WCI #334: How You’re Being Ripped Off By Incompetent and Corrupt CMS Bureaucrats with Dr. Alex Shteynshlyuger
Sep 28, 2023
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Dr. Alex Shteynshlyuger educates doctors about payment processing fees, which cost them millions. They discuss regulations, third-party providers, and the impact on medical practices. The chapter also highlights the issue of prioritization in healthcare and the impact of incompetent and corrupt CMS bureaucrats.
Payment processor fees imposed on healthcare providers by companies like Zealous violate federal regulations and cost medical practices billions of dollars annually.
The clear conflict of interest between Matthew Albright, former intern director of the Division of National Standards at CMS, and his role as a lobbyist for Zealous has allowed illegal fees to be imposed on healthcare providers, and CMS must be held accountable.
Deep dives
The Problem of Payment Processor Fees
Payment processor fees imposed by companies like Zealous on healthcare providers are a major issue. These fees violate federal regulations that require health plans to send payments electronically at no cost. Zealous charges fees of 2.5% for electronic transactions, which can add up to billions of dollars each year for medical practices. This not only affects the profitability of practices but also leads to increased healthcare costs. CMS needs to enforce existing regulations and stop these illegal fees.
The Role of Matthew Albright
Matthew Albright, a former intern director of the Division of National Standards at CMS, played a significant role in writing regulations regarding electronic transactions between physicians and health insurance companies. However, he later became a lobbyist for Zealous, the company he was supposed to regulate. This clear conflict of interest has allowed Zealous and other companies to impose illegal fees on healthcare providers. CMS must be held accountable and forced to enforce the laws they created.
The VA's Resistance to Paying Fees
The VA has taken steps to resist paying payment processor fees imposed by companies like Zealous. They have stopped accepting virtual credit cards and instead requested paper checks. However, this is not an ideal solution and incurs higher costs. CMS needs to enforce the law and ensure that healthcare providers, including the VA, receive electronic payments at no cost.
Taking Legal Action to Solve the Problem
Suing CMS for violation of the Administrative Procedure Act seems to be the most viable solution. However, legal action is costly and requires significant financial resources. Physicians need to join forces, raise funds, and sponsor a lawsuit to hold CMS accountable and force them to comply with the law. The involvement and support of medical associations and societies are crucial in achieving this goal.
Our guest today is Dr. Alex Shteynshlyuger. We learned about him in a ProPublica article we recently came across. Dr. Alex is on a crusade to educate docs about one very big way that they are getting ripped off and likely don't even know it. He educates us on what payment processing fees are, and how they came to impact docs. These fees are costing doctors millions and millions of dollars every single year. We hope everyone will listen to this episode and then fight for changes to this policy!
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