Marilyn Heine Profile picture
Physician Leader. Tenacious Advocate. Enthusiastic Mentor. Champion for physicians, patients, public health, and the patient-physician relationship.
Sep 22 7 tweets 3 min read
🧵⁦@AmerMedicalAssn⁩ & ⁦@ahahospitals⁩ support Texas suit challenging surprise billing rule provision.

👉 Read: ama-assn.org/press-center/p…

#NoSurprisesAct 2/ Press release states:

“Hospitals and doctors strongly believe that no patient should fear receiving a surprise medical bill and that patients should be kept out of the middle of any billing disputes between providers and commercial health insurance companies.”

continued 👇
Sep 16 7 tweets 5 min read
🧵👏👏 TY ⁦@RepBera⁩ ⁦@RepLarryBucshon⁩ for introducing HR 8800, the “Supporting Medicare Providers Act of 2022.”

This would give critical support to physicians who, w/release of the proposed rule for the 2023 Medicare Physician Fee Schedule, again face payment cuts. 2/ Read: Across-the-board Medicare physician pay cuts are wrong way forward

ama-assn.org/practice-manag…
Jun 6 7 tweets 6 min read
🔥 Congress is rushing to push through a bill that recklessly expands scope of practice.

Tell #Congress vote NO on H.R. 6087.

•Threatens patients’ health & safety,
•Leads to ⬆️ health care costs
•Does little to expand access, particularly in rural & underserved areas. Image 2/ Vote NO on H.R. 6087:

@CongBoyle @RepBrianFitz @CongressmanGT @RepMeuser @RepJohnJoyce @RepDwightEvans @RepDean @RepHoulahan @RepSusanWild @GReschenthaler @MikeKellyPA @RepConorLamb @mgs @USRepMikeDoyle @RepCartwright @RepFredKeller @RepScottPerry 
@RepSmucker
May 27 6 tweets 4 min read
🔥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.”
May 25 9 tweets 4 min read
🧵⬆️ evidence that insurer-imposed authorizations for drugs & medical services can be a hazardous & burdensome administrative obstacle to patient-centered care.

Yet “…health insurer industry continues to show apathetic or ineffectual follow-through on mutually accepted reforms” Image 2/ “Prior authorization requirements should be selectively applied to physicians based on demonstrated adherence to evidence-based guidelines and quality measures, according to the consensus statement.” But happens in only 9%. Image
Apr 28 9 tweets 5 min read
🧵 ⁦@AmerMedicalAssn⁩ Prez ⁦@GeraldHarmonMD⁩ stated:

An investigation by ⁦@OIGatHHS⁩ “into the inappropriate use of #PriorAuthorization by Medicare Advantage plans uncovered information that mirrors physician experiences.”

Read report: oig.hhs.gov/oei/reports/OE… 2/ “Surveys of physicians have consistently found that excessive authorization controls required by health insurers are persistently responsible for serious harm when necessary medical care is delayed, denied, or disrupted.” #FixPriorAuth

See 2021 survey: ama-assn.org/system/files/p…
Dec 10, 2021 4 tweets 2 min read
🧵👏👏Patients & Physicians Grateful for #Congress Fending Off #Medicare Cuts

“These automatic cuts should remind members of the needed reforms. Congress can get a head start on doing the right thing when it reconvenes early next year.”

AMA statement: tinyurl.com/2wtbarfc 2/ Last evening, the Senate passed legislation to halt Medicare physician payment cuts that were scheduled to take effect on January 1. President Biden is expected to sign the bill into law.

Highlights of the physician payment provisions include the following: 👇
Dec 9, 2021 16 tweets 6 min read
🧵⁦@AmerMedicalAssn⁩ ⁦@ahahospitals⁩ representing physicians, hospitals, and health systems sued the federal government today over the misguided implementation of the federal surprise billing law, No Surprises Act. The final rules jeopardize access to patient care. 2/ The associations are joined in the suit by plaintiffs including Renown Health, UMass Memorial Health and 2 physicians based in North Carolina.

The lawsuit challenges a narrow but critical provision of a rule issued on 9/30/2021 by @HHSGov @USDOL @USTreasury.
Dec 2, 2021 8 tweets 6 min read
🧵New report from ⁦@AmerMedicalAssn⁩ documents UNPRECEDENTED changes in #Medicare spending as people decided to delay or forgo #healthcare services during onset of #COVID19 pandemic.

👉Read tinyurl.com/2uhu4vv5

🎇Warrants urgent action by Congress to stop Medicare cuts Image 2/ Despite a mid-year rebound after sharp declines early in the year, Medicare spending on physician services during 2020 NEVER RECOVERED to its pre-pandemic trend.

Struggling physician practices face a difficult and precarious road to recovery.

tinyurl.com/358y86bx
Dec 2, 2021 7 tweets 4 min read
🧵Statement from ⁦@AmerMedicalAssn⁩:

🔥Congress fails patients and physicians on Medicare cuts

“Physicians have warned #Congress for months about the pending and perilous Medicare cuts coming on January 1.”

@SpeakerPelosi @GOPLeader @SenSchumer@LeaderMcConnellImage 2/ “Yet, the end of the year is quickly approaching and it is clear that #Congress is not prioritizing support for the nation’s health care providers who have been on the front lines of the #COVID19 #pandemic.”
Nov 3, 2021 6 tweets 6 min read
🧵Clock is ticking.⏰

🔥Patients’ access to care is at risk.

🎇 Congress must act to avert looming cuts to Medicare physician payments: >245 Representatives urge action tinyurl.com/sumadprz

‼️Physician practices face financial peril as 2021 ends: tinyurl.com/5asd4sp9 Image 2/ CMS just released the rule that determines Medicare physician payments.

@AmerMedicalAssn statement:

“While the AMA will thoroughly analyze the 2,400+ page rule, it is a reminder of the financial peril facing physician practices at the end of the year.”
Nov 3, 2021 7 tweets 5 min read
🧵@AmerMedicalAssn⁩ wrote to ⁦@RepBarragan⁩ ⁦@RepLBR⁩ ⁦@RepLarryBucshon⁩ ⁦@RepYoungKim⁩ in support of HR 4217, “Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act of 2021”

#maternalhealth Image 2/ If passed, the bill would create a task force on maternal #mentalhealth which would identify, evaluate, make recommendations to coordinate & improve federal responses to maternal mental health conditions, create a national strategic plan for addressing mental health disorders.
Oct 23, 2021 12 tweets 8 min read
🧵A bipartisan pair of congressional physicians ⁦@RepBera⁩ ⁦@RepLarryBucshon⁩ is leading a major effort urging House leadership
@GOPLeader⁩ ⁦@SpeakerPelosi
to avert impending #Medicare payment cuts that add up to a reduction of nearly 10% effective Jan. 1. 2/ More than 245 other representatives from both parties in a letter asking House leadership to provide financial sustainability for physicians and help maintain access to care.

Read: bera.house.gov/sites/bera.hou…
Sep 10, 2021 5 tweets 3 min read
🧵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.
Sep 8, 2021 14 tweets 9 min read
🧵⁦@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”
Aug 4, 2021 9 tweets 7 min read
🧵#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.”
Aug 3, 2021 8 tweets 3 min read
🧵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.
Jul 21, 2021 21 tweets 6 min read
🧵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…”
Jul 20, 2021 12 tweets 5 min read
🧵#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.
May 19, 2021 18 tweets 10 min read
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…]
May 17, 2021 5 tweets 3 min read
1/ New report from ⁦@AmerMedicalAssn⁩ provides:

•Detailed look at official US healthcare spending estimates through 2019 using data from ⁦@CMSGov
•Preliminary estimates of 2020 health spending from ⁦@Altarum

ama-assn.org/system/files/2… 2/ •Health spending was 17.7% of GDP in 2019 and increased by 4.6% to $3.8 trillion ($11,582 per capita).
•Spending in hospital care (6.2%) and prescription drugs (5.7%) grew faster than physician services (4.2%) in 2019.