Follow up from today’s post I looked into the group whose video ad is running in the Root post, and what I found is concerning. The ad is titled "EXPOSED: Double Billing." Its disclaimer reads "Paid for by Patients for Safe and Affordable Health Insurance." It is a limited liability company. The only place its legal name appears is the website's privacy policy. There is no named executive director, no board, no staff, no spokesperson, and no press release. Its listed address is 712 H Street NE, Suite 1403, in Washington, DC. That address belongs to a FedEx and UPS shipping store. "Suite 1403" is a mailbox. Its website launched in January 2025. The files behind it are hosted on a WordPress network that also hosts campaign pages for Republican candidates. Most of its pages were written by an account called "Web Ops," not by anyone at the group. This isn't a patient organization that hired a web designer. It's a political vendor's product with a patient-sounding name on the front. In 18 months, its campaigns have covered oncology drug vials, out-of-network doctors, upcoding, hospital facility fees, a state-specific attack on a hospital system in Indiana, and now modifier 25. Every single one targets a doctor or a hospital. Not one targets an insurer. Not one mentions prior authorization, claim denials, or the profits of the companies that sit between patients and their care. Look at who it lets speak. Its "facts" page cites AHIP, the insurance industry's trade association. Its billing campaign is built on a Blue Cross Blue Shield Association report. Its surprise-billing pages repeat the insurer line that arbitration costs too much and doctors win too often. The op-eds it promotes are written by a former Florida Blue executive, a former chief medical officer of Regence Blue Cross, and a former chief medical officer of AmeriHealth Caritas. Not one practicing physician. Not one patient. A group that says it speaks for patients, has no patients, no leaders, and no address, and only ever points in one direction is suspicious at best. Notice the timing. The comment period closed September 14. More than 150 medical organizations told CMS to withdraw this proposal. CMS tried the same cut in 2019 and pulled it. The final rule is due within weeks. Nine influencers and a video ad showed up in exactly that window, with the same talking points, thanking the administration for a rule it hasn't finalized yet. That is a pressure campaign not a public awareness campaign. Why would an insurer care about a Medicare rule? Commercial plans already fight physicians over modifier 25 claims. Physicians push back because Medicare, the benchmark, pays in full. If CMS cuts it, every commercial contract in the country follows, and the cut stops being something a doctor can appeal. The savings won’t ever go to seniors. They will go to the plans and their shareholders. Who funds this and why are we hearing from a mailbox instead of a person? If you want to argue that Medicare should pay less for same-day services, make that argument. Put your name on it. Publish your data. Tell us who you work for. Defend it in the comment period and in the open. What you shouldn't do is fund a video from a mailbox, pay nine accounts to run the same script, and call it a grassroots movement. Patients do deserve transparency. That starts with knowing who is talking to them.

Let’s talk about physician payment for a minute and why that AMA graph just doesn’t feel like it tells the whole story. Here’s why… Let’s start with how the AMA calculates its graphic. They work on the specified update, which is what Congress set out to do that year… but that’s only half the story Each year, the conversion factor (CF) is recalculated by multiplying the prior year CF by the statutory update by the budget-neutrality adjustment. When you only go on the statutory update, you miss a big potential gain or loss due to budget neutrality. @anish_koka has explained why budget neutrality has doomed the physician fee schedule permanently. The AMA has provided Congress with years of bad data that ignores the massive financial trouble that budget neutrality has caused and created a far rosier picture. When you look at the AMA graph, it appears doctors have seen a 10% increase since 2000. The 2000 CF was $36.6137. The 2027 proposed CF is $32.84. That’s over 10% in the negative direction. We need truth in advertising. I begged the specialty societies and the AMA to fix their graphs. I spent 3 years asking for it. No one listened. So, I did what I had to do and I pulled the data together. Below is the work product of that venture and a graph that I think (visually) shows the much more striking reason why doctors are leaving medicine or selling their practices. The first graph looks at things from the perspective of the 2000 CF. If we just compare how much doctors and hospitals are paid, we see that physician pay via CF has declined 10.3% while hospital pay has increased 97% and inflation (MEI) has increased 71%. That seems pretty stark but I think the second graph uses the same numbers but in a more effective way. The second graph assumes that MEI is the baseline. In other words, what if doctors just got what they were paid in 2000, updated for the cost of inflation. Now we see what really has happened. Doctors are 81.3% behind inflation while hospitals are 26.8% above inflation. No wonder hospitals are buyers and doctors are sellers in this market. It’s time for truth in advertising. It’s time Congress and CMS heard the real numbers. 81% behind inflation over 25 years and even worse when compared to HOPDs. Our government created this crisis and they will need to understand the issues they created to get us out. Follow us at @IndeMedAction as we shine the light on issues critical to independent physicians.