🧵⁦@AmerMedicalAssn⁩ greatly appreciates the recent action taken by ⁦@USDOL⁩ to help protect patients with a #mentalillness.

dol.gov/newsroom/relea…

#MentalHealth #MentalHealthMatters #MentalHealthParity Image
2/ “The DOL action fining United Behavioral Healthcare & United Healthcare $13.6 million is indicative of the widespread violations by health insurers of state & federal #mentalhealth & #substanceusedisorder parity laws, including the Mental Health Parity & Addiction Equity Act”
3/ @AmerMedicalAssn wrote:

“We urge the @USDOL, as well as the states, to increase efforts to review plans on a regular basis to ensure they are in compliance with MHPAEA and hold them accountable if they are not.”
4/ “The @AmerMedicalAssn is not surprised that your investigation found violations ‘going back to at least 2013.’ United’s failure to comply with the law for patients with #mentalillness and #substanceusedisorders is hardly limited to this action.”
5/ “As the AMA highlighted in our July 24, 2020 letter to the DOL, there is increasing evidence of widespread, frequent violations by many different insurers—but these violations only come to light because of meaningful oversight and enforcement actions.”
6/ “It is deeply concerning that each time regulators investigate, they find violations.

In DE a few weeks ago, for example, regulators announced more than $1.3 million in fines for repeated discriminatory violations of #mentalhealth & #substanceusedisorder parity requirements.”
7/ “At this point in MHPAEA’s existence, there is no reason for health insurers to continue to violate the law—violations that harm patients with #mentalillness and invariably cause considerable harm and suffering, including long-term disability and death.”

#MentalHealthMatters
8/ “The @USDOL’s partnership, moreover, with the New York State Attorney General highlights the importance of state-federal cooperation in conducting meaningful [#mentalhealth and #substanceusedisorder] parity oversight and enforcement.”
9/ “This is one reason why the @AmerMedicalAssn continues to strongly advocate to state regulators at the National Association of Insurance Commissioners to make enforcement [of mental health and substance use disorder parity] a high priority.” @naic
10/ “This includes using proven tools to prospectively measure plans’ compliance, as well as undertake new efforts to improve the equitable provision of care for those with a #mentalillness or #substanceusedisorder.”
11/ “The @AmerMedicalAssn @APAPsychiatric and @ASAMorg have advocated, for example, for ‘enhanced attestation’ to require health plans to demonstrate they have completed the comparative analysis required by MHPAEA before violations harm patients.”
12/ “As part of the AMA’s recommendations to @ONDCP
regarding its 2022 National Drug Control Strategy, AMA urged the Biden Administration to provide the DOL with the necessary resources and make clear that strong parity oversight and enforcement must be of the highest priority.”
13/ “AMA believes that such enforcement is particularly important given that DOL now can require health insurance carriers to submit a comparative analysis that their #mentalhealth & #substanceusedisorder benefits are in parity compared w/ the plan’s medical/surgical benefits.”
14/ @AmerMedicalAssn emphasizes:

“Health plans’ history of more than a decade of noncompliance [with the Mental Health Parity & Addiction Equity Act of 2008] must not be tolerated, & the @USDOL’s leadership in this area is greatly appreciated.”

Read: tinyurl.com/2z3wv863

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More from @MarilynHeineMD

10 Sep
🧵HHS Announces $25.5B in #COVID19 Provider Funding

Administration announced today ⁦@HHSGov through @HRSAgov⁩ is making $25.5 billion in new funding available for physicians and other #healthcare providers affected by the #pandemic.

Details: tinyurl.com/yvw85hyr
2/ Important:

👉 • HHS is also announcing today a final 60-day grace period to help providers come into compliance with their PRF Reporting requirements if they fail to meet the deadline on September 30, 2021, for the first PRF Reporting Time Period.
3/ 👉 While the deadlines to use funds and the Reporting Time Period will not change, HHS will not initiate collection activities or similar enforcement actions for noncompliant providers during this grace period.
Read 5 tweets
4 Aug
🧵#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.”
3/ Expanded #telehealth flexibilities have proven to be a lifeline for countless patients trying to retain access to their physician during the #pandemic.
Read 9 tweets
3 Aug
🧵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. Image
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.
Read 8 tweets
21 Jul
🧵AMA to #Congress:

•Do not extend 2% #Medicare sequester as a spending offset in soon-to-be considered #infrastructure package.

•Do not divert scarce health-related offsets to meet objectives unrelated to healthcare.

Physicians already face steep Medicare fiscal challenges.
2/ AMA expresses “deepening alarm concerning the growing financial instability of the Medicare physician payment system.”

“Not only does Congress seem indifferent to the confluence of fiscal uncertainties confronting physician practices at the end of this year, but…”
3/ “…lawmakers’ pursuit of policies to extend the current Medicare sequester that, in effect, will require physicians and health systems to pay for
hard infrastructure amplifies our ongoing concerns.”
Read 21 tweets
20 Jul
🧵#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
19 May
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.
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…]
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.
Read 18 tweets

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