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Marilyn Heine

@MarilynHeineMD

8 Sep

@AmerMedicalAssn

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

dol.gov/newsroom/relea…

#MentalHealth #MentalHealthMatters #MentalHealthParity

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”

@AmerMedicalAssn

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.”

Read 14 tweets

Marilyn Heine

@MarilynHeineMD

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.

@aafp

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

Marilyn Heine

@MarilynHeineMD

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.

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

Marilyn Heine

@MarilynHeineMD

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

Marilyn Heine

@MarilynHeineMD

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

@HHSGov

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

Marilyn Heine

@MarilynHeineMD

19 May

@AmerMedicalAssn

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.

@RepDelBene

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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