BCBS (and others) complain about the consolidation of anesthesia practices and then announce they will be paying less for anesthesia procedures which will lead to… more consolidation. Another example of the disconnect between payment policy and the value of the care provided.

Right on Damian! Secretary Xavier Becerra is “either oblivious…or indifferent” just as he’s been in the 4 Texas Medical Association cases that he & the other depts. have lost on the #NoSurprisesAct . HHS.gov Sec. was asked by Congressman Greg Murphy, M.D. for a report on when his Dept. had enforced the NSA penalty

from Caitlin Owens
Major health insurance companies are nearing too big to fail status--their revenue makes up ~30% of $5T US Healthcare expenditure!

We need a MamaBell/StandardOil intervention U.S. Department of Justice Chuck Schumer Speaker Mike Johnson

axios.com/2024/04/19/hea…

When a politician talks about 'cutting healthcare costs,' make really sure that they don't really mean 'making insurance company executives richer.'

About 98% of the time, it's the latter.

UnitedHealthcare: 23 hours
CVS: 1 Day
Elevance: 2 Days
Cigna: 2 Days

Jeffrey Davis Robert King Jeff’s comments are spot on. IDR is not working b/c the Administration tried to convert the NSA statute into a benchmarking law to garner the $18-22B in savings that U.S. CBO had estimated that then Chair Rep. F. Pallone’s bill would yield over 10 yrs. It would have benchmarked

1/
I’ve been to war, twice. Iraq in ‘09 and Afghanistan in 2011. I am just a fucking ER doc. But it was there, in the deserts far,far from home, that I made my bones as a newly board certified ER doc. It is around that time, I think that I lost my capacity to feel joy.

The @AHAhospitals is taking action! 🏥 Following the alarming The New York Times investigative article by Chris Hamby, they've urged U.S. Department of Labor DOL Secretary Julie A. Su Acting Secretary Julie Su to probe the shady practices of fourth party repricer MultiPlan & AHIP Texas Association of Health Plans members

Prior authorization continues to burden physicians and patients. In this study, only 0.3% of all claims were ultimately denied but it took over a month on average to get approval and even longer when the insurance company initially denied the care then ultimately reversed course.

4/👇🏻

3/ Here’s a companion piece to Chris Hamby remarkable investigative story. 2 key takeaways: UnitedHealthcare made over $1B off of the MultiPlan & related firms “out of network savings program” + MP employees were of course incentivized on their bonuses which were tied to locking in

2/ Here UnitedHealthcare internal documents show how it was quickly moving away from FAIR Health which it was mandated to use for only 5 yrs per the UnitedHealthcare Ingenix settlement. Why is that? Is it b/c FH is an independently governed, non-profit who is paid a flat fee for its database (ironically

GM Mr. Cuban, Mark Cuban if you want Exhibits A-Z on how you should disrupt the #thirdpartyadministrator #TPA business, read Chris Hamby’s outstanding investigative piece on MultiPlan UnitedHealthcare’s nearly $51K admin fee on a ~$153K hospital bill where MP recommended & UHC allowed

‼️🚨So AHIP Texas Association of Health Plans Blue Cross Blue Shield Association member BCBSTX are changing their Anesthesia Coding Policy (CPCP010) June 2024 - they will no longer offer payment for ASA physical status (P code) modifiers on anesthesia services. This will negatively impact physician

Physicians want to open hospitals where other entities have failed. The Affordable Care Act prevents these physicians from building hospitals in the communities of need. Instead they can only build clinics. It’s time to repeal Section 6001 of the Act. This is in the community

So, Loren Adler, in response to your Closing Note, & Matt Fiedler The Brookings Institution need a “Well, Bless Your Heart ❤️” reminder about what happens when corrupt federal rule-making, which denies congressional intent of the #nosurprisesact , occurs, especially regarding the #QPA .

Half of Optum management is CMSGov in-and-out-of-government staff; half of CMSGov staff is UnitedHealthcare staff. The other half is AHIP & Vice versa

Truly a single-payer, single-provider, captive-regulator system.
#FOIA - CMS -> UHC Leadership
MedicalQuack Lawrence Melniker

Take a minute and realize how absolutely laughable this statement (quoted below) that increased physician payments in NSA above an artificially low QPA will cause an increase in insurance premiums.

FACTS:

One half of one percent of all claims are NSA eligible per AHIP (.005).

Adam Bruggeman, MD Brookings Institute annual report… funded by:

Big banks
Rockefellers
Walmart
LEGO (lol)
Mega-donor foundations/family offices