ZPAC retweeted
At Becker’s CEO + CFO Roundtable, Zotec’s Mark Isenberg and @RAYUSradiology Kit Crancer discussed how regulatory and operational pressures affect healthcare margins and physician capacity.
@BeckersHR
ZPAC retweeted
Thanks to all who have signed up for "30 second advocacy" and sent emails to their members of Congress this year and prior yrs.
Congress only has ~20 legislative days left in '26 during the Lame Duck Congress starting Nov. 9th, and many dozens of bills to consider.
As we like to say in physician advocacy, you're either at the table or on the table.
ZPAC retweeted
🎉 Exciting News for Breast Health Education!
The @HHSGov (HHS) through its Office on Women’s Health, has announced a coordinated effort with the Agency for Healthcare Research and Quality (AHRQ) and DenseBreast-info.org (DBI) to advance breast cancer screening, expand breast density education, and promote timely diagnostic follow-up, particularly for midlife women.
We are proud to be part of this important national effort to help women better understand their breast health and make informed screening decisions.
🔗 Read the full HHS press release HERE: hhs.gov/press-room/hhs-stren…
#DenseBreasts #FindItEarly
ZPAC retweeted
Dr. Tilden Childs' group has won 95% of federal IDR disputes, yet millions in awards remain unpaid. He joins Ed Gaines on #ZotecAnswers to discuss why.
Listen: zotec-answers.simplecast.com….
ZPAC retweeted
Zotec will be at @RBMAConnect Michiana in Kalamazoo, MI, Oct. 22–23. What’s next for your radiology practice’s reporting or patient financial experience? Connect with our team at the meeting.
ZPAC retweeted
October is Breast Cancer Awareness Month. Early detection and regular screenings can make a meaningful difference in breast cancer outcomes. I encourage everyone to talk with their doctor about their risk and recommended screenings. Together, we can raise awareness and support those fighting this disease.
ZPAC retweeted
Dr. Eliot Goldner, President elect of the FL College of Emergency Physicians (@FCEP), is our guest this week to discuss FCEP’s advocacy along side @EDPMA to preserve the FL state based IDR process.
Eliot has been a key leader in addressing the issues that arose due to an interpretation of FL that we believed was not supported by the law.
Have you listened to Zotec Answers - A Healthcare Podcast yet? Check it out here: zotec-answers.simplecast.com…
ZPAC retweeted
This #BreastCancerAwarenessMonth, Zotec stands with everyone impacted by breast cancer and honors survivors and fighters everywhere. 🩷 Early detection matters—help spread awareness, support research and encourage regular screenings. #ZotecPartners #Healthcare
ZPAC retweeted
How is AI impacting the healthcare space writ large and the revenue cycle management space in particular are a couple of issues that my @ZotecPartners colleagues Jen Fox and Megan Applegarth discuss on this week’s Zotec Answers podcast.
podcasts.apple.com/us/podcas…
ZPAC retweeted
📣 Your Voice Matters! The Find It Early Act has been introduced, help push it forward. DBI's #FindItEarlyAct page has a "Lobbying 101" guide: how to contact your congressperson, set up a meeting, what to ask, and how to follow up.
ow.ly/IAWn50ZT1En
#WorldDenseBreastDay
ZPAC retweeted
Growth starts with trying something new. For Zotec’s Megan Applegarth, stepping outside her comfort zone and learning along the way has shaped her career—and helps Team Zotec continue to grow and adapt together.
#ZotecPartners #Leadership #CareerGrowth
ZPAC retweeted
Those who blame the Docs for the No Surprises Act issues are sadly misinformed. There are bad apples, and they need to be addressed, but when the IDR process rules for the Docs 80-90% of the time and the Insurance companies still don’t pay, ask Willie Sutton where the problem is.
ZPAC retweeted
The House is planning to return next week. HR 4710 (the bill referenced below) could be on the docket for "mark up" by the Ways and Means health sub-committee.
Congress Is Returning. Act Now on the No Surprises Act Enforcement Act. votervoice.net/Shares/BpzzuA…
ZPAC retweeted
What’s really happening with the No Surprises Act—and who’s gaming who?
🎧 Ed Gaines of Zotec and Dave Walker of Radiology Associates of North Texas break down the challenges, impacts and realities healthcare organizations need to know.
Listen: bit.ly/4xB4mkk
ZPAC retweeted
Dave Walker, CRO of RANT, explains again how non-compliant @BCBSTX “QPAs” (initial payments for OON services) have been historically & have not been the median in network rates based on a 2019 baseline +28% for inflation as required by the NSA statute. radiologybusiness.com/topics…
ZPAC retweeted
Listening to a fantastic @AJR_Radiology podcast about how insurance companies use “ghost rates” to circumvent the agreed upon prices in the No Surprises Act. They “negotiate” super low rates with practices that will never bill for certain codes (e.g., psychiatric codes for a radiology practice) then use those “ghost rates” that no one will ever use to calculate an artificially depressed price for out-of-network care under the No Surprises Act.
ZPAC retweeted
Woot Woot! (don’t believe I have ever started that way)
Reports/analysis still coming in as the decision was just released but @texmed just won their TMA III en banc appeal (all the 5th Circuit appellate judges hear and decide the case) w/ one small exception on the ruling.
That makes it a clean sweep in the TMA I, II, III and IV litigation for the physicians—bye-bye ghost rates by the health plans!
If you add that physicians and their supporting community are 7-0 against the health plans’ end around the NSA in federal court, I would say that is quite a record in litigation.
HUGE thanks to the TMA, legal team, community of supporters and others who participated in these cases.
When we look back years from now and even today, I cannot imagine where the community would have been without this litigation.
In EM, you would have been benchmarked to the QPA which based on the most recent CMS public use file data for POS 23 (Q3 & Q4 ‘25) would have been about $170-75.
While I have said in many presentations on the NSA, God bless Texas and the TMA!
ZPAC retweeted
So, the health plans claim that physician groups are “abusing” the NSA IDR process and IDR needs to be eliminated in favor of a benchmark standard.
Perhaps the plans forgot that the federal district and appellate courts have all rejected their arguments that Congress intended to establish a benchmark as contrary to literal provision of the #NoSurprisesAct.
What about the plans’ obligations to negotiate contract rates at fair and reasonable rates?
Here, Dave Walker, Chief Revenue Officer (CRO) of one of the largest independent radiology groups in the US, Radiology Associates of North Texas (RANT), explains his over 25+ attempts over years to negotiate fair rates with @BCBSTX to no avail. RANT continues to request to be in network but at fair and reasonable rates.
Perhaps an irony that only those who deal with the plans everyday can appreciate—Blue’s Texas state IDR process representative accepted Dave’s offer while the folks who run their federal IDR refused—for the same health plan!
Zotec Answers: What is really happening with the No Surprises Act and wh... youtu.be/-_cxAf9JW7Q?is=56Yd… via @YouTube
ZPAC retweeted
1/Join my Zotec Partners’ colleague, Mark Isenberg, and me as we discuss the 2027 Medicare Physician Fee Schedule (MPFS) Proposed Rule and how you can in about 10 seconds engage your members of Congress to address the pressing issues presented by this…. podcasts.apple.com/us/podcas…
ZPAC retweeted
1/New Kaiser/Peterson analysis of over 250 ACA health plans shows a median increase of +15% in premiums for ‘27.
Meanwhile: the plans cite the No Surprises Act as one of the factors driving up costs while the 2 largest plans, UHC and Anthem BCBS (or whatever they are called this week), minted nearly $15,000,000,000 in net profits in the first half of ‘26.
ACA insurers propose 15% premium bump for 2027: 6 notes beckerspayer.com/payer/aca/a…
