1/ POTUS Executive Order (EO) is potentially back on & here’s the outline on the terms & conditions—the EO has been drafted—whether he announces it in the Queen's City today & that he’ll sign it is another open issue: #medtwitter
1. The prohibition on surprise medical billing...
1. The prohibition on surprise medical billing...
2/ will be linked to the hospital’s conditions of participation (CoPs);
2. By law, physicians do not have CoPs—hospitals have them—so this may be an immediate potential legal argument against his actions;
3. The EO would pit hospitals against the physicians credentialed....
2. By law, physicians do not have CoPs—hospitals have them—so this may be an immediate potential legal argument against his actions;
3. The EO would pit hospitals against the physicians credentialed....
3/ at the hospital;
4. The concept is “network matching” & was raised during the E&C committee hearings and rejected by the committee as a solution—require that every physician group credentialed by the hospital “match” the hospital’s network of health plans;
5. The hospitals
4. The concept is “network matching” & was raised during the E&C committee hearings and rejected by the committee as a solution—require that every physician group credentialed by the hospital “match” the hospital’s network of health plans;
5. The hospitals
4/ (AHA) in testimony to E&C also rejected network matching as a solution to SMB, because it shifts too much power to the health plans;
6.CMS would have to issue new regs. re: CoPs which would be subject to review & comment—and very likely litigation by physicians & hospitals
6.CMS would have to issue new regs. re: CoPs which would be subject to review & comment—and very likely litigation by physicians & hospitals
5/ @ahahospitals @AmerMedicalAssn @ACEPNow @EDPMA @RadiologyACR @ASALifeline @drdanchoi @fuzzymittens @813JAFERD @Reese_Tassey @amychomd @RichDuszak @reh3md @MGMA @RBMAConnect
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