Fedweek

OPM has issued its annual “call letter” to FEHB carriers, which as in past years stresses cost-control steps, particularly regarding prescription drugs, along with some expansion of benefits. The letter starts the annual process of negotiations between OPM and the carriers that ends in an announcement of new premium rates and specific coverage terms in the fall for the following year. OPM said that despite years of stress on controlling prescription drug costs, “rising drug prices and increasing drug utilization continue to drive up FEHB program premiums. In 2015, 25.5 percent of the total FEHB healthcare budget was spent on drugs. Most FEHB carriers also report a significant increase in drug cost per member per year.” OPM encouraged carriers to strengthen policies aimed at controlling those costs such as restrictions on especially expensive drugs, saying it is “particularly interested in proposals that optimize safe use and evidence based formulary management of drugs for mental health conditions, substance use disorders, immunosuppression, diabetes, HIV, seizure disorders, and cancer.”