⚠️ 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...
...@USOPM, @USTreasury, @USDOL, and @HHSGov (IFR: Requirements Related to Surprise Billing; Part I).

4⃣ Compounding the problem, @nytimes' @sarahkliff (also cited in the IFR) and @sangerkatz ran with this grossly conflicted @NEJM report, generating deceptive national #media.
5⃣ Even #insurer friendly @BrookingsInst / @SchaefferCenter expert @LorenAdler appears to agree with us, stating, "Suggesting what you would say in the paper, I would say that's not normal."

6⃣ In terms of skewing the #data, UnitedHealth's chief actuary wrote in an e-mail...
..."It should be very good research, however, at present, only UHC data will be used." Need we say more?

7⃣ As #HHS, #CMS, #Treasury, #Labor, #OMB and other #Biden administration officials continue their work on the next #NoSurprisesAct regulations, it is essential that they...
...seriously reconsider this wildly misleading report which has been used by so many -- even including @USCBO to score -- in crafting this enormously consequential mandate. Ultimately, these regs must spell out a *FAIR #IDR* process, which not only treats providers and...
...#insurance companies equally, but also is free of influence by these types of underhanded "research" studies concocted by the nation's most powerful #health insurers.

#conflictofinterest #healthcare #medtwitter #hospitals #doctors #WashingtonDC #fairIDR $UNH @UnitedHealthGrp

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More from @A4Horg

13 Aug
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... Image
...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
25 Jun
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
7 Oct 20
The only way to solve #surprisemedicalbills is with a #fairIDR. But we need to get to the crux of this #SMB issue.

☑️ Everyone agrees to take #patients out of the dispute b/w #insurer & #doctor.
☑️ Everyone agrees to let the 2 parties negotiate the bills if the initial...

1/6
payment is deemed to be unacceptable.
☑️ Everyone agrees that there must be a fall back to a neutral third party (i.e., an #IDR entity).

⭐️BUT, what is disputed is whether this IDR will be a fair process where both sides can equally make their case for what is the most...

2/6
appropriate amount for that non-contracted service OR whether the IDR will be rigged and so unfair that the insurer will always win the dispute.

Many IDR proposals, sadly, are unfair, pointing the IDR to primarily consider the contracted rates #health insurers make up...

3/6
Read 12 tweets
24 Jul 20
📰 Terrific study out this week from @ndpanalytics showing the impact of #Covid_19 on independent #medical practices.

The findings are *staggering*.💥

They not only explain why gov't needs to provide immediate financial #relief to these practices, 1/4 bit.ly/3jASNUZ
Read 4 tweets

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