Some New Coverages Outlined

The call letter also is the annual opportunity for OPM to recommend-or mandate-that carriers provide certain types of coverage. As in the past, OPM told the carriers that any additional coverage they wish to offer must be cost-neutral. While not requiring new coverage, OPM stressed to carriers that current trends in the health care industry are to cover certain services not now widespread in the FEHB. These include routine osteoporosis screening for all women age 65 and older and at 60 and older for those at increased risk; and influenza vaccination for those age 50 and older. It also noted that last year it made similar observations about certain other procedures, including colonoscopies, changes in cholesterol screenings and autologous tandem transplants for germ cell tumors and said that carriers who did not incorporate those coverages in 2003 should consider them for 2004. OPM also emphasized consumer education, patient safety and anti-fraud activities, and noted that 2004 plan year brochures will include information about the flexible spending account program that is starting this July. It further said it expects that FEHB carriers will provide benefits for medically necessary services for any covered members who might develop side effects resulting from smallpox vaccinations or any other treatment relating to potential bioterrorist attacks.