Discover and read the best of Twitter Threads about #nosurprisesact

Most recents (10)

1/ Ironic that in the latest "shake-down" of #NC physicians @BlueCrossNC starts out by saying that they are a "non-profit" seeking to drive down "the costs of delivering healthcare." Let's look at their CEO comp. in '20--$3.14M + 8 of their execs. received at least $1.33M in.....
2/ compensation in '19; you may remember back in Nov. '21, citing to the #NoSurprisesAct, #NCBlue demanded that 54 hospital based groups immediately agree to contract rate reductions in the range of -5% to -30% or face contract termination--thought the letter was "fake news".....
3/ and it wasn't as an NC practice manager who knew the BCBSNC VP who signed the letter called him & said "is this for real?" Yes it was, said the VP; anyway the latest iteration of @BlueCrossNC w/ 60-70% of the commercial market using it's oligopoly power is cited below; for....
Read 6 tweets
⚖️ LEGAL LOOKOUT 1: We’ve read with interest the amicus brief below filed by 24 health policy experts in the @texmed v. @HHSGov lawsuit, as we filed one, too.

Without any further digging, though, we can see off the bat that a majority of the so-called experts who signed

(1/8) ImageImageImage
onto this brief are funded by the #insurance industry.

We respect and cherish the fact that everyone party to a significant #policy debate like this one over #regulatory implementation of the #NoSurprisesAct has a voice.

But, a question to @RonaldKlain, @SecBecerra, and

(2/8)
@BrooksLaSureCMS: How can you reconcile the fact that the administration’s #regulations rely on these bankrolled academics and experts while also claiming that these regulations help #patients and our #healthcare system? This is an alternative reality.

(3/8)
Read 19 tweets
If you'll indulge me, I'd like to do an end-of-year 🧵highlighting the incredible work by colleagues @KFF.
Here's a sample of the health policy & COVID analyses this year by @KrutikaAmin @matthew_t_rae @NirmitaPanchal @nishakurani @emmawage @gio_j_ramirez & @JaredOrtaliza (1/10)
2/ Looking at OECD data, @JaredOrtaliza @gio_j_ramirez @VenkSathees and @KrutikaAmin found the pandemic set back life expectancy far more in the U.S. than in similarly large/wealthy nations.
Life expectancy of Hispanic and Black Americans was set back most
healthsystemtracker.org/chart-collecti…
3/ Sadly @KrutikaAmin found that not only did the U.S. experience some of the worst excess death rates overall in 2020, we also saw many more young people die than did peer countries. Again, this is in part due to racial disparities, as more POC died young
healthsystemtracker.org/brief/covid-19…
Read 10 tweets
@ZachJonesForTX @mass_marion 1/ Zach--where do I begin? 1. For those thinking that the #NoSurprisesAct is about out of network (OON)/balance billing (BB)--maybe 3-6% of a hospital based group--sorry--it's all about in network rates; the vaulted @USCBOcostest calculated that the Energy & Commerce bill in '19.
@ZachJonesForTX @mass_marion @USCBOcostest 2/ would "save" ~$20B over 10 yrs. BUT 80% of that savings would come from the declination in network rates; my opinion you say? Actually no--last week @BlueCrossNC wrote to over 50 physician groups in #NC citing the NSA and NC state law--groups in Rad., Anesthesia & EM--and....
@ZachJonesForTX @mass_marion @USCBOcostest @BlueCrossNC 3/ demanded (and we have letters to support the same) between -5% to -20% in current participation agreements (cuts rumored to be as high as -30%) else #BCBSNC would consider terminating the agreement b/c the #NSA & the #QPA as calculated would permit "interim reductions".....
Read 11 tweets
We issued the following statement this a.m. on the @UHC-@zackcooperYale-@Yale #surprisemedicalbill "research" scandal.

Read here ➡️ conta.cc/3lZWcjP

To ensure that forthcoming #NoSurprisesAct regs are implemented fairly and to protect #patients nationwide, we will...
...continue to shine a bright light on this trickery.

According to our President Christopher Sheeron, "We have long believed that this #Yale study, and several others that have shaped this debate over the past several years, was blatantly concocted out of the public eye by...
...insurers. Rose Adams' unveiling of this nasty truth is welcomed enthusiastically by #patients, #hospitals, #physicians, and many others who are sick of the #health #insurance industry's dirty tricks.

"As regulators at #HHS, #CMS, and other federal agencies continue...
Read 17 tweets
⚠️ GROSS COI REVEALED: In an extraordinary and fantastically written investigative report, @theintercept's @rose_n_adams unveils how @UHC co-opted @zackcooperYale's #surprisemedicalbill study, all while #Congress embraced it as "academic" and "unbiased" work to write #SMB law.
1⃣ This lays bare how #UnitedHealth has manipulated #surprisebill "research" to enrich itself at the expense of all #patients and the frontline #medical providers risking their lives over the past few years of #Covid.

2⃣ The study was foundational in the #SMB debate, and...
...Congress was duped. We believe that Congressional #investigations are now warranted by the #House and #Senate #Judiciary Committees. @HouseJudiciary @JudiciaryDems

3⃣ This work from Prof. #Cooper and his @Yale team was cited *10 TIMES* in the first #regulation issued by...
Read 19 tweets
🧵#OurAMA issues initial summary of “Interim Final Rule (Part 1) Implementing Certain Provisions of the #NoSurprisesAct.”

Several initial concerns:
•Way the QPA (median contracted rate) will be determined
•Provisions that ⬆️ admin burden for physicians without patient benefit Image
2/ July 1 @HHSGov @USDOL @USTreasury (Tri-Agencies), @USOPM released an IFR with comment period tinyurl.com/smenwxk4 implementing many provisions of the #NoSurprisesAct signed into law as part of the Consolidated Appropriations Act, 2021 COVID-19 relief bill.
3/ Given statutory timeframes required under the NSA & the pending implementation of most provisions by January 1, 2022, the Departments made the decision to issue an IFR.

As a result, the requirements outlined in the IFR are final & will become effective on September 13, 2021.
Read 12 tweets
With new regulations on #SurpriseBills expected to drop momentarily, a reminder that about 1 in 5 emergency visits results in an out-of-network charge, putting patients at risk of surprise bills healthsystemtracker.org/brief/an-exami…
Even for childbirth -- something patients have months to prepare for, and it's common for new parents to even go on TOURS of hospitals in preparation for -- 1 in 10 in-network hospitalizations comes with an out-of-network charge healthsystemtracker.org/brief/surprise…
Soon, most surprise billing practice should stop with implementation of the No Surprises Act.

But there are holes in these protections, particularly for ground ambulance rides (which are exactly the sort of situations patients feel powerless in). healthsystemtracker.org/brief/ground-a…
Read 12 tweets
MUST READ: *Terrific* letter to @SecBecerra, @SecYellen, and @SecMartyWalsh signed by 97 Members of Congress and spearheaded by @RepTomSuozzi and @RepBradWenstrup.

They urge @HHSGov, @USTreasury, and @USDOL to not only reflect congressional...

➡️ hanys.org/communications…
...intent in their rulemaking by ensuring a balanced process to settle payment disputes between #health plans and providers, but also ensure an #IDR process that captures the unique circumstances of each billing dispute and does not cause any single piece of information to be...
Read 11 tweets
@HouseCommerce (Chair Pallone/ Ranking Widen) released #NoSurprisesAct 7/9/19 & #healthplans could not happier: 1. Median contracted rates pegged to ‘19 initially as benchmark—watch out below for the low ball offers this yr; 2. Benchmark adjusted for CPI-U (thx? For what?) ....
(2) Pt cost sharing is this weird form of federalism—the lesser of what the Pt would pay under state law, e.g. CA (125% of CMS) or calculated on median K rates (did I say the health plans are still on a bender from last night over this bill?); 3. 1 of the broadest bans on #OON ..
(3) OON ban includes ED care + any facility care if faculty is In Network services + if there’s no par provider & if the service was the result of unforeseen medical needs + Pt consent & cost estimate for OON service must be 72 hours pre service; does not apply to ERISA plans ...
Read 5 tweets

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