Discover and read the best of Twitter Threads about #IDR

Most recents (15)

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...

(1/2)
...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
Read 8 tweets
🧵on #IDR recently, I talked with the #CBO as a SME to help their modeling, with the limited information they had.

I refused to guess what % of people in the portfolio would go into the "new IDR" as details were lacking. I smart not to as REPAYE will be the vessel of changes.
I think this plan will encourage more people with UG debt to enroll in REPAYE and see what happens - sorta like insurance against economic shocks, as I said to @AnnaHelhoski in the piece she modeled outcomes for last year.
The ≤$12k marker for UG debt to be forgiven at 10 years seems arbitrary - as $17K is the average loan debt for those with an Associates and $14k with a certificate.

This should help stop-outs, though - but $20k just makes more sense without the complexity of +$1k = 1 more year.
Read 15 tweets
3 basic types of @IamMas7er #IDR setups.

Use with CONFLUANCE:
- Bias & Narrative
- Market Structure
- ICT PD arrays Image
These 3 types have deferent thought process. Basically when one failed the other one could manifest itself.
Note that the External rejection could be from the DR or IDR, and the Internal rejection could be from the 0.5 or deeply from 0.79.
That is why you need CONFLUANCE.
PLEASE do not get me wrong -
We do not trade patterns or schemes, we trade algo logic.
We analyze liquidity, We asses time, We calculate risk and only then seize the opportunity.
Read 7 tweets
Want to share my #IDR Setups of @IamMas7er :

Let's broadly divide them into 3 types:
- External IDR/DR rejection
- Internal IDR/DR rejection
- Internal rejection - Midpoint / OTE

Now let's remember our early indications:
- DR Structure
- Overnight DR follows Regular DR

🧵
The A+ setup is the internal rejection that comes AFTER an IDR break (Break = M5 CLOSE outside the IDR).
But you can still use the external and internal and risk less %.
1. Internal rejection - Midpoint example:
Here you don't have an IDR confirmation but it belongs to the highest prob type
Read 8 tweets
Ok, time to get into this GAO report on #IDR. Reading from the perspective of who are most likely engaged in these programs (Female, Middle-Earning, High Debt Borrowers - and potentially minority borrowers).

preprints.apsanet.org/engage/apsa/ar…

ir.library.louisville.edu/jsfa/vol50/iss…

1
That abstract is catching. Credit for getting the point right away. A bit misleading though, they talk about the 7k loans eligible at $49m - but later on, those are held by 3k borrowers for $16k per borrower on average. Per borrower stat should also be up there for clarity.

2
I expect the average amount forgiven to increase over time - as the Federal Government changed the parameters of loans, more people became reliant on loans, connections to the Great Recession, and grad school enrollment. Eventually, it will get closer to averages seen in PSLF

3
Read 22 tweets
⚖️ 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
⚠️ 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
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
1/ Check out this detailed summary by AMAzing ⁦@AmerMedicalAssn⁩ advocacy staff:

•Select provisions of the Consolidated Appropriations Act, a comprehensive omnibus spending package

•AMA table of #Medicare physician impact broken down by specialty ImageImage
2/ Dec. 22, 2020, the President signed into law the Consolidated Appropriations Act, 2021 that:

•Funds the federal government through FY 2021,

•Provides a new round of #COVID19 relief and economic stimulus, and

•Imposes new restrictions on #SurpriseMedicalBilling.
3/ For an @AmerMedicalAssn summary of select provisions in the Consolidated Appropriations Act, please see here: tinyurl.com/y65utfno
Read 13 tweets
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
Dün #USDTRY kurunda gözlenen oynaklığın Türkiye’ye özgü etkenlerden (örneğin TCMB’nin parasal genişleme uygulamaları) kaynaklandığı kanaatinde değilim. #USD karşısında gelişen piyasa ekonomileri (EM) paralarının çoğu
#ZAR #BRL #IDR #INR #MXN
hatta #XAUUSD benzer seyir izledi.
ABD’de salgınla ilgili görünümün kötüleşmesi, toparlanmanın başlangıçta düşünülenden daha uzun süreceğine ve ekonomi üzerindeki etkilerin en azından bir kısmının kalıcı olacağına ilişkin beklentiler sebebiyle genel bir olumsuzluk yaşanmış görünüyor.
Merkez Bankasının TL likiditesini genişletecek kararları belki TRY kurunun hareketini bir miktar etkilemiş olabilir ama bu ikincil görünüyor.
Bu dönemde sakin kalmak, ani kararlarla pozisyon değiştirmemek önemli.
Read 5 tweets
!!!NEW!!! A cross-kingdom conserved ER-phagy receptor maintains endoplasmic reticulum homeostasis during stress #autophagy #ER_phagy #ER_Literature #ufmylation biorxiv.org/content/10.110… a thread 1/8
Via a screen in Arabidopsis, we identified C53, an #IDR containing highly conserved protein, as a direct #ATG8 interactor. It interacts 8/9 arabidopsis, 1/2 marchantia and 2/6 human ATG8s via the LDS 2/8
Using native mass spec, ITC, SPR and cell biology, we showed that it binds ATG8 via a non-canonical AIM, that we named Shuffled AIM (sAIM)- IDWG 3/8
Read 8 tweets
When #NJ enacted 1 of the worst in the USA #suprisemedicalbilling laws (Aug. '18), #healthplans did the following: 1. @HorizonBCBS said Sept. '18 "reasonable reimbursement" as 110% of CMS as that is what the law required; 2. no meaningful access to #IDR... nj.com/healthfit/2020…
2/ b/c the statute provides no IDR unless the delta between the #physician charges & initial payment is $1K or >; 3. @UHC begins terminating long standing #physician participation Ks to redirect Pts. to clinics owned by their other subsidiary; 4. physician groups are now suing...
@UHC 5/ so 1 could cynically conclude that by benchmarking physician $ to CMS rates, eliminating Ks that are fair coverage & laws w/ no meaningful & accessible dispute resolution results in those very physician groups potentially having to sell out & leading to > vertical integration.
Read 3 tweets
With my fellow @EDPMA board members to lobby on #surpisebilling —to make the case that benchmarking is an existential threat to ⁦@EmergencyDocs⁩ given the EMATAL mandate & that an accessible IDR like that in NY is essential. Image
EMTALA I meant
W/ Drs. B. Freudenthal (left) @arhalpern & R. Pilgrim at Cong. J. Morelle—one of the principal authors of the #NY #IDR state law in #surprisebilling when he was an assembly man— for an update on the stunning >100 bi partisan co-sponsors of #RuizRoe HR 3502. @EDPMA @EmergencyDocs Image
Read 3 tweets
@teampelosi @EnergyCommerce @WaysMeansCmte @EdLaborCmte @SenateHELP Over 100 physician specialty societies & state medical societies are urging you to solve surprise billing with #IDR. drive.google.com/file/d/1YdR6HF…
A chorus of independent physicians (not PE companies or the people who surprise bill) recognize the danger of a benchmark solution and are asking you to listen.
"Simply put, certain proposed solutions for surprise billing will kill you or someone you love."linkedin.com/pulse/your-chi…
The health policy "experts" you have heard from don't want to tell you about EMTALA. You MUST understand EMTALA in order to understand how new benchmark regulation would cede #RateSetting power to #BigInsurance at the expense of patients & the safety net.
Read 32 tweets

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