Fedweek

OPM has said that as medical issues related to the pandemic evolve, the FEHB program will change with it and in the meantime it is asking carriers to look into mental health among other considerations that have arisen in the past year.

“During the COVID-19 pandemic, OPM and FEHB carriers have worked together to ensure that all FEHB enrollees have equitable access to diagnostic tests, therapeutics, vaccines, and telehealth coverage,” it said in its call letter to carriers in preparation for the 2022 plan year.

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“OPM will continue to work with FEHB carriers to help safeguard the health of FEHB members, provide necessary COVID-related coverage and address issues of health and social inequity to prevent and remedy differences in COVID-19 care outcomes […] OPM will issue further guidance as prevention and treatment methodologies evolve,” it said.

It said that self-quarantine, isolating, shelter-in-place and social distancing have had an impact on all Americans, “but especially persons suffering from mental and behavioral health conditions such as depression, anxiety, or substance use disorders (SUDs). For many with these conditions, forced isolation can further exacerbate the condition and, for those in recovery for SUD, can be a powerful trigger to relapse.”

“OPM strongly encourages FEHB carriers to focus on the provision of mental health benefits by continual monitoring of both provider access and availability. FEHB carriers should contract with providers who ensure care coordination during transitions (e.g. movement of patients between levels of care, at hospital discharge). FEHB carriers should leverage ongoing telehealth expansion to address provider shortages while educating members regarding the availability of these services,” it said.

OPM also strongly encouraged carriers to “continue to improve access and reimbursement for integrated mental health, substance use and primary care services. Carriers are also expected to address in their plan proposals what stigma reduction strategies they will be using, such as enhanced provider and member education.”

OPM last fall said that the pandemic somewhat eased the upward pressure on premiums for the 2021 plan year because enrollees were postponing care out of concerns about going into medical offices. A recent IG report found decreases in screenings and other preventive treatments for that reason, raising warnings about the potential health impacts.

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2021 Federal Employees Handbook