health benefits
Theranos lab is a jeopardy to patient safety, says the Government
The Centers for Medicare and Medicaid services has always been vigilant in making judgements about various medical centers across the country and recently they have ruled the Theranos Facility in Newark, California is posing an “immediate jeopardy to the safety of patients”. A letter has been sent to the company in this regard assigning them 10 days to improve the lab and ensure “acceptable evidence of correction”
Theranos lab under scrutiny:
The document lists down a lot of problems and probably the most significant one being the one with the laboratory director. Apart from him, the technical supervisor and the analytic systems of the lab have all been deemed incapable of performing standard procedures. This has all been concluded after the department made inspections in December. There has not been much explanations associated with the discoveries as presented by the department but condition level deficiencies have been the biggest culprits in this regard.
The lab could even lost its certification if it doesn’t take immediate correctional actions and that would mean that the Theranos lab would not be able to perform any tests. CMS can also decide upon fining the lab up to 10 thousand dollars per day.
Even though there are concerns regarding the lab that do need correction, we still feel that they could have been provided with a little over 10 days to make the required changes. The administration of the lab has ascertained that they realize they have made some mistakes and there are some infrastructural changes that are needed but they require some more time to make all the corrections. They have ensured CMS that their efforts are in full flow and they will try their best to meet the deadline but if they don’t, we certainly hope that they get an extension to right their wrong.
Open Season Brings Changes to Federal Health Benefits
Federal employees have until December 14 to add, delete or otherwise change their federal health benefits through the FEHB program.
Open enrollment is also available for qualifying federal employees and eligible family members (children—up to age 26– and spouses). Open enrollment season is the time for employees to make changes to their policies, reduce or add coverage. Individuals who qualify for federal employee health benefits have the option to do one or more of the following:
-Enroll, if not already participating
-Cancel Enrollment
-Change plans
-Change from self only to self and family coverage.
-Change from self and family to self only coverage.
This open season adds a new coverage option for federal employees. In addition to Self Only and Self and Family, employees may also add Self plus One. Self-coverage covers the employee only. Self and Family offers coverage to the employee and qualified family members, which include:
-Spouses (including common law)
-Children under the age of 26 including natural children, legally adopted children and stepchildren
-Most foster children in your care
-Children over the age of 26 who cannot care for themselves due to a mental or physical disability that was present before age 26.
Self Plus One
The new plan, “Self plus One”, provides health coverage for the employee and one family member. The new plan is cheaper than the self plus family and offers a more affordable option for families who do not have children or additional dependents to cover. The self plus one plan was approved in 2013, but does not take effect until January 2016, though interested parties should register before December 14, to qualify for this next year.
Eligibility requirements for the additional family member are the same as the traditional policies. Spouses, children under the age of 26 and individuals with mental disabilities that occurred before the age of 26 may be the additional individual covered under the policy.
Not a Benefit to all Families
A Human Resources Specialist with the Air Force, Erica Cathro, told reporters that some families might see a savings by choosing the self plus one, but not all employees. Employees should look closely at the plans to determine whether this new option will actually save them money. Cathro explained, “The formula used to calculate the government contribution is based on the average of al plan premiums and requires that the Office of Personnel Management calculate a maximum contribution for each enrollment type. If a plan’s premium costs exceed the government allotted contribution for a self only, self plus one or self and family enrollment, the employee must pay the remaining amount.”
Federal employees are encouraged to compare the self plus one plan with self plus family to see if the change will help them.
Any employees who choose to cover their family are responsible for contacting the HR department during the year to update coverage for family members including new children and children aging out of coverage.
Federal employees may also notice chances to the flexible spending accounts. New to this year’s policies include the elimination of a grace period and the addition of an allowable $500 carryover of unused funds. In addition, employees must reenroll for the next year to receive any of their carryover funds.
Unions Seek to Prevent Fed Employees Health Benefits Premium Hike
A few days ago, the U.S. Office of Personnel Management (OPM) today announced premiums for the 2016 Federal Employees Health Benefits (FEHB) Program will rise by an average of 6.4 percent.
OPM is offering a new Self Plus One enrollment type in the FEHB Program that will provide coverage for an enrollee and one designated eligible family member. All FEHB plans will offer a Self Only, Self Plus One, and Self and Family enrollment type beginning in 2016.
On average, enrollees with Self Only coverage will pay $5.50 more each pay period; enrollees with Self and Family coverage will pay $19.61 more per pay period. Those who opt for Self Plus One coverage will pay $8.92 more per pay period than they previously paid for Self and Family coverage. The Government contributes approximately 70 percent of the total cost of a plan’s premium.
“I am pleased that OPM has implemented the new Self Plus One choice for the 2016 plan year. This will give enrollees an opportunity to select coverage just for themselves and their spouse or child,” said OPM Acting Director Beth Cobert.
Federal employee unions including NARFE and NTEU were obviously not as pleased as Director Cobert at the hike in premiums for the health benefits program.
NTEU Seeks Congressional Action to Prevent FEHB Premium Hike
The National Treasury Employees Union (NTEU) issued a statement noting that this 6.4 percent increase in premiums further underscores the need for Congress to act on cost-saving prescription drug contracting and benefit management reforms for FEHB.
OPM attributed the higher rate of increase in large part to increased prescription drug utilization.
“NTEU views prescription drug reforms as an essential way to better control drug spending in FEHBP, which would reduce costs for federal employees and retirees,” NTEU National President Tony Reardon said. “FEHBP enrollees are paying more than they should.”
Specifically, what the NTEU is asking for is support for Rep. Stephen Lynch’s (D-Mass.) legislation—H.R. 2175. The bill would provide OPM with enhanced oversight and contracting authority to ensure that FEHB participants are receiving the best possible drug prices.
The bill also requires that Pharmacy Benefit Managers (PBMs) operate as middlemen to negotiate prescription drug prices with drug companies and pharmacies on behalf of individual FEHB plans, and return any rebates, incentives, and other price discounts obtained from drug manufacturers to FEHB.
