@sonodoc99@mssnytweet@CNBC 2/ @pfizer CEO on @CNBC said that they have 50M doses ready for ‘20 & 1.3B doses scheduled for ‘21 + no negative implications were reported yet the firm does not have visibility into the panel’s specific data set + Pt cohort ranges from 84 to 12 yrs. old....
@sonodoc99@mssnytweet@CNBC@pfizer@BeckyQuick@US_FDA 5/ @pfizer vaccine is a 2 dose regiment & clinical trial data show protection & efficacy after the first dose, w/in a week—sounds like about ~3-4 weeks between 1st & 2d doses. 90% efficacy would be in the range of small pox & much better than the flu.
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...
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....
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
1/ As reported in PoliticoPro –
Trump preparing executive orders on health care this week
By Susannah Luthi, Daniel Lippman, Dan Diamond
09/22/2020 02:51 PM EDT
President Donald Trump is planning to announce a series of executive actions on health care as soon as Thursday...
2/ & one EO is expected to be on #surprisemedicalbilling --been rumored for months & details are not known--last WH idea was outright ban on OON/BB w/ no mechanism for physicians & health plans to resolve $ disputes but Pts would be protected--WH COS Meadows was against ....
3/ benchmarking when he represented Asheville NC in the US House--legal authority of POTUS here very questionable as it relates specifically (but not limited to) to ACA and ERISA plans as those have specific Congressional statutes authorizing same--physicians have been approached
1/ So the #TX health plans--after supporting the solution to #surprisemedicalbilling which passed unanimously--are now pointing fingers--lets consider the facts--1. per the TX Dept. of Insurance (TDI), when clinicians informally settle their dispute before the formal dispute ....
2/ resolution process (IDR), the plans are settling for 4X of the original reimbursement paid; when clinicians go thru the IDR process, the independent dispute adjudicator is awarding >5.3X of the plan's initial reimbursement--based on TDI's report of the 1st 6 months--see charts
3/ So the original plan reimbursements are unreasonably low--one could reasonably conclude--so low that the plans are willing to pay 4X in settlement before IDR--& the Pts are protected & removed from the IDR process--the statutory factors for determining the final $ are strong
@CMSGov issued ‘21 Medicare #Physician Fee Schedule Proposed Final Rule w/ comment period & the news is not good —the Medicare “conversion factor” which applies to physicians & other clinicians is proposed to decline >10.5% in ‘21—happy reading > 1350 pgs cms.gov/files/document…
2/ Major expansion of #telehealth per the press release, details to follow.
3/ major hospital based specialists will be significantly cut in’21 by Medicare in the midst of a global pandemic—@EmergencyDocs -6%, anesthesiologists-8%, radiology -11% and IR -9%. Congress & @CMSGov here they come—Table 90, page 899.
Good luck to my good friend @lukebjensen & @nyempiretennis to take the King Trophy, doesn’t hurt to have #tennis HOF Kim Clijsters pictured here & out of retirement and crushing the ball!
How about Coach Jensens sub of Jack Sock who lit up that mixed doubles final w/ @CoCoVandey who held serve like a true champ at the end!
The Jensen’s now have a second WTT champion coach!!! Congrats buddy!! @CoCoVandey was lights out with everything on line she ripped a winner return of serve—no win by 2 here—the entire came down to 1 point.
Yet another example of perhaps well meaning legislators who do not understand these dynamics rushing to get a really bad bill on #surprisemedicalbilling passed the #MI Senate--HB 4459 is bench-marking in the worst way + no meaningful & accessible dispute resolution; Senate ...
2/ MI Senate consideration in committee is 7/29/20 (last minute move by supporters to push through a bad bill for health plans) so we need groups & docs to do calls to action--physician coalition is multi-specialty & unified in opposition--see below--@MichStateMedSoc@MCEP_NEWS