyed two victories in the U.S. Court of Appeals for the D.C. Circuit today. As Healthcare Dive reports

  • The Court of Appeals affirmed a lower court decision upholding the Administration’s short term duration health plan rule. The FEHBlog sees no harm in giving consumers greater choice of health care coverage after Congress zeroed out the individual mandate.
  • The Court of Appeals reversed a lower court decision and thereby upheld the Administration’s Medicare “site neutrality” rule that “reduced some payments to off-campus hospital outpatient departments to make them consistent with other outpatient payments.” The court reasoned that

“Reducing the payment rate for a particular OPPS service readily qualifies, in common parlance, as a ‘method for controlling unnecessary increases in the volume’ of that service,” according to the opinion. “The lower the reimbursement rate for a service, the less the incentive to provide it, all else being equal. Reducing the reimbursement rate thus is naturally suited to addressing unnecessary increases in the overall volume of a service provided by hospitals.”

Makes perfect sense to the FEHBlog.

Monday roundup

The Wall Street Journal seeks to answer a question that the FEHBlog has been pondering — “Scientists Hoped Summer Temperatures Would Tamp Down Covid-19 Cases. What Happened?” “There are three likely reasons, public-health and infectious-disease experts said. They have to do with the current [relatively low] levels of immunity in the population, how the virus is transmitted [by respiratory droplets] and how people behave [/fail to follow public health guidance].” Oh well.

The Hill reports that “The two main health insurance lobbying groups, America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association, wrote a letter to congressional leaders on Friday making a [wide] range of requests for the next coronavirus response package, expected later this month.” Check it out.

HHS’s Substance Abuse and Mental Health Services Administration today finalized a revised 42 CFR Part 2 rule intended to better facilitate coordination of patient care. Part 2, which dates back to 1975, applies to substance use disorder patient records held by certain federally assisted health care providers. Here is a link to the FAQs on the final rule. The next time that SAMHSA revises this rule it will do so to align the rule with the generally applicable HIPAA Privacy Rule in accordance with the CARES Act. The statutory deadline for this action is March 27, 2021.

Fedsmith offers an article discussing whether federal annuitants with FEHB coverage also should elect to purchase Medicare Part prescription drug coverage. Here is OPM’s guidance:

Part D: There is a monthly premium for Part D coverage. Most Federal employees do not need to enroll in the Medicare drug program, since all Federal Employees Health Benefits Program plans will have prescription drug benefits that are at least equal to the standard Medicare prescription drug coverage. Still, you may want to be aware of the benefits Medicare is offering, so you can help others make informed decisions. If you have limited savings and a low income, you may be eligible for Medicare’s Low-Income Benefits. For people with limited income and resources, extra help in paying for a Medicare prescription drug plan is available. Information regarding this program is available through the Social Security Administration (SSA). For more information about this extra help, visit SSA online at www.ssa.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).