Congress returns to work on Capitol Hill on Tuesday following the Columbus Day holiday tomorrow.

The Medicare Open Enrollment Period begins on Tuesday October 15 and ends on December 7. This is the period within which Medicare beneficiaries can select or change Medicare Advantage and Medicare Part D prescription drug plans for the 2020 calendar year. The FEHBlog becomes eligible for Medicare on December 1, 2019.

The FEHBlog was expecting to join a Medicare Advantage plan. However, a Medicare expert as well as his internist advised him to join traditional Medicare and add Medicare Part D and Medicare supplemental coverage.  Why? If you don’t like your Medicare Advantage plan, in most states, including the FEHBlog’s state Maryland, you don’t have guaranteed access to a Medicare supplement plan as discussed in this article. In contrast, FEHBP annuitant enrollees can join a Medicare Advantage plan without losing their right to return to the FEHBP as OPM explains here. While you can carry FEHB coverage without picking up Medicare Part B coverage, you can’t enroll for Medicare Advantage unless you have enrolled for Medicare Part B.  Live and learn.

The Fall Take Back Your Prescriptions (unused prescription safe disposal) Day is Saturday October 26. Here’s a link to the Drug Enforcement Administration Day collection site locator. Plans should use their social media to notify members about this valuable opportunity.

As the FEHBlog sits here typing away while the NFL is on TV, the FEHBlog was impressed by the NFL’s new Crucial Catch initiative with the American Cancer Society. The initiative features “The Defender, a new [online] tool that provides personalized tips on how to reduce your risk of cancer.”

Earlier this year, the Department of Health and Human Services proposed to eliminate prescription drug rebates from Medicare and the ACA exchange plans, among others, but not commercial and FEHB plans. The prescription drug manufacturers cheered on this initiative but did not promise to preserve the economic status quo by lowering their prescription drug prices.  HHS backed offed on this initiative because insurers convinced HHS that eliminating rebates would raise premiums. The FEHBlog nearly fell off his chair when he read this BioCentury article:

[The Food and Drug Administration] FDA has completed a draft guidance that would create a legal loophole for drug companies to bypass legal commitments to pay rebates to PBMs and payers. The guidance, which is under review at the Office of Management and Budget, is intended to allow companies to sell drugs at net prices that don’t include rebate payments. 

If and when it is implemented, HHS believes the guidance would enable drug companies to create a parallel market that would function alongside regular supply chains. In this separate channel, imported drugs could be sold at lower list prices to patients who are uninsured or who have large deductibles. 

The guidance could also give companies the ability to free themselves from long-term contracts and negotiate new contracts for distributing drugs through conventional supply chains. 

The scheme, first announced by HHS in a plan released in July, rests on FDA giving the green-light to a sleight of hand trick involving National Drug Codes (NDCs), codes that FDA assigns to drugs so it can track them throughout the supply chain.

Wow.