Marilyn Heine Profile picture
May 27, 2022 6 tweets 4 min read Read on X
🔥A must-read: ⁦@oncologyCOA⁩ report on #PBMs

Some takeaways:

“…PBMs make up an oligopoly of rich, vertically integrated conglomerates that routinely prey on health care practices, providers, and their patients.”
2/ “PBMs have done this by overwhelmingly abusing their responsibility to protect Americans from this country’s drug pricing crisis, instead exploiting the opacity throughout the nation’s drug supply chain to enrich themselves.”
3/ “[The report] explores how the recent levels of consolidation among PBMs and health insurers is adversely impacting #cancer care, fueling drug costs, all while allowing for massive profits for #PBMs and health insurance companies.”
4/ “Examining the most pervasive and abusive #PBM tactics, each section highlights the adverse impact of PBMs on #patients, health care payers (including #Medicare, #Medicaid, employers, and taxpayers), and providers, while also detailing potential solutions.”
5/ “[Solutions] include legislative efforts at both the state and federal levels…regulators (both state and federal) have tremendous tools available to them, that up until this point, have not been widely utilized.”
6/ To read the @oncologyCOA report, “Pharmacy Benefit Manager Exposé: How PBMs Adversely Impact Cancer Care While Profiting at the Expense of Patients, Providers, Employers, and Taxpayers.” please see:
communityoncology.org/wp-content/upl…

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Marilyn Heine

Marilyn Heine Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @MarilynHeineMD

Apr 23
🚨🧵UnitedHealth Group (UHG) issued a press release 4/22 with more info about the Change Healthcare #Cyberattack and the impact of the breach on personal data.

UHG officials have agreed to address any additional questions from the ⁦@AmerMedicalAssn⁩ or the Federation. Image
2/ Please read the UHG press release here:

Send any questions you may have to ama.advocacy@ama-assn.org. AMA will try to get answers from UHG. tinyurl.com/2mcj4uh5
Image
3/ UHG’s press release states its preliminary findings from ongoing investigation & review of data involved in the cyberattack are:

a. Based on sampling of their data, files containing protected health info (PHI) or personally identifiable info (PII) were involved in the breach.
Read 12 tweets
Mar 27
🚨🧵@AmerMedicalAssn 3/26 Update on Change Healthcare cyber outage

❗️Important Survey: How has the cyber outage affected your practice? Help inform AMA advocacy for you. Deadline 3/29 tinyurl.com/9bjca2ft
Image
2/ On March 25, the Department of Health and Human Services (HHS) distributed these resources to assist physicians, pharmacists and hospitals, with the aftermath of the Change Healthcare #cybersecurity attacks.

👉 tinyurl.com/4pjvmpyz
Image
3/ AMA told HHS multiple times that physicians were having difficulty securing info from health insurers about:

-availability of assistance w/payments
-flexibilities from admin requirements
-additional contact info for troubleshooting d/t Change Healthcare cybersecurity attack
Read 8 tweets
Mar 21
🚨🧵@AmerMedicalAssn⁩ Update on Change Healthcare cyber outage:

3/19, @RepMMM @RepRobinKelly + 94 bipartisan Reps wrote @SecBecerra alerting the Admin of ongoing challenges physicians & patients continue to experience as part of the #Cyberattack.

Read tinyurl.com/3jhsssux

Image
Image
2/ 🔴 The letter:

🔺Highlighted the inability of physician practices to file claims and receive payment

🔺Urged @CMSgov to clarify why they issued such stringent repayment terms for advance payments on March 9
@CMSGov 3/ 🔴 The letter also:

🔺Highlighted how many patients are being forced to pay out-of-pocket for many pharmaceuticals and health care services stemming from the cyberattack
Read 7 tweets
Mar 13
🚨🧵 AMA urged ⁦@HHSGov⁩ ⁦@USDOL⁩ & all healthcare system partners to use all regulatory flexibilities to continue supporting physicians & addressing the enormous interruption in physician practice ops caused by CHNG #cybersecurity incident.

tinyurl.com/bdhzj8ef
Image
2/ The letter also asked the Depts to address additional concerns of physicians:

1. Create an inventory of all the health plans that are currently offering advance payments.

2. Ensure all Medicare Administrative Contractors (MACs) and health plans are accepting paper claims.

&
Image
Image
3/ Letter also asks Depts to:

3. Provide more specifies and support for physicians requesting expedited electronic data interchange enrollment to switch claims processing clearinghouses.

4. Automatically apply hardship exemptions for CMS-impacted programs.

&
Read 13 tweets
Dec 19, 2023
🎇🧵High levels of market concentration leaves millions of Americans with limited competitive options for health insurance.

Can harm patients by raising insurance premiums above competitive levels.

⁦@AmerMedicalAssn⁩ identified industry giants with biggest market shares. Image
2/ The 2023 edition of Competition in Health Insurance: A Comprehensive Study of U.S. Markets examined 381 metropolitan statistical areas (MSAs), the 50 states and D.C. and tabulated market shares for the two largest health insurance companies.

👉Report tinyurl.com/347exrrp
3/ The report also analyzed state and MSA-level market concentration according to measures used in current federal antitrust guidelines: tinyurl.com/24phh5jd
Image
Read 13 tweets
Nov 29, 2023
🧵@AmerMedicalAssn released new principles for augmented intelligence #AI development, deployment, and use—“a critical step toward fostering a consistent governance structure for advancements in health care technology.”

👉Read Principles here: tinyurl.com/mrxdunx2
Image
2/ “Building upon current policy on AI, the principles serve as the cornerstone for AMA advocacy on AI and…”

[AMA policy on #AI in health care: ] tinyurl.com/45msttk8
Image
3/ “… the organization's commitment to supporting the implementation of national governance policies that prioritize the development and deployment of #AI in a manner that is ethical, equitable, responsible, & transparent.”

[See also: ] tinyurl.com/23tb2ztn
Image
Read 17 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(