tag:blogger.com,1999:blog-261073102009-07-14T22:31:34.955-04:00An Ermer & Brownell PLLC service providing Federal Employees Health Benefits Program and general health benefits law and policy information -- but not legal adviceDavid Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.comBlogger817125tag:blogger.com,1999:blog-26107310.post-69570453115426681192009-07-14T22:01:00.002-04:002009-07-14T22:31:30.314-04:00

It was a big day on Capitol Hill as the House leadership introduced H.R. 3200, its 1,018 page long America's Affordable Health Choices Act of 2009. The House fact sheets are available here. Business Insurance explains thatUnder the proposal, employers would have to pay 72.5% of the premium forindividual coverage and 65% of the premium for family coverage. In addition,health care plan enrollees

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-69868945388053189962009-07-13T22:17:00.003-04:002009-07-13T22:43:07.794-04:00

Modern Healthcare reports that the House healthcare reform bill will be introduced tomorrow. “It is our plan to introduce legislation tomorrow,” [House Speaker Nancy] Pelosi said, adding that it won’t be the final product, but rather a version that could still be shaped as it goes through the committee process. “It’s just the beginning.” The Wall Street Journal notes that "With few Republicans,

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-46467268609017780552009-07-12T15:46:00.002-04:002009-07-12T16:22:01.078-04:00

The AP reports that this afternoon that "President Barack Obama's overhaul of the nation's health systems is unlikely to be completed by the White House's August deadline, lawmakers said Sunday as Congress turns its attention to other priorities." such as Senate consideration of Judge Sotomayor's nomination to the Supreme Court. Meanwhile Modern Healthcare reports thatHouse Ways and Means

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-53845966980219485902009-07-09T21:48:00.002-04:002009-07-09T22:01:29.173-04:00

The AP reports that the a group of Democrats (wisely in my view) is urging the House leadership to slow down on the health care reform initiative. "The emerging bill [in the House] 'lacks a number of elements essential to preserving what works and fixing what is broken,' 40 members of the Blue Dog Coalition of moderate to conservative Democrats wrote in a letter to party leaders. To win their

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-23921256167328324572009-07-08T21:36:00.003-04:002009-07-08T21:49:01.882-04:00

The House Federal Workforce Subcommittee held a hearing today on a bill (HR 2517, S. 1102) that would extend FEHBP coverage to federal employees. The Subcommittee chairman, Rep. Stephen Lynch (D Mass.) and OPM Director John Berry, among others, expressed support for the bill. OPM suggested several technical corrections to the bill in Director Berry's testimony.Govexec.com reports that a Senate

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-50736410213082838352009-07-05T15:24:00.003-04:002009-07-05T18:40:18.673-04:00

Congress returns from its Fourth of July holiday this week and attention again will turn to health care reform. The San Francisco Chronicle has provided a useful chart comparing the House Tri-Committee proposal, the Senate Health Education Labor and Pensions Committee proposal, which was updated on July 1, and the Senate Finance Committee proposal, which is the only one of the three to seek

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-71529554941079316082009-07-01T21:32:00.002-04:002009-07-01T21:53:06.137-04:00

CMS announced proposed Medicare Part B physician reimbursements changes for the 2010 calendar year. The principal change is that physician administered drug costs will be pulled out of the RBRVS reimbursement (I'm not sure how those expenses will be reimbursed). According to the Hill, While legislation is needed to prevent a [Medicare] cut [in Part B physician reimbursement] in next year’s rates,

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-51648935296186338082009-06-30T22:00:00.003-04:002009-06-30T22:28:19.054-04:00

According to an Institute of Medicine press release, A new report from the Institute of Medicine recommends 100 health topics that should get priority attention and funding from a new national research effort to identify which health care services work best. It also spells out actions and resources needed to ensure that this comparative effectiveness researchinitiative will be a sustained effort

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-36197067983891977062009-06-28T16:43:00.002-04:002009-06-28T17:13:42.709-04:00

Reuters reports that The White House weighed in last week on the competing legislative proposals to create a regulatory pathway for bio-similar (or bio-generic drugs). The White House recommended to the House leadership that a seven year period of patent protection for brand name biologic drugs would provide an adequate return on the invested capital. The biologic drug manufacturers have been

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-63046685838396502502009-06-25T22:31:00.004-04:002009-06-26T11:32:50.293-04:00

Rep. Danny Davis (D Ill) has reintroduced his bill (HR 2978) to increase the maximum age for dependent children under the FEHBP from 22 to 25. The bill has been referred to the House Oversight and Government Reform Committee.The Federal Workforce Subcommittee of that House Committee has scheduled a hearing for July 8, at 2 p.m., on the bill (HR 2517) that would extend FEHBP coverage, among other

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-31356701792067833412009-06-24T21:40:00.002-04:002009-06-24T22:11:00.702-04:00

The Federal Workforce Subcommittee of the House Oversight & Government Reform Committee held a hearing on FEHBP prescription drug benefits this afternoon. I had expected the hearing to focus on a recent GAO report on the cost of specialty drugs to FEHBP members. Instead, the Chairman, Stephen Lynch (D MA) was interested in exploring the transparency of prescription benefit manager contracts and

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-6953446406640589122009-06-21T15:50:00.003-04:002009-06-21T20:20:31.569-04:00

House Federal Workforce Subcommittee Chairman Stephen Lynch announced last week that on June 24 at 10 am, his subcommittee will hold a hearing on the cost of specialty drugs in the FEHB Program. The GAO recently issued a report on this topic. Specialty drugs are typically injected biologics rather than chemicals in pill form. The Pharmacy Times reported on February 1, 2009, that Looking ahead,

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-19208828296803175642009-06-17T20:28:00.002-04:002009-06-17T20:53:02.680-04:00

Taking his cue from Secretary of State Hillary Clinton, the President extended certain non-statutory fringe benefits to same sex domestic partners, including voluntary long term care insurance and allowing employees to use sick leave to care for those domestic partners and their children. The President also reiterated his call for the repeal of the federal Defense of Marriage Act which prohibits

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-48580860676956797112009-06-16T22:18:00.002-04:002009-06-16T22:38:36.812-04:00

Senate Finance Committee Chairman Max Baucus is holding off on the release of his healthcare reform bill until he can get his funding problems straightened out according to the Politico. Business Insurance similarly reports that House Democrats are struggling to find a way to fund this initiative. Meanwhile, Congressional Republicans, according to CNN.com, continue to pitch their more modest

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-79177092944650858862009-06-14T22:03:00.003-04:002009-06-14T22:56:01.217-04:00

The OPM Inspector General's semi-annual report to Congress for the period ending March 31, 2009, is posted here. This report discusses the Inspector General's audits of FEHB plans and his anti-fraud efforts against providers and others.OPM published in the June 11 Federal Register its list of medically underserved states for 2010. There was no change from 2009. This action is required in order to

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-22315163781945898802009-06-11T21:53:00.003-04:002009-06-11T22:26:27.548-04:00

Today was a good day because I enjoy having my opinions vindicated.First, the New York Times reported that the American Medical Association opposes the inclusion of a public option in the reformed health care system. Common sense at last. The public option as envisioned by Sen. Kennedy would eclipse the private health insurance market and impose low Medicare level pricing on providers who

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-26527958694233573322009-06-09T21:30:00.002-04:002009-06-09T22:00:58.280-04:00

I heard Princeton Prof. Uwe Reinhardt speak yesterday at a Society of Actuaries meeting in Toronto, Canada, which is a nice city.Prof. Reinhardt supports the President's healthcare reform initiative. He does not believe that a single payer system will work in America because Americans do not have the same favorable attitude toward government that Canadians do. (But see this op ed from today's

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-7008875027238171862009-06-07T08:07:00.002-04:002009-06-07T08:15:37.025-04:00

The FEHB Program's enrollment is about 50% federal and USPS annuitants. Consequently, it's significant that according to the Federal Times, "Military and federal retirees, disabled veterans and others receiving inflation-adjusted federal benefits should not expect to see any increase this year, according to a new Congressional Budget Office estimate."On Thursday, the House of Representatives

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-29454522368885905532009-06-04T21:50:00.003-04:002009-06-04T22:18:11.093-04:00

According to the White House blog, the President spelled out his health reform vision yesterday in a letter to Senators Ted Kennedy and Max Baucus. His letter talks about his support for universal coverage , for establishing a health insurance exchange similar to the FEHBP except that unlike the FEHBP the health insurance exchange would include a public plan option, and hold down Medicare

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-76102582996693249912009-06-01T21:49:00.002-04:002009-06-01T21:54:05.679-04:00

Following up on last month's meeting with President Obama, the American Medical Association, the American Hospital Association, America's Health Insurance Plans, Phrma, and more sent the President a letter with more detailed suggestions on bending the health care cost curve. Also today, the GAO released a report on FEHB plan member cost sharing for specialty or biologic drugs. The PBM trade

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-4695796495955427032009-05-31T17:47:00.004-04:002009-06-02T16:56:52.547-04:00

Word of Senate Health Education Labor and Pensions Committee Chairman Ted Kennedy's healthcare reform proposal leaked last week, and the New York Times promptly and in my view understandably reported yesterday that Kennedy's plan is at odds with the bipartisan plan under development by Senate Finance Committee Chairman Max Baucus. The New York Times reported that As a starting point for his bill,

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-49848260429358076242009-05-27T21:33:00.002-04:002009-05-27T21:58:44.873-04:00

Govexec.com reports that OPM Director John Berry said today that "his longer-term goals include moving aggressively to control costs in the Federal Employees Health Benefits Program." That objective is easier said than achieved, particularly given the demographics of the FEHB Program. Because the federal government offers generous retiree benefits, half of the Program's four million enrollees

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-39483668733813529562009-05-26T21:25:00.005-04:002009-05-30T11:05:26.576-04:00

President Obama today nominated U.S. appellate judge Sonia Sotomayor to the Supreme Court seat being vacated by Justice Souter. I can tell my answering service to stand down. Also the FEHBlog notes that the good Judge authored the U.S. Court of Appeals for the Second Circuit's decision in the Empire Healthchoice Assurance Inc v. McVeigh, 396 F.3d 135, case which the Supreme Court ultimately

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-80140930361374669162009-05-24T17:23:00.003-04:002009-05-25T18:45:45.465-04:00

Happy Memorial Day weekend, everyone.Following up last Thursday's post, the AP expanded on Senator Baucus's health care reform comments to report that "the health overhaul would cover nearly everyone _ 94 percent to 96 percent of the population _ but not undocumented workers. The current system covers 86% according to the same article. Also the American Hospital Association weighed in with Sen.

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0tag:blogger.com,1999:blog-26107310.post-47293383507026599302009-05-21T21:00:00.002-04:002009-05-21T22:17:56.778-04:00

According to the Hill, Senate Finance Committee chairman Max Baucus is predicting 75% to 80% chance of passing health reform this year. I think that the chances of health care reform are high, and President Obama certainly has learned from his Secretary of State's mistakes in 2003, but it is risky to count your chickens before they hatch. I am puzzled by the fact that the Medicare trustees'

David Ermerhttp://www.blogger.com/profile/11841542810249024908noreply@blogger.com0