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As a subtle reminder: my tweets are my own; my employer or trade organizations where I am board member or speaker have nothing to with my tweets or the thoughts expressed therein. #healthlawyertweets
Ed Gaines
27.4K posts
Ed Gaines
@EdGainesIII
#healthcare #attorney #physicians & #clinicians advocate, honorary member of #ACEP & co-founder #EDPMA, #tennis enthusiast & dad—posting as an individual
- Front page @WSJ investigative report on diagnosis upcoding by health plans & I hope y'all are sitting down b/c @UHC adds add'l diags. more than any other plan, over $1400 per #MedicareAdvantage member. UHC has nurses call Advantage members, offers $50 gift cards if their nurse
- Replying to @slater_paulWelcome to the profession and all of the best success to you and your family!
- As expected, the #healthplan CEOs are crushing it w/ salary, bonus options beckerspayer.com/payer/the-10-h…
- You don't have to be Milt Friedman to understand that #PBMs are not using their economies of scale to bring down drug prices. In fact, it's the opposite, thanks to vertical integration and self-dealing. #BigMiddleManager #HowPBMsWork
00:00 - My PSA—Hello @mcuban—since you are dunking the pharma industry (based on your profile) why don’t you do the same for the “third party administrator” (TPA) industry as well? You could dominate the TPA industry inside of 3 years. Offer fair contract rates to physicians, hospitals
- 1/I have no word for this news…
- Yep, hospitals receiving nearly +3% on their Medicare update w/ CMS concerned about an inflationary update, while physicians face nearly a -3% cut because Congress has not mandated that CMS care about an inflationary update. We must make them care via legislation!
- “@UHC denies payment for care 40% more than other national insurance carriers we contract with” says the @DukeHealth physician CEO. That is correct sir & thank you for calling them out & let’s see if other health systems can do the same. beckershospitalreview.com/finance/duke-h…
- Numbers don’t lie—looks like their margin is his opportunity @mcuban beckershospitalreview.com/pharmacy/25-dr…
- How in the name responsible fiscal gov’t should @CMSGov be proposing major increases at +4.4% in #MedicareAdvantage for 2026 NOW when there are exactly 9 days left in the current administration? If there was any doubt in your minds about how captured this Administration was by
- This is an outrage —MA plans w/ an +5% payment bump in ‘25 while the physicians continue to be down -2.83% on Medicare.Big shocker! Dems or Reps, health insurance companies always get their way.🤦🏽♂️🤬
