OPM continues discriminatory medication formulary decisions for FEHBP

flagLast year and this year, I have asked over and over again for some help in getting information about why the OPM is allowed to prohibit common prescriptions based on seemingly gender-centric reasons. There are maybe one or two reasons why these decisions apply to females as well, but the policy language is clear.

In March of 2014, I started asking for a medication which would treat two health problems. In March of 2015, after a year of waiting, I finally got the medication I asked for. Five different doctors sent authorization requests for the wrong diagnosis.

All along in this process I had been told by Blue Cross-Blue Shield that the medication in question was only able to be prescribed for a certain condition and no others. According to them, no medications for “…inadequacy, dysfunction, or sex change…” would be approved, according to the plan approved by the OPM.

I called the OPM several times over the last year.

One of the times I actually got to speak to an OPM employee in the section where these plans are drafted and approved, only for Blue Cross-Blue Shield.  The man I spoke to said he didn’t remember a particular reason for prohibition of this medication, but did remember that things are cut and added to these plans on a cost benefit basis mostly.

Then I tried contacting my U.S. Senator on this issue. This is where the progress stopped.

Next time: OPM has a non-response to the complaint.



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Mark Brooks

Independent Journalist/Photographer --- Retired Land Surveyor originally from Colorado. USN Veteran. Involved as a citizen and journalist in politics and open government locally and sometimes statewide. Interests: photography, music, justice and equality for everyone.

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