Happy National Employee Benefits Day!

The Office of Personnel Management issued a proposed rule that would amend its Federal Employees Benefits Acquisition Regulation to update certain marketing provisions for the self plus one option and its contract clause matrix. The comment deadline on this proposed rule is May 2, 2019.

The Labor Department released frequently asked questions on the recent federal district court decision torpedoing the agency’s association health plan rule.

The FEHBlog does expect Congress to enact laws this year concerning surprise billing and prescription drug pricing, In this regard, the Wall Street Journal reports today that

“A push to curb surprise medical bills has found support among both Democrats and Republicans on Capitol Hill but also ignited a fight within the health-care industry over how far the federal government should go in regulating prices,” and 

“Smaller profit from the sale of generic drugs is squeezing the two biggest U.S. pharmacy chains, with Walgreens Boots Alliance Inc. joining rival CVS Health Corp. in lowering earnings goals for the year.”

Also the majority and minority leaders of the Senate Finance Committee issued a press release challenging prescription benefit managers to hold down the price of insulin for people with diabetes.

Last month, the senators sent letters to Eli Lilly, Novo Nordisk and Sanofi, the three largest insulin manufacturers in the United States, kicking off their bipartisan investigation into insulin prices.

In their letters today to the PBMs, the senators wrote, “while manufacturers set the list price for insulin, pharmacy benefit managers (PBMs) play a critical role in the pricing of insulin on which people living with diabetes depend…As the primary negotiators for government payers, commercial insurers and individual employers, PBMs are in a unique position to leverage their size to lower drug prices.”

As consumers face rising bills at the pharmacy counter, it is unclear whether PBMs are appropriately leveraging their power for the benefit of taxpayers and patients, especially patients who take multiple or high-cost medications,” the senators continued.

Next week PBM executives will be testifying before this Committee.