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CMS Office of Burden Reduction - Parody Account Profile
CMS Office of Burden Reduction - Parody Account

@CMS_Burden_GOV

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The Office of Burden Reduction at CMS is run by career experts in administrative burdens and government waste. A parody account. #CMS1984onSteroids

Washington DC and the Moon
https://t.co/Co6LWPJOGK
Joined April 2023
Don't wanna be here? Send us removal request.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 month
Under @CMS_Burden_GOV leadership, the American Health system has been consistently #1 in Administrative Costs and Burdens since the day #HIPAA Administrative Simplification requirements were signed into law (1996)! We thank @SouthPark for recognizing that we have achieved the
@marklewismd
Mark Lewis, MD, FASCO
@marklewismd
1 month
As I stand here with a fax in hand that denies one of my patients on chemo an antinausea drug which could get them through the American holiday weekend more tolerably & humanely, I realize that South Park is now a documentary:
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Congressman Murphy is not wrong. Medicare practices are not sustainable as the costs easily overwhelm revenue. For a fairly busy practice with one physician, the math is simple: at 7,000 wRVU (roughly 15,000 total RVU), Medicare reimbursement is $480,000 at $32 per RVU. Just
@RepGregMurphy
Congressman Greg Murphy, M.D.
@RepGregMurphy
6 months
Physicians, who see Medicare patients, struggle to keep their doors open because of debilitating reimbursement cuts each year. Congress must step up and protect America’s doctors and patients. My bill, the Preserving Seniors’ Access to Physicians Act, will get the job done.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
@clavelluro We suggest that you pay attention to our official announcements:
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Official Statement from CMS Leadership. We hear complaints that there is an increase in recoupment or refund requests from health plans. Many requests are outright illegal. Recently, @ElevanceHealth requested a refund from the wrong provider for a patient of a different
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Official Statement from CMS Leadership. We hear complaints that there is an increase in recoupment or refund requests from health plans. Many requests are outright illegal. Recently, @ElevanceHealth requested a refund from the wrong provider for a patient of a different
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
Official statement from @CMSGov leadership. We want to congratulate @UHC + @Optum for being the #1 healthcare provider in the USA We are committed to making "United Healthcare for All" a reality. @DGlaucomflecken @BrooksLaSureCMS @DrBrian4Health
@DGlaucomflecken
Dr. Glaucomflecken
@DGlaucomflecken
10 months
United Healthcare For All
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
MedPac report details how Medicare Advantage plans charge the government 23% more than it would have cost to treat the same patients in traditional Medicare without gimmicks such as prior authorizations and "death" AI algorithms. That's page 26! Now, they deny 30-50% of care
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
We thank the hard-working @medicarepayment for putting together a valuable presentation on the Medicare Advantage program. Of note is page 11: % of expenses paid to related parties - which means MA health plan pays itself on top of the "usual" profit.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
8 months
@CMSGov Office of Burden Reduction ( #OBRHI ) asked @AmerMedicalAssn for comment. According to the #AMA #CPT Committee, the Guardian Angel of RVUs, the following cannot be billed as they have no CPT codes and no RVU values assigned to them: - prior authorizations - appeals of
@DrPsychMD
Alëna A. Balasanova, MD, FAPA
@DrPsychMD
8 months
@PeonyMd @StefanKertesz @BruckelJeffrey They kick in 15 min after threshold & you’re paid for those 15 min when they kick in. & Yes, in my specialty & the way my practice is constructed, the credit I get for my work is fair. I’m not collections based but rather RVU based. It all depends on specialty & practice setting.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
We received numerous requests for comment on the @medicarepayment slide. "It is important to remember that overpaying Medicare Advantage plans supports American businesses and outsourced jobs in the Philippines and Pakistan. The Philippines and Pakistan are ardent American
@bobjherman
Bob Herman
@bobjherman
6 months
An updated, and truly damning, MedPAC slide: Medicare Advantage plans are being overpaid by tens of billions of taxpayer dollars *every year* by both attracting healthier, lower-cost people and coding the hell out of everyone who enrolls.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
The AMA president is running the greatest disinformation campaign in US history. Only 5-10% of prior authorizations fall under the rules. Drugs are excluded from the rules (70% of prior authorizations). Commercial health plans are excluded. There is ZERO enforcement and ZERO
@DoctorJesseMD
Jesse Ehrenfeld MD MPH
@DoctorJesseMD
6 months
Here's what you need to know about the important prior authorization win for physicians and patients, that just happened this week --a direct result of @AmerMedicalAssn advocacy!
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
Official Statement from @CMSGov Leadership. It's bad enough that we are subject to #FOIA . As a result we are forced to transact business with our industry partners @BCBSA , @AHIPCoverage and @BMAlliance at Cafe Milano + DC's dark bar corners. All the critics know is to scream
@DrJBhattacharya
Jay Bhattacharya
@DrJBhattacharya
9 months
In the middle of @bfcarlson 's excellent meditation on techniques authoritarians use to undo civilization, he lands on a healthy civilization's key defense mechanism: dissenters must be given space to think and express unorthodox ideas. Scroll up and read the whole thread!
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
8 months
Official Statement from @CMSGov + @ONC_HealthIT Leadership: Soon enough, doctors across the country will have a reason to rejoice. Our #ePA (electronic prior authorization) proposal will allow default real-time prior authorization of every single thing doctors order, built
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
Everyone loves the fax. Especially health insurance companies.
@ReasObBob
Bob Brown
@ReasObBob
7 months
@Colin_Hung @jamesian This decision in 2008 by @ONC_HealthIT did more to extend the life of fax machines in health care than any other recent event. ONC suddenly, quietly, and mysteriously abandoned their primary objective of developing and implementing a national health information infrastructure
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
We excluded #MIPS as it's a complete fraud imposed on physician practices. " Compliance with MIPS costs $12,800 per physician per year and physicians spend 53 hours per year on MIPS-related tasks. "
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
Our data shows that #MIPS has not cured a single patient. In fact, @CMSGov does not have the resources, know-how, or use for all the #MIPS data. It basically "dies" in @CMSGov databases. #MIPS does generate a tremendous amount of pointless work for medical practices. #Innovation
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
Official Announcement CMS leadership was informed that Change Healthcare, part of @Optum , has been hacked, and its services are not available. Change Healthcare is the largest clearinghouse and touches millions of HIPAA electronic transactions daily, including 270/271
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
On behalf of hospitals and doctors @ahahospitals @AmerMedicalAssn , CMS took a strong stance, asking @UHC to atone for the problems created by the Change Healthcare situation. In response to our demand for accountability, @UHC agreed to offer interest-free loans to providers up
@AndersGilberg
Anders Gilberg
@AndersGilberg
4 months
@JMLineberger @ahahospitals @MGMA @HIMSS @ACHEConnect @hfmaorg @IdahoMGMA @IdahoMedAssn I really hope they’re not going to charge physicians and other providers for these loans… profiting on the provider loan interest while pocketing $ on the float from millions of unpaid claims.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
11 months
America's "non-profit" hospitals get $billions of dollars in CMS supplemental payments and 340B discounts for providing care to uninsured low-income patients. Rules dictate each must have a policy for providing no-cost or low-cost income-determined fees. Under the watchful eye
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
Official statement from @CMSGov Leadership. We are aware of the rainstorm in the Nevada desert that stranded Burning Man attendees which include many #healthcare venture capitalists. @CMSGov Leadership is working to help. @HHSGov has declared a national emergency: 1. We are
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
Official Statement from CMS Leadership. @CMS_Burden_GOV found that @BCBSIL , part of @HCSC , violated multiple federal laws for many years by engaging in unfair business practices. BlueShield of Illinois abusing its power to impose administrative costs on out-of-network
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
We thank you for asking a very insightful question. In response to our inquiry, @UHC informed us that Optum Change Healthcare charges the hackers the same percentage that Optum Vpay charges the doctors for getting their claims paid, as reported by @propublica : 4-5%!
@Markroot14
Mark Root
@Markroot14
4 months
@CMS_Burden_GOV @Optum What % are they charging the hackers?
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Correction, @RoKhanna . No one gives "free emergency care." Emergency care is not manna - it doesn't fall from the skies. It's what we at @CMSGov call an "unfunded mandate." Likely illegal under the Taking Clause. Doctors are forced to provide uncompensated care, while
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
Official Statement from @CMSGov Leadership: It came to our attention that @AARP Medicare Advantage plans from @UHC are tricking patients. The PPO MA plans have $1,000 deductible at Medicare rates, which are going down. 80% of patients would never reach a $1,000 out-of-network
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
8 months
Official Statement from @CMSGov Leadership: We respectfully disagree that it's a "huge money-making scam." Medicare Advantage works as designed, to transfer money from the government to insurance companies, free from government oversight and free from enforcement of applicable
@KatieOrrico
Katie O'Meara Orrico
@KatieOrrico
8 months
Medicare Advantage is a huge money-making scam. #Congress must take action to reform #Medicare Advantage. "...deny, deny, deny...[MA plans] are taking over Medicare and they are taking advantage of elderly patients." #FixPriorAuth See this @NBCNews 👇
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
Official Communication from @CMSGov Leadership: We received many inquiries as to why @CMSGov is not doing anything in response to onerous practices by #MedicareAdvantage plans. @CMSGov cannot solve "stupid." It's a free country. If a provider chooses to sign an onerous
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
Official Communication from @CMSGov Leadership: We are aware that many Medicare Advantage plans scam providers and do not pay #MIPS bonuses to physicians. We recommend that you drop participation in #MA plans that impose administrative burdens (Prior Authorization) and pay you
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
8 months
Official Statement from @CMSGov Leadership. Our industry-leading collaboration on #HealthEquity has benefited many. Fixing #HealthEquity is a long-term project with no easily measurable outcomes. That's why there is no role for @OIGatHHS to look into what the #ROI on
@DrJBhattacharya
Jay Bhattacharya
@DrJBhattacharya
8 months
Social Science & Medicine just published a spicy paper by Jerel Ezell on the "Health Disparities Industrial Complex". The thesis is that the academic discipline of health disparities has the consequence of perpetuating these disparities. 1/5
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
Our data shows that #MIPS has not cured a single patient. In fact, @CMSGov does not have the resources, know-how, or use for all the #MIPS data. It basically "dies" in @CMSGov databases. #MIPS does generate a tremendous amount of pointless work for medical practices. #Innovation
@CMSGov
CMSGov
@CMSGov
1 year
Unable to attend our recent Merit-based Incentive Payment System ( #MIPS ) webinars? A recording, transcript, and slide deck will be posted on our #QPP Webinar Library within 2 weeks of each session:
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
@DrBrian4Health @MarilynHeineMD @cscla @AmerMedicalAssn The @AmerMedicalAssn has invested deeply in #PriorAuth + #MedicareAdvantage through innovative @Health2047 solutions. Zing Medicare Advantage plan, a proud graduate of @AmerMedicalAssn venture fund. For example, @myamazinghealth Zing Medicare Advantage plan with truly Zing!!!
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
CMS is committed to imposing prior authorization requirements on physician practices and embedding them deep into the EMR. That is why we finalized the requirement for #MIPS penalties in the CMS Interoperability and Prior Authorization Final Rule. MIPS is a budget-neutral
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Health plans told @CMSGov that their worst nightmare is for their members to experience the prior authorization process themselves. That is why, despite numerous suggestions to allow patients to initiate and be involved in the prior authorization process, we listened to our
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
As we clarified, neither the FBI nor @CMSGov can help doctors and hospitals get paid in view of UnitedHealth's Change Healthcare cyberattack. Various options are available for providers to survive the 'cash' crunch. "Optum Pay Advance" loans may allow practices to survive and
@bobjherman
Bob Herman
@bobjherman
4 months
NEW: The cyberattack on UnitedHealth's Change Healthcare is completely disrupting how hospitals & pharmacies can submit claims, and how insurers can pay them. Hospitals will be on a call w/ FBI, other fed agencies today. w/ @brittanytrang & @TaraBannow :
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
11 months
Official Communication from the CMS Office of #Burden #Reduction ( #OBRHI ): We thank @Cezary and @propublica for spotlighting the work that we do at @CMS_Burden_GOV . The story demonstrates our unwavering commitment to our favored stakeholders.
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The Hidden Fee Costing Doctors Millions Every Year

A powerful lobbyist convinced a federal agency that doctors can be forced to pay fees on money that health insurers owe them. Big companies rake in profits while doctors are saddled with yet another...

www.propublica.org
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
Official Statement from @CMSGov Office Of Burden Reduction ( #OBRHI ) Leadership We received an immense response to CMS-0057-P - Prior Authorization Standards. It seems that we have a problem. @WEDIonline advises us that "Complexity is Great!" Sample Responses: ""Too often
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
But 90% of health plan members who experience a serious medical problem experience the wonders of prior authorization.
@DutchRojas
Dutch Rojas
@DutchRojas
4 months
90% of health plan members never reach their deductibles. Not #healthcare
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
We thank @GlobeOpinion for giving a shout-out to @CMSGov . Virtual credit cards and EFT fees are illegal per #HIPAA . >$5 billion a year in fees collected by @ZelisHealthcare , @UHC @Optum is pure theft.
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Doctors shouldn’t be overcharged for electronic payments - The Boston Globe

Technology meant to save the system money is costing doctors money and lining insurers’ pockets.

www.bostonglobe.com
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
8 months
@CMSGov consulted our advisors, #OptumServe and @WEDIonline , the official statutorily-designated advisor to CMS. What we heard was, "No way, no how." These radical ideas to promote transparency and accountability would cause significant difficulties for the industry's leading
@cscla
Brian Gantwerker, MD, FAANS, FACS 🟧🇮🇱
@cscla
8 months
Recipe for fixing insurance #MedTwitter 1) Link auth to payment 2) Mandate 75% of customer service be stateside 3) Centralize payer dispute department 4) Create digital auth + document upload process 5) Digitize the claim payment 2 clearly reflect the patient and line item paid
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
Official Communication from the CMS Office of Burden Reduction ( #OBRHI ). Recent announcements by @Cigna + @UHC that they are cutting >20% of prior authorization overnight with no 'clinical' safety repercussions confirm that #PriorAuth is a scam.
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UnitedHealth cutting back on prior authorizations

UnitedHealthcare will soon drop prior authorization requirements across multiple procedures.

www.axios.com
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
Official statement from @CMSGov Leadership. Today, at the recommendation of @HHSGov , @POTUS declared @mass_marion an enemy combatant. A White House ceremony with a framed designation will be announced once @POTUS returns from Labor Day weekend.
@mass_marion
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits
@mass_marion
10 months
I think it’s really helpful for the general public to know that medical science can be wrong. For decades, kids got baby aspirin and then we discovered it caused Reyes syndrome. Physicians that are the most trustworthy are the ones that are the soonest to come along and say “we
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
Dr. Mass - @CMSGov Leadership is disappointed with your mischaracterization of our record on #MIPS . @CMSGov leadership under @POTUS is committed to radical transparency. You must have attended a conference under the prior administration. We have been more than transparent
@mass_marion
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits
@mass_marion
9 months
Todays must read 👇 I’ll add my own story here, re quizzing CMS about quality metrics… Several years ago, I went to an ‘innovate healthcare’ conference. After lunch, with the crowd sleepy…
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
#BidenomicsWorks Joe Biden, a son of Scranton PA, delivers. President Biden delivered to doctors unprecedented #inflation , with the cost of running medical practices up >30% over the past 2 years. In 2024, @POTUS will once again deliver a cut in reimbursement to the doctors.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
What happens to millions of patients whose #PriorAuth was denied for the 20-25% of services that suddenly don't need #PriorAuth overnight? How are these patients going to be compensated for denial of care due to unnecessary #PriorAuth ? How are doctors going to be compensated
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
Official Statement on Behalf of @CMSGovLeadership : "The #NoSurprisesAct IDRE fees were set at the recommendation of our most esteemed vendor, #OptumServe using their expertise in #AI + advanced data analysis. #OptumServe brings the breadth and depth of #UnitedHealthcare +
@CRCook1978
Christopher Cook, D.O., FASA
@CRCook1978
10 months
So @CMSGov @HHSGov dropped the hammer 🔨 again on #Medtwitter Proposed #Nosurprisesact Admin. Fee & Certified IDRE Fee Ranges: Admin. fee $150 & IDRE Fee Range of $200-$840 for single determinations & $268-$1,173 for batched. For batched exceeding 25 items, IDRE may set a
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
Complaints related to the unavailability of electronic transactions as a result of @UHC Change Healthcare network interruption can be filed with @CMSGov and @CAQH . @EdGainesIII @TedOkonCOA @matthewstoller @realdocspeaks @Nenaadvocacy · @korinreid @NickelBagsArt @ArthritisSTL
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
CMS Office of Burden Reduction, Division of National Standards, enforces all national standards related to all electronic transactions, including pharmacy transactions. Complaints related to the unavailability of electronic transactions as a result of @UHC Change Healthcare
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
As a Medicare age-eligible @POTUS , @JoeBiden is eligible for the Annual Wellness Visit, which is a perfect opportunity to address balance problems and to fit @POTUS with a cane or a walker. Schedule your Annual Wellness Visit today! Medicare will pay for a cane or a walker. #PSA
@nypost
New York Post
@nypost
1 year
Today's cover: Joe Biden takes hard fall at Air Force Academy commencement ceremony
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
CMS Prior Authorization + Interoperability Final Rules (CMS-0057-F): CMS Leadership does not think that patients have the right to advocate for themselves. That would expose what insurance companies don't want to see: "members to experience the prior authorization process
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Health plans told @CMSGov that their worst nightmare is for their members to experience the prior authorization process themselves. That is why, despite numerous suggestions to allow patients to initiate and be involved in the prior authorization process, we listened to our
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
8 months
@CMSGov Office of Burden Reduction ( #OBRHI ) is committed to radical transparency. Here are our notes from our listening sessions. This is what we heard from patients @ONC_HealthIT : "I am trying to get on the "Patient Portal." "They want to know where I was born, my dog's
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
CMS leadership and staff protect the American people from the dangers of democracy. With the recently released CMS Prior Authorization requirements, we protected the American people from such radical and dangerous ideas as "reasonable" regulation of prior authorization. We
@out2sea90210
Politics, Policies & Pop Culture 🇺🇸🌎
@out2sea90210
5 months
A great discussion on the managerial class, the "deep state" and how this impacts corporations and politics. We always know someone else is in control but who is that exactly?
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
As of Jan 1, 2024, stage 3 of CMS' Health Plan Price Transparency Regulations are in full effect. Federal Law mandates that health plans offer access to searchable "contracted" rates for ALL services on their portals to patients via word search and CPT search. If you're
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
In fact, even as they are cutting prior authorizations via announcements, insurances create new #PriorAuth + new barriers to care. The only solution to #PriorAuthorization is strict regulation, fair payment to physicians for each prior authorization, and punitive financial
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
On behalf of the government, we want to remind you that @UHC owns @Optum , which employs 10% of all physicians in the US, and owns medical practices and healthcare "staffing" companies, including surgical centers. A significant part of "medical costs" are recycled and laundered
@wagieeacc
Martin Shkreli (e/acc)
@wagieeacc
6 months
Disagree entirely. One of the myths 'managed care' has propagated, or is entirely misunderstood, is that 'health insurance' margins are low. They are not. They do not do at-risk insurance anymore. All of the premiums are pass-through, and there is clearly no risk to the
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
CMS leadership acknowledges that HHS/CMS programs cover >30% of the US population (Medicaid/Medicare), and @CMSGov has regulatory jurisdiction over these plans. We have chosen not to do anything about the market dislocations and inefficiencies created by PBMs. We hope
@linakhanFTC
Lina Khan
@linakhanFTC
4 months
At today's Roundtable on PBMs, I shared stories @FTC has heard from patients, doctors, and pharmacists about how these middlemen may be hiking drug prices, limiting patients' access to certain medicines, and driving community pharmacists out of business.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
To assist @usairforce in locating the missing stealth fighter jet, @CMSGov will use its authority to issue a MIPS measure, "Sightings of a plane by doctors on call," reportable by doctors. #MIPS #QPP
F-35 Stealth Fighter Goes Missing Near North Charleston After Pilot Ejects 

"If you have any information that may help our recovery teams locate the F-35..." 

www.zerohedge.com
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
@CMSGov is proud to work hand-in-hand with @AHIPCoverage to hand over billions of perfectly good $$$ to insurance companies. What we pay for: - rampant violations of Network Directory requirements - improper upcoding of perfectly healthy patients - denied claims
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
We ask you to be civil, Dr. Choi. Medicare Advantage is not a scam. It brings at least $1,600 in net profit to health plans for each member, likely much more given that >30% of 'expenses" are with 'related' entities. Have you ever been to Davos on a private jet? It's not
@drdanchoi
Dan Choi, MD, FAAOS
@drdanchoi
6 months
Medicare Advantage (MA) is a total scam. It’s certainly not an advantage and would be more accurately called Medicare DISadvantage. It’s crazy to me that now over 50% of Medicare enrollees have switched over to Medicare Advantage plans run by profit seeking BUCAs. 1/4
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
@CMSGov Office of Burden Reduction is committed to radical transparency. Our Twitter account will take a leading role across the government to inform the American people. Thank you, @BrooksLaSureCMS , @SecBecerra , for your leadership! #HIPAA #AdminSimp
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
8 months
Official Statement from CMS Office of Burden Reduction ( #OBRHI ) Leadership Team: We have listened to many physicians who agree that #HospitalCredentialing is outdated. However, it is an important jobs program for @JointCommision . We know many hospitals are still doing 'pen+
@CRCook1978
Christopher Cook, D.O., FASA
@CRCook1978
8 months
I limit complaints/grievances on X. 🚨 #HospitalCredentialing is Ridiculous 🚨 4 Man- hours all requiring the physician’s personal attention per application nearly impossible to complete in one sitting 🪑 because of all of the moving parts & up to $400 application fee/facility.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
As our own @AMugge pointed out, "prior authorization is an essential tool." The problem with doctors is that American medical education has spoiled them with Academic Medicine, isolating them from our very real beauracratic concerns. It is time that @acgme + @AAMCtoday focus
@wendellpotter
Wendell Potter
@wendellpotter
8 months
This is essential. This could happen to you and probably will. Watch the video
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Health plans told @CMSGov that their worst nightmare is for their members to experience the prior authorization process themselves. That is why, despite numerous suggestions to allow patients to initiate and be involved in the prior authorization process, we listened to our
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
@OSUWexMed And, even more from our angry friends @OSUWexMed . Ohio - give us a smile! "Payers expect OSUWMC to manage their PA intermediaries and resolve issues which increases our workloads exponentially" "Payers are unable to identify by group number or indicator on the member’s ID card
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
8 months
We thank @AmerMedicalAssn for support of these flawed #PriorAuth + #Interoperability regulations that bow too much to health plans' need to deny access and if patients somehow manage to access their doctor then to deny care. @CMSGov Leadership is concerned that these capricious
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
We want to congratulate those physicians who have earned recognition for washing their hands. We have been brainstorming whether to require a 4-hour hand-washing CME or a 6-hour hand-washing CME as part of our CMS Innovation agenda.
4-hour Handwashing CME
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6-hour handwashing CME
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Make it a #MIPS
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@AlanHawxbyMD
Dr_H
@AlanHawxbyMD
7 months
Current status
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
8 months
The @BCBSAssociation is doing a fabulous job: RAISING premiums Increasing barriers to care increasing Prior Authorizations increasing wrongful prior authorization denials while Cutting payments to physicians with inflation-high costs even higher. Killing independent
@BCBSAssociation
Blue Cross Blue Shield Association
@BCBSAssociation
8 months
Join us! 📅
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
Boy-oh-boy. It was brought to our attention at @CMSGov that @Yale health plan is not aware of 45 CFR § 162.925. Bad @Yale . Healthcare claim transaction, ASC X12N 837, is a recognized national treasure. Pssss....penalties are a well-kept secret.
@TakeWeightOffMD
Dr Murphy WeightLoss
@TakeWeightOffMD
1 year
Never thought I would have to admit @Yale is a deadbeat. It literally shoved insurance claims under a rug and ignored them for years. Despite collaborating with me on multiple publications they continue to refuse payment for tests performed 3 years ago. Really despicable guys.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
7 years in prison for a Virginia woman for stealing $211K No prison for @CIGNA for stealing $172 million (likely more). @linakhanFTC @RoKhanna @BernieSanders @SenWarren @SteveScalise @SenatorDurbin @RogerMarshallMD
@OIGatHHS
OIG at HHS
@OIGatHHS
9 months
A Virginia woman was sentenced to 84 months in prison for defrauding Virginia #Medicaid of $211,176.96 in a home health care fraud scheme that spanned over seven years. Read more:
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
@CMSGov Leadership applauds healthcare innovations. Self-care is the best care. @CMSinnovates is working on a waiver of coverage for #MA plans. In this innovative program, patients will be given $130 to buy a disposable #Duodenoscope on Amazon with #YouTube instructions for
@thehouseofpod
Kaveh MD
@thehouseofpod
10 months
I can tell you from experience, this is very, very difficult to do.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
With more than 50,000 health plans (and >3,000 Medicare Advantage plans), each with its own rules, each abusing doctors in its own special way, doctors have nowhere to run. #FixPriorAuth Thank you, @BrooksLaSureCMS + @SecBecerra , for your leadership! Transparency is our
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Under CMS leadership, doctors don't need to see patients anymore. The number of doctors working for insurance companies is at an all-time high!
@LighthouseDPC
Humane Healthcare for All
@LighthouseDPC
6 months
@DutchRojas We have a Physician Time shortage NOT a Physician Shortage. We have more Medical Schools now than we did 20 years ago. Over 50% of the Doctors time is spent on administrative tasks since we stopped using paper charts and starting using Electronic Medical Records(EMRs). If a
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
30-60% of Medicare Advantage "expenses" are paid to 'related parties." @BrooksLaSureCMS calls it "Money laundering" in today's comments to the press and calls on @OIGatHHS to "investigate thoroughly" and "impose punitive penalties."
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
We thank the hard-working @medicarepayment for putting together a valuable presentation on the Medicare Advantage program. Of note is page 11: % of expenses paid to related parties - which means MA health plan pays itself on top of the "usual" profit.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Our own Alexandra Mugge, Director of Health Informatics at @CMSGov , on #PriorAuth : "We all know that prior authorization is a part of the healthcare system, and it is here to stay and plays a critical role." @Policy2Progress @HealthIT_Policy @mswain37 @ecm104 @AMugge
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
It came to our attention that @CVSHealth #CVS Caremark issues arbitrary and capricious denials for testosterone replacement therapy for men with age-related hypogonadism. Under @KarenSLynch leadership, CVS claims "guidelines" and "policies" that it fails to name. ERISA Summary
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
Despite Monday being a work-from-home European vacation for CMS leadership, we are working more than usual this Monday morning. Official Statement from @CMSGov leadership: @CMSGov leadership supports transparency for #Providers . There is no need for transparency for #PBMs ,
@mass_marion
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits
@mass_marion
2 years
This would stop should @Free2CareHC 's expanded "Sunshine for All" conflicts of interest in medicine be adopted. Original paper here: Updated version in process Writing is HARD work!
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
We are probably going to get in trouble, but it's worth it. Shout out to @CMAorg for winning Dobson v. Secretary of Health and Human Services Off-label use is common + effective; Medicare randomly denies treatment. The "Compendia" are mostly worthless.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Our own Alexandra Mugge, Director of Health Informatics at @CMSGov , on #PriorAuth : "We all know that prior authorization is a part of the healthcare system, and it is here to stay and plays a critical role." @JJWUrology @BrantMDJD @amyfaithho @InfinityHealth8 @PtRightsAdvoc
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
More from our angry friends @OSUWexMed : "We have payers with different prior authorization request (PAR) requirements across different plans that it oversees... For instance, one of our payers has over 400 separate plans we have to navigate, most of which have different PA
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
@DrLisaBanh We suggest that you talk to @PamelaWibleMD
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
As could be expected, the jet was found without surgeons' assistance. But it's a good idea to keep a bit of pressure on surgeons to keep them on their toes with #MIPS + #QPP . @DavidBalatHC @mass_marion @anish_koka @JJWUrology @amitayer @cscla
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Debris reportedly found in South Carolina after F-35 stealth fighter...

Authorities found a debris field Monday afternoon in the US military’s search for a missing F-35 stealth jet that a pilot ejected from Sunday during a bizarre “mishap,” officials said.

nypost.com
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
Many patients on Medicare Advantage are spending Christmas praying for their prior authorizations to be approved after being denied. Cancer can progress fast - with insurance companies off for 2 weeks (Christmas + NYE), it is not a fun time for patients with cancer. Without
@JoeBiden
Joe Biden
@JoeBiden
6 months
Jill and I hope you are able to spend time with your loved ones this holiday season. During this time, we’re also thinking of the brave women and men in uniform who defend our nation, many of them away from their families. We wish you joy and happiness this Christmas Eve.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
Official Communication from the CMS Office of #Burden #Reduction ( #OBRHI ). We promised you #FAQs on #HIPAA #AdminSimp every Friday. We are pleased to introduce the 2nd #FAQ : Q2. If a health plan violates a HIPAA Administrative Simplification Requirement, such as not
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
@subailey Dr. Bailey - please don't be as angry as our friends at @OSUWexMed . We can suggest a few stress-reduction strategies when on hold: 1. Take deep, slow breaths 2. Think about a pleasant experience you had with another prior authorization 3. Use cognitive-behavior therapy
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
CMS Leadership received numerous inquiries about this situation. We want to clarify that contractual prices for colonoscopy are used in many situations - in the No Surprises Act (NSA), for out-of-network reimbursement @FAIRHealth , and for in-network contractual negotiations.
@bobjherman
Bob Herman
@bobjherman
5 months
A gastroenterology practice, owned by private equity, charged a couple $600 each for their colonoscopy "surgical trays." Their health insurer went along with it, until they appealed. Pretty despicable behavior all around, reported by @samanthann :
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
11 months
As promised, every Friday except some Fridays, we bring you another #FAQ from your favorite CMS Office of Burden Reduction, #OBRHI #CMS1984onSteroids . This one comes from our #WEDISummer presentation to @WEDI , @AHIP , @BCBS . We had so many excellent questions that our team put
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
@BCBSIL requires that patients do their own prior authorization. CMS leadership, @BrooksLaSureCMS , denied patients the right to do electronic prior authorization. Patients must call from their hospital bed + wait for hours on hold. "If any Provider outside Illinois (except
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
CMS Prior Authorization + Interoperability Final Rules (CMS-0057-F): CMS Leadership does not think that patients have the right to advocate for themselves. That would expose what insurance companies don't want to see: "members to experience the prior authorization process
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
@VPrasadMDMPH There are maybe 5 institutions in the country that actually deserve the non-profit status, whether through research, education of the next generation of physicians + nurses, or charity care. As a hint, none of them are located in Manhattan. We are looking for nominations -
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
@CMSGov Leadership congratulates @OIGatHHS on addressing corruption in healthcare. The problem, of course, originates with the discrepancies in payments for "capital-intensive" radiology vs "manual labor". PET scans are overpaid. Treating the patient is underpaid. Radiation
@OIGatHHS
OIG at HHS
@OIGatHHS
9 months
A mobile cardiac imaging company & founder agreed to pay $85M to resolve False Claims Act allegations that they paid referring cardiologists excessive fees to supervise PET scans in violation of the Anti-Kickback Statute & the Physician Self-Referral Law.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
11 months
Our favorite suspects @WEDIonline are coming up with interesting, cunning ideas like this: "Answer to Prior Authorization Burden Reduction: Regulation vs. Automation." The answer to #PriorAuth , a sham like no others, is #regulation , then more regulation of #automation . #HIPAA
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
CMS Leadership wants to commend @Cigna for its timely response to appeals from patients and doctors. Cigna states: "The Appeal is still in process and will be finalized in 90-180 calendar days from the date received." We are confident that without any meaningful financial
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
@CMSGov Leadership recently became aware of a critical issue affecting physicians + hospitals. We want to thank Ron Howrigon of Fulcrum Strategies for raising concerns about "Shared Savings": #HealthEquity #AdminSimp
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
CMS's idea of an API is a "Fax". API is an automated electronic communication between computers. CMS proposes that API updates are made visible not in real-time as most APIs do, not within seconds or minutes, but 24 hours later. Well, fax takes about 3-5 minutes per page.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
@CMSGov
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
Our data shows that #MIPS has not cured a single patient. In fact, @CMSGov does not have the resources, know-how, or use for all the #MIPS data. It basically "dies" in @CMSGov databases. #MIPS does generate a tremendous amount of pointless work for medical practices. #Innovation
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
CMS asked MedPac for clarification. @medicarepayment does NOT recommend increasing Medicare rates by 50%. Instead, MedPac recommends NOT updating the rates for inflation, but instead giving only half the increase in inflation. If inflation is 10%, @medicarepayment proposes to
@AndersGilberg
Anders Gilberg
@AndersGilberg
4 months
On the heels of Congress allowing a 1.69% cut to Medicare physician reimbursement to stand for the remainder of 2024, today’s MedPAC recommendation to provide a 50% inflationary update for physician services in 2025 is woefully inadequate.   I am mystified why MedPAC even bothers
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
11 months
@MdBreathe @astros @MethodistHosp There would be no #HealthEquity without the @astros sponsorships and billboards all over Houston. At @CMSGov , we value #HealthEquity greatly.
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
Many of our #Twitter followers noticed that @CMSGov is at the forefront of #HealthEquity . We received many requests to explain #HealthEquity . #HealthEquity is a shorthand for the transformation of patients' #health into insurer #equity . In the case below, for example,
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
It's official. BCBSA is a little dishonest. In it's comments on CMS Prior Authorization + Interoperability Final Rules (CMS-0057-F): BCBSA claims it would take them 2 days to process 15,000 electronic API calls while claiming to process millions of transactions a day. BCBSA
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
In response to our demand for accountability, @UHC agreed to offer interest-free loans to providers. @Optum clarified that providers can qualify for interest-free Optum PayDay loans if they agree to forfeit the right to appeal @UHC claim denials and recoupments.
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
4 months
On behalf of hospitals and doctors @ahahospitals @AmerMedicalAssn , CMS took a strong stance, asking @UHC to atone for the problems created by the Change Healthcare situation. In response to our demand for accountability, @UHC agreed to offer interest-free loans to providers up
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
CMS Administrator @BrooksLaSureCMS will attend the American Medical Association (AMA) National Advocacy Conference on Tuesday, Feb. 13th. Administrator Chiquita Brooks-LaSure will discuss why @AHIPCoverage wins, and doctors lose every single time across administrations,
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
11 months
Claim denials by @AHIPCoverage @BCBSAssociation @BMAlliance have been reviewed by @CMSGov at the highest levels. Health plans informed @CMSGov that claim denial is part of the #HealthEquity initiative designed to deny care equitably to the broadest cross-section of the US
@propublica
ProPublica
@propublica
1 year
New: Insurers’ denial rates — a critical measure of how reliably they pay for customers’ care — remain mostly secret to the public. Federal and state regulators have done little to change that.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
Official Statement from @CMSGov Leadership: It is 'rich' for the @AmerMedicalAssn to complain. When @CMSGov asked for comments on the proposed rules, the AMA did not raise any concerns about the lack of enforcement. Just as a reminder, the proposed MA #PriorAuth regulations
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
7 months
We want to congratulate @BCBSAssociation , @BCBSNCFound , and @AHIPCoverage for leading innovative solutions, such as aligning physicians' financial interests with insurance stock prices without employing doctors directly. @CMSinnovates thinks it's a suboptimal but acceptable
@ArthritisSTL
ArthritisCenterSTL
@ArthritisSTL
7 months
WHAT? Paying physicians 2 DELAY treatment? @BCBSNCFound @ElevanceHealth insane policies.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
8 months
Official Statement from @CMSGov Leadership. Complexity is the "moat", to quote Warren Buffett, that protects excessive profits and limits competition. Meaningless + arbitrary "variability" does not contribute to product choices. Patients have no meaningful choices.
@AtulGroverMD
Atul Grover, MD, PhD
@AtulGroverMD
8 months
"317 987 health plans in the US market, roughly 1 plan for every 1000 people in the country" a single claims form would help... AI Will Not Reduce Health Care’s Administrative Burden
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
1 year
@kiswanson @UHC Thank you for raising your concerns. #Bidenomics guides us in making a brighter future for everyone around us @CMSGov . We are surrounded by some of the best talents from @UHC @BMAlliance @AHIPCoverage . The central tenet of #Bidenomics , according to our valiant leader
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
Manipulating "contracted rates" is a fraudulent practice and has significant repercussions for the healthcare system as they are used in NSA (No Surprises Act) arbitration, price negotiations by competing organizations, @FAIRHealth , which is written into law in a number of
@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
5 months
CMS Leadership received numerous inquiries about this situation. We want to clarify that contractual prices for colonoscopy are used in many situations - in the No Surprises Act (NSA), for out-of-network reimbursement @FAIRHealth , and for in-network contractual negotiations.
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
10 months
Fast forward to 14 minutes - discussion of drug shortages by @DrCaliff_FDA If brand-name 'innovator' medications are 'too costly', what is the cost of not having a medication? Lives are the price paid for 'not having' critical medications. @DGlaucomflecken @WaysandMeansGOP
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
9 months
@CMSGov Leadership wants to give heartfelt thanks to @medicarepayment . However, we are disappointed that @medicarepayment is not on board with the @CMSGov policy agenda. The entire #HealthPolicy nerd community is quietly laughing at the comedic reprieve that is the
@ClaireErnstJD
Claire Ernst
@ClaireErnstJD
9 months
General comments/concerns from the Commissioners: - Concerned about increase in 99214/99215 billing, "substantial shift." Larry hints at wanting CMS to look at it - Commissioners admit its harder to measure quality/cost in the clinician world, so they focus more on access
Tweet media one
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@CMS_Burden_GOV
CMS Office of Burden Reduction - Parody Account
@CMS_Burden_GOV
6 months
CMS received numerous questions about the enforcement of Health Plan Price Transparency requirements. The enforcement is complaint-driven. We ask patient advocacy organizations to spread the word and ask patients to file complaints with CMS: We hear
@j_luh
Join Y. Luh (he/him/dude/他)
@j_luh
6 months
@CMS_Burden_GOV And how will this be enforced? @JordanJ65544091
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