Action for Health Profile picture
Jan 31 8 tweets 30 min read
NEW: Many congratulations to @texmed, @AdamCorley, & @TxRadSociety on launching their *fourth* #NoSurprisesAct #lawsuit against @HHSGov, @CMSGov, @USTreasury, & @USDOL.

This filing challenges the government's decision to impose a 600% increase in administrative #IDR...

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...fees and the requirement to batch by the same #CPT code.

⏰ Time is running out, and #regulators must be compelled to stand up and operate a fully-functioning, fair, accessible, & *timely* IDR process, just like the law prescribed.

(2/2)

#NSA #fixitnow #badreg #IDRE

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More from @A4Horg

Jan 20, 2022
⚖️ LEGAL LOOKOUT 1: We’ve read with interest the amicus brief below filed by 24 health policy experts in the @texmed v. @HHSGov lawsuit, as we filed one, too.

Without any further digging, though, we can see off the bat that a majority of the so-called experts who signed

(1/8) ImageImageImage
onto this brief are funded by the #insurance industry.

We respect and cherish the fact that everyone party to a significant #policy debate like this one over #regulatory implementation of the #NoSurprisesAct has a voice.

But, a question to @RonaldKlain, @SecBecerra, and

(2/8)
@BrooksLaSureCMS: How can you reconcile the fact that the administration’s #regulations rely on these bankrolled academics and experts while also claiming that these regulations help #patients and our #healthcare system? This is an alternative reality.

(3/8)
Read 19 tweets
Aug 13, 2021
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...
...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
Aug 11, 2021
⚠️ 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...
Read 19 tweets
Jun 25, 2021
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
Oct 7, 2020
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

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