Discover and read the best of Twitter Threads about #ourama
Most recents (11)
🎇#FixPriorAuth
🧵”The approval process health insurers impose on medical services or drugs is generating a toll that exceeds the purported benefits, according to a physician survey released today by @AmerMedicalAssn and shared in a letter to federal health officials.”
🧵”The approval process health insurers impose on medical services or drugs is generating a toll that exceeds the purported benefits, according to a physician survey released today by @AmerMedicalAssn and shared in a letter to federal health officials.”
2/ For an infographic of the survey results, please see👇
ama-assn.org/system/files/p…
For more from the @AmerMedicalAssn press release, please read on. #OurAMA
ama-assn.org/system/files/p…
For more from the @AmerMedicalAssn press release, please read on. #OurAMA
3/ “While health insurers claim prior authorization requirements are used for cost and quality control, a vast majority of physicians say authorization controls lead to unnecessary waste and avoidable patient harm.”
#FixPriorAuth
#FixPriorAuth
🧵#OurAMA finds widespread lack of competition in local markets across US where #PBMs provide services to commercial health insurers.
First analysis to examine variations in market shares/competition among PBMs at state/metropolitan levels.
Read: tinyurl.com/bdf8m258
First analysis to examine variations in market shares/competition among PBMs at state/metropolitan levels.
Read: tinyurl.com/bdf8m258
2/ AMA’s competition analysis presents national and local market insight on 5 different #PBM services performed for insurers:
•rebate negotiation
•retail network management
•claim adjudication
•formulary management
•benefit design
Read report here: ama-assn.org/system/files/p…
•rebate negotiation
•retail network management
•claim adjudication
•formulary management
•benefit design
Read report here: ama-assn.org/system/files/p…
3/ @AmerMedicalAssn President @JackResneckMD said:
“The AMA already has serious concerns about #PBM business practices that can have a detrimental impact on patients’ access to and cost of prescription drugs.”
“PBM markets require careful scrutiny…” See👇
“The AMA already has serious concerns about #PBM business practices that can have a detrimental impact on patients’ access to and cost of prescription drugs.”
“PBM markets require careful scrutiny…” See👇
🧵@AmerMedicalAssn & @ahahospitals support Texas suit challenging surprise billing rule provision.
👉 Read: ama-assn.org/press-center/p…
#NoSurprisesAct
👉 Read: ama-assn.org/press-center/p…
#NoSurprisesAct
2/ Press release states:
“Hospitals and doctors strongly believe that no patient should fear receiving a surprise medical bill and that patients should be kept out of the middle of any billing disputes between providers and commercial health insurance companies.”
continued 👇
“Hospitals and doctors strongly believe that no patient should fear receiving a surprise medical bill and that patients should be kept out of the middle of any billing disputes between providers and commercial health insurance companies.”
continued 👇
3/“The AHA & AMA fully support the lawsuit just filed in the United States District Court for the Eastern District of Texas which challenges the government’s August 2022 final rule (tinyurl.com/ycypc2fa) regarding the No Surprises Act’s independent dispute resolution process.”
🧵Clock is ticking.⏰
🔥Patients’ access to care is at risk.
🎇 Congress must act to avert looming cuts to Medicare physician payments: >245 Representatives urge action tinyurl.com/sumadprz
‼️Physician practices face financial peril as 2021 ends: tinyurl.com/5asd4sp9
🔥Patients’ access to care is at risk.
🎇 Congress must act to avert looming cuts to Medicare physician payments: >245 Representatives urge action tinyurl.com/sumadprz
‼️Physician practices face financial peril as 2021 ends: tinyurl.com/5asd4sp9
2/ CMS just released the rule that determines Medicare physician payments.
@AmerMedicalAssn statement:
“While the AMA will thoroughly analyze the 2,400+ page rule, it is a reminder of the financial peril facing physician practices at the end of the year.”
@AmerMedicalAssn statement:
“While the AMA will thoroughly analyze the 2,400+ page rule, it is a reminder of the financial peril facing physician practices at the end of the year.”
3/ “The final rule includes a reduction in the 2022 Medicare conversion factor of about 3.85 percent. The AMA is strongly advocating for Congress to avert this and other looming cuts to Medicare physician payments that, overall, will produce a combined 9.75 percent cut for 2022.”
🧵#OurAMA joined over 400 prominent physician, #healthcare and #technology stakeholder groups on a letter urging Congressional leadership to pass legislation that would permanently continue many of the current #telehealth flexibilities enacted at beginning of the #COVID19 PHE.
2/ @aafp @ACPinternists @FAHhospitals
@ConnectwCare @AmericanTelemed @CTATech @HealthIsMobile @Zoom video conferencing were among the diverse collection of cosigners pushing federal lawmakers to address the impending “#telehealth cliff.”
@ConnectwCare @AmericanTelemed @CTATech @HealthIsMobile @Zoom video conferencing were among the diverse collection of cosigners pushing federal lawmakers to address the impending “#telehealth cliff.”
3/ Expanded #telehealth flexibilities have proven to be a lifeline for countless patients trying to retain access to their physician during the #pandemic.
🧵UHC modifies laboratory designated diagnostic provider (DDP) program
AMA, many state medical associations, & national medical specialty societies expressed strong concerns about the DDP’s impact on physician practices & patients. In response to this advocacy, UHC made changes.
AMA, many state medical associations, & national medical specialty societies expressed strong concerns about the DDP’s impact on physician practices & patients. In response to this advocacy, UHC made changes.
2/ Earlier this year, United Healthcare (UHC) announced the launch of its Designated Diagnostic Provider (DDP) program for laboratory services. To qualify as a DDP, a laboratory must meet certain quality and efficiency (i.e., cost) requirements.
3/ UHC initially presented the DDP as a strict covered/not covered benefit design, under which patients receiving services from a non-DDP laboratory would be responsible for the full cost of the test(s)—even if the lab was in network.
🧵#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
Several initial concerns:
•Way the QPA (median contracted rate) will be determined
•Provisions that ⬆️ admin burden for physicians without patient benefit
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.
As a result, the requirements outlined in the IFR are final & will become effective on September 13, 2021.
1/ @AmerMedicalAssn press release on the urgency to #fixpriorauth:
At the height of the #COVID19 #pandemic, physicians reported being bedeviled by unnecessary, bureaucratic obstacles that the health insurance industry pledged to reduce three years ago.
At the height of the #COVID19 #pandemic, physicians reported being bedeviled by unnecessary, bureaucratic obstacles that the health insurance industry pledged to reduce three years ago.
2/ The data highlights the urgent need for new bipartisan legislation introduced in the House, the Improving Seniors’ Timely Access to Care Act. [TY @RepDelBene @MikeKellyPA @RepBera @RepLarryBucshon for introducing this vital measure.]
[See data here: ama-assn.org/system/files/2…]
[See data here: ama-assn.org/system/files/2…]
3/#OurAMA-conducted survey shows physicians are running into roadblocks because of #priorauthorization, the process of requiring health care professionals to obtain advance approval from health plans before a prescription medication or medical service is delivered to the patient.
1/ Take care to not run afoul of #HIPAA. Lest you risk penalties and jeopardize the patient-physician relationship.
“Protecting information gathered in association with the care of the patient is a core value in health care.” tinyurl.com/45rk8hr4 ama-assn.org/practice-manag…
“Protecting information gathered in association with the care of the patient is a core value in health care.” tinyurl.com/45rk8hr4 ama-assn.org/practice-manag…
1/ @AmerMedicalAssn submitted comments to @CMSGov regarding a NPRM on provider burden reduction and #priorauthorization: tinyurl.com/y5ebobkf
The NPRM cited #OurAMA prior authorization survey data and grassroots website FixPriorAuth.org
The NPRM cited #OurAMA prior authorization survey data and grassroots website FixPriorAuth.org
2/ The rule proposes policies to help make the prior authorization process more efficient and transparent.
The NPRM would require #Medicaid, CHIP, and federally facilitated health exchange plans to:
•Support technology that would convey #priorauthorization requirements
The NPRM would require #Medicaid, CHIP, and federally facilitated health exchange plans to:
•Support technology that would convey #priorauthorization requirements
3/ The NPRM would also require impacted payers to:
•Automate the exchange of supporting clinical data from physicians’ #EHR workflow
•Publicly report data on #priorauthorization programs and comply with processing timeframes
•Automate the exchange of supporting clinical data from physicians’ #EHR workflow
•Publicly report data on #priorauthorization programs and comply with processing timeframes
#Hahnemann is a cautionary tale of for-profit companies plundering a #SafetyNetHospital for a land deal. After speaking with several former physician trainees and the Internal Medicine PD @DaveAizenberg. The stories were disheartening. We must do better. #HahnemannStories 1/
#Hahnemann #tweetorial-In all the talk of policy changes and corporate malfeasance, the personal impact cannot be undersold. One story that needs to be shared is that of Erika Correa (permission given to share her experience). #HahnemannStories #medtwitter #MembersMoveMedicine 2/
Dr. Correa was starting #HemeOnc fellowship orientation at #Hahnemann when the closure was announced on June 26. She was suddenly without a program, funding, or health insurance. She had bought a house in Philadelphia, planning to stay at least 3 more years. #medtwitter 3/
