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Prescription Drug Price Hikes, Pay Raises, Benefits in the 2016 Budget and More

A weekly roundup of pay and benefits news.

These days it’s rare to find a benefits change that will both save the government money and help federal employees. But the Veterans Affairs Department on Wednesday touted a new service that does just that. More than 57,000 veterans are using an online tool that allows them to track the status of their prescription medications requested through the VA Mail Order Pharmacy, the department announced.

The prescription tracker – available through My HealtheVet -- was the idea of VA employee Kenneth Siehr. The tool is designed to save money by cutting down on calls to VA medical centers, and it earned Siehr a Securing Americans Value and Efficiency (SAVE) award in 2013.  

VA is planning further enhancements to the tracker, including images of the medicine being sent and a secure messaging alert to let veterans know when an order is mailed.

“VA prescription refill online is an excellent example of how one employee looked at the process of VA prescription tracking through the eyes of our veterans and came up with an idea that better serves veterans,” said Carolyn M. Clancy, VA’s interim undersecretary for health, in a statement.

Meanwhile, some participants in the military’s TRICARE health insurance program may notice their wallets feel a little lighter than usual after visiting the pharmacy. That’s because co-pays for many prescription drugs increased on Feb. 1.

The price hikes, mandated by the fiscal 2015 Defense Authorization Act, do not apply to drugs purchased from military pharmacies and generic drugs obtained through TRICARE Pharmacy Home Delivery. Those drugs will still be available at no cost to participants.

The co-pays for most other prescription drugs increased $3. Formulary brand name drugs purchased through Home Delivery, which offers up to a 90-day supply, now cost $16, rather than $13; co-pays for non-formulary brand name drugs ordered through Home Delivery went from $43 to $46.

Beneficiaries who fill their prescriptions at in-network retail pharmacies are now paying $8 rather than $5 for generic formulary drugs; $20 rather than $17 for brand name formulary drugs; and $47 rather than $44 for non-formulary drugs. For more information on the new co-pays, visit the TRICARE website.

While an extra $3 here and there can add up, the prescription drug co-pay changes are relatively small compared to possible military health care reforms proposed late last week by the Military Compensation and Retirement Modernization Commission and those outlined in President Obama’s fiscal 2016 budget request.

The commission recommended moving family members, reserves and some retirees out of TRICARE and onto health insurance plans in the private sector, similar to the menu of choices civilian federal employees have under the coverage. Active duty service members would remain in the current health care system, and would receive a basic health care allowance in their paychecks to help pay for their dependents’ health insurance coverage. 

Obama’s fiscal 2016 budget proposed replacing TRICARE by Jan. 1, 2017, with a “consolidated health plan that incorporates cost-sharing for certain members.” And, similar to previous budgets, Obama’s plan called for creating an enrollment fee for new TRICARE for Life beneficiaries and tying TRICARE fees to retired recipients’ income.

The president’s proposal did bear some positive news for military members. It recommended a 1.3 percent pay raise for them, along with a 1.5 percent increase in the basic housing allowance and a 3.4 percent increase in the basic subsistence allowance. 

Civilian federal employees would also receive a 1.3 percent pay hike next year under Obama’s plan. The document – released Monday -- pushes several other fed-friendly benefits changes, including partial retirement and paid parental leave for the birth, adoption, or foster placement of a child. The partial retirement benefit technically exists, but no agency has implemented it yet, and some have said they might never offer it. Phased retirement would allow eligible feds to work 20 hours per week, receiving half their pay as well as half their retirement annuity, while mentoring their successors.

The proposed leave benefit would provide new federal parents with six weeks of paid time off; currently, federal workers can take up to 12 weeks of unpaid leave through the 1993 Family and Medical Leave Act, or tap their accrued sick and annual leave to avoid three months without a paycheck.

One federal employee also wants to improve workplace conditions for new mothers when they do return to work after their leave. A petition published Tuesday on the White House’s We the People website seeks better accommodations for nursing mothers at large federal agencies.

Despite Office of Personnel Management guidelines suggesting that “an exceptional workplace could provide such things as a sink, refrigerator, freezer, paper towels, and disinfecting cleaning supplies” in lactation rooms, many federal mothers “are forced to pump in unsanitary storerooms and janitors' closets,” the petition stated. OPM’s suggested accommodations should be mandatory for large federal worksites, the petition said.

“It is bad enough that mothers are forced to return to work early because of [the lack of] maternity leave legislation,” it states. “At least provide us with good conditions in which to pump and maintain breastfeeding for our children.”

So far it has 181 signatures. It would need to receive 99,819 more by March 5 in order to warrant a White House response.

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