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Federal Retiree Weighs Whether To Keep FEHB Or Switch To Medigap. By Michelle Andrews October 8, 2012. Comptroller General OF THE UNITED STATES OPM Should Promote Medical Necessity Programs For Federal Employees’ Health Insurance This is GAO’s third report calling for the Office of Personnel Management to pay more. To establish a consistent assessment system that includes objective performance standards, OPM has developed the FEHB Plan Performance Assessment. This assessment incorporates a discrete set of quantifiable measures to examine. We want to ensure that this contributes to healthy outcomes for Federal employees and their families. Federal agency personnel, particularly Employee Assistance Program (EAP) staff, represent an important front line in our effort to do this. In this memo, we want to offer information and assistance to you and your EAPs, enlist your support, and encourage your suggestions. We need your help. At the White House Conference on Mental Health held on June 7, 1. President Clinton directed the Office of Personnel Management (OPM) to achieve mental health and substance abuse parity in the (FEHB) Program for contract year 2. Subsequent to the President's directive, OPM issued its annual policy guidance letter for the year 2. FEHB health plans on April 1. Our letter directed health plans to provide network parity coverage for all diagnostic categories of mental health and substance abuse conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV). We encouraged health plans to manage mental health and substance abuse care in order to expand coverage cost effectively. FEHB Program Carrier Letter All FEHB Carriers U.S. Office of Personnel Management Healthcare and Insurance. Population Health and Wellness – OPM continues to focus on programs and benefits that. We required that coverage be made available for services to treat all DSM IV diagnoses to the extent that the services: are included in authorized treatment plans; delivered in accordance with standard protocols; and meet medical necessity determination criteria Parity in the FEHB Program means that coverage for mental health, substance abuse, medical, surgical, and hospital services will be identical with regard to traditional medical care deductibles, coinsurance, copays, and day and visit limitations. Historically, health plans have applied higher patient cost sharing and shorter day and visit limitations to mental health and substance abuse services than they did to services for physical illness or injury. Beginning January 1, 2. We anticipate that FEHB health plans will implement these benefit enhancements in a variety of ways. Fraud and Abuse: Stronger Controls Needed in Federal Employees Health Benefits Program GGD-91-95: Published: Jul 16, 1991. Publicly Released: Jul 24, 1991. Federal employees.1 Specifically, the Federal Employees Health Benefits (FEHB. 1 Urban Indian organizations carrying out programs under title V. Some health plans will use the services of managed behavioral health care organizations (MBHO) and their networks of providers, while others will manage their own provider networks. Since your front line EAP personnel are involved in the initial assessment of conditions and treatment referrals, they play a vital role in achieving healthy outcomes for Federal employees and their families. Your EAP personnel, who already have relationships with FEHB health plans and their MBHOs, need to work closely with those organizations so that they can effectively coordinate the changes that will occur at the beginning of the 2. They need to be certain that they are up to date on their local health plans' benefits, network entry procedures, authorization processes, care transition procedures, and telephone systems to facilitate appropriate referrals. OPM's Office of Insurance Programs will work with FEHB health plans to educate Federal enrollees and their families on this parity initiative through a multi- faceted approach using enrollment guides, brochures, and web sites. Your EAP personnel will be able to access health plan brochures that contain plan benefits, procedures and phone numbers on the FEHB web site at www. November. The web site also will have other information on parity including a set of questions and answers that will explain our approach. Smooth coordination between your EAPs and FEHB health plans will enable Federal enrollees and their families to get the care they need when they need it. This will benefit our workforce by improving health outcomes, providing financial protection, and reducing employee absences and disabilities. Please share this memorandum with your EAP personnel and encourage them to participate fully in our upcoming communication and education efforts. Their participation is vital to our success. They may contact Mike Kaszynski, Policy Analyst, Insurance Policy and Information Division, through email at mwkaszyn@opm. The point of contact for EAP matters is Frank Cavanaugh, EAP Program Manager, Office of Workforce Relations, at ftcavana@opm. We would like to thank you for your help in implementing this important initiative. Attachment. Attachment. Mental Health and Substance Abuse Parity. Introduction. At the White House Conference on Mental Health held on June 7, 1. President Clinton directed OPM to achieve mental health and substance abuse parity in the FEHB Program by contract year 2. Achieving parity means that your Plan's coverage for mental health and substance abuse must be identical with regard to traditional medical care deductibles, coinsurance, copays, and day and visit limitations. We recognize that there are a variety of benefit design approaches that can meet this standard. This letter sets out the elements that we anticipate will be present in your proposal for introduction of parity in the 2. We look forward to working cooperatively with you to implement this initiative. Background. For the past several years, we have negotiated changes to improve mental health and substance abuse benefits in the FEHB Program. At our 1. 99. 8 and 1. We stated then and in subsequent discussions that we expect your proposals for 2. We also provided you with extensive information about this initiative at our carrier conference in October 1. To help us develop more specific guidance for implementing parity in the FEHB Program, we contracted with the Washington Business Group on Health (WBGH) for a report on the practices of other large employers. WBGH assembled a group of eight employers who provide parity or near parity benefits in their health plans and collected information from them on best practices and potential pitfalls. They analyzed and synthesized the approaches of the participants and provided recommendations to OPM in a report published March 1. We sent you a copy by email. The text also is available on both the OPM and WBGH web sites. The OPM web site is www. The WBGH web site is www. The report helped us immeasurably to clarify issues and refine our approach. Delivery Systems. The overriding goal of parity is to expand the range of benefits offered while managing costs effectively. Based on studies by the National Institute of Mental Health, the Substance Abuse and Mental Health Services Administration, and others, we believe that you can deliver parity coverage cost effectively in a fully coordinated managed behavioral health environment. We anticipate that your parity benefit proposals will likely encompass an appropriate care- management structure. For Plans that currently provide unmanaged fee- for- service or point of service mental health and substance abuse benefits levels that are below those for medical benefits, you may continue to offer these benefits, but you must also provide in- network benefits that meet the parity standards. However you choose to provide parity benefits, access to providers of care should be consistent with the intent of the . They can establish networks of providers for you and manage network services using treatment plans and care coordinators. Alternatively, they can manage the care delivered by your existing network providers. If you decide to contract with a MBHO, please include in your selection criteria such factors as accreditation by an independent organization. If you do not choose to use an MBHO, we still encourage you to consider approaches such as gatekeeper referrals to network providers, authorized treatment plans, pre- certification of inpatient services, concurrent review, discharge planning, case management, retrospective review, and disease management programs. We will be looking for proposed strategies that will expand access to services and mitigate the cost impact of doing so. We also expect you to develop benefit packages that will make effective use of available treatment methods. Since much successful treatment for mental health and substance abuse conditions is now being delivered through alternative modalities such as partial hospitalization and intensive outpatient care, we encourage a flexible approach to covering a continuum of care from a comprehensive group of facilities and providers. The experience of other purchasers has shown that in order to manage care effectively, access should be available 2. While the prudent layperson standard will continue to apply to mental health and substance abuse as well as medical emergencies, this level of access can ensure that care is rendered in settings that are most appropriate and cost effective. Full coordination of care between primary care physicians and behavioral health providers and networks can also improve both outcomes and cost effectiveness. Discharge planning should assure that inpatient treatment is followed by appropriate outpatient care. Coordination of care is especially important for patients with multiple diagnoses. Covered Services. You must provide coverage for clinically proven treatment for mental illness and substance abuse. We expect that will include all categories of mental health and substance abuse conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) to the extent that the services for these conditions are included in authorized treatment plans. Treatment plans should be in accordance with standard protocols, and meet medical necessity determination criteria. You may limit parity benefits when patients do not substantially follow their treatment plans. However, you must continue to provide medically necessary services to stabilize the patient during acute episodes. As before, you are not required to cover services that are currently covered and paid for by public entities, such as state or local government or schools. 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