President of the Texas Medical Board. Board Member, Federation of State Medical Boards Vice-Chair CGB, US Anesthesia Partners.
Houston, Texas
Joined June 2009
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Sherif Zaafran, MD retweeted
A lot of folks don't, Mark! UnitedHealth Group holds a controlling stake in RVO Health, which operates popular health info sites like Healthline and Healthgrades.
I didn't know UnitedHealth controlled those sites until we published the Sunlight Report. UnitedHealth has so much influence over the health information millions of Americans rely on. Surely nothing to see here.
who knew that United Healthcare owned a big internet media company. What could go wrong ?
sunlightreportinsurance.com/…
Sherif Zaafran, MD retweeted
“Winning a legislative debate is only one step. The rulemaking, licensing, and enforcement decisions that follow can determine whether a statute achieves its intended purpose,” writes Dr. Sherif Zaafran.
Learn: ow.ly/gvJu50ZRaHV
@szaafran @ASAGrassroots
Sherif Zaafran, MD retweeted
NEW: We've just released an updated Sunlight Report on UnitedHealth Group.
Our research now identifies 2,807 entities across UnitedHealth's sprawling corporate empire, including 376 additional entities since our original report in 2025.
Here's what the Center for Health & Democracy (@cforhd) found.
NEW: We’ve released the latest edition of our Sunlight Report on UnitedHealth Group!
Our updated research reveals 2,807 entities across UnitedHealth’s sprawling corporate empire, including 376 additional entities identified since our original report in 2025.
From its insurance empire and physician practices to pharmacies and surgery centers, UnitedHealth’s reach into American health care is enormous.
For more, check out the full Sunlight Report on UnitedHealth Group: sunlightreportinsurance.com/
Always great to get together with good friends. Dr. Senator Donna Campbell, our incredible Chair of the Education Committee, our new legislator Dr. Ray Callas, and of course our Chair of the Texas GOP Caucus, Dr. Tom Oliverson. – at Bulverde, TX
Sherif Zaafran, MD retweeted
UnitedHealth Group's profits jumped 55% last quarter, and now the company says a law protecting patients from surprise medical bills is driving up costs. But records show UnitedHealth helped fund the research that led to that same law.
Check out the full story:
healthcareuncovered.substack…
Sherif Zaafran, MD retweeted
After commenting multiple times, 100s of hours of work and waiting nearly 2.5 years, our considerable advocacy as a community has paid off—here are the highlights from the CMS Final Rule on IDR Operations under the #NoSurprisesAct —my editorial comments in are in bold:
1. Plans and issuers must use CARCs and RARCs to communicate NSA-related information on remittance advice. Huge potential win for physicians and will reduce the ineligible claims significantly.
2. Open negotiation must move through the Federal IDR portal, with expanded notice content. The plans have been ignoring the open negotiation (ON) process—not sure that will be working so well for them now.
3. A new open negotiation response notice is required within the first 15 business days. See previous comments.
4. IDR initiation notices require more information, and the non-initiating party must respond within 3 business days. Potentially neutral.
5. Certified IDR entities get 5 business days after final selection to make eligibility determinations. Also potentially good when the CARCs and RARCs are mandated.
6. Plans and issuers must register in the Federal IDR portal. This could be huge but the devil will be in the details.
7. Batching rules are expanded and clarified. Could be a plus/minus
8. Cooling-off for batched disputes is reduced to 30 business days. Better, but we wanted 1 day cooling but way better than the current 90 days.
9. The administrative fee is reduced to $15 per party per dispute. Huge win here as the current CMS fee is $115 per party.
10. CMS declines to finalize certain proposed fee-collection changes and reduced-fee structures for low-dollar or ineligible disputes. The low dollar structure could have really helped radiology.
For those who question the resources spent in time and money for advocacy by the physician and supporting community, this rule, subject to reviewing all 600+ pages, could be Exhibit A for why we do it.
cms.gov/files/document/feder…
Sherif Zaafran, MD retweeted
1/ Unfortunately Becker’s buried the lead here.
Yes @UHC is seeking a premium increase by 10/1/26 in #MD—OF OVER 17%!!!
Recall that 2025 was the worst $ year for UHC of the last 10. In the spring of ‘25, after denying the @WSJ stories for months, UHC finally admitted to both civil and criminal investigations of their #MedicareAdvantage (MA) lines of business. CEO abruptly resigned his position and then from the board, with United announcing “an internal investigation” of its MA biz.
So, is United expecting the good folks of Maryland and other states to pay for their poor management? Sure sounds like that is occurring. Are major increases in the cards for the rest of America?
26,000 Maryland UnitedHealth members could see mid-year rate increases beckerspayer.com/payer/26000…
Sherif Zaafran, MD retweeted
Exhibit A for passage of the No Surprises Act Enforcement Act (H.R. 4710) is demonstrated by the experience of Radiology Associates of North Texas (RANT), one of the largest independent radiology groups in the US.
According to Radiology Business (5/20/2026), "Radiology Associates estimates it has prevailed in about 95% of finalized IDR disputes with Blue Cross Blue Shield of Texas, the state’s largest insurer. However, more than $3.5 million in awarded balances remain unpaid. RANT estimated that $1.64 million of this total has been outstanding for over 120 days. As of Tuesday, BCBS Texas has paid approximately 2% of awarded balances."
RANT is not alone in this experience.
The Emergency Dept. Practice Management Association (EDPMA), representing well over 60% of the ED groups providing care to ED patients (or organizations supporting the provision of care), released a study in April 2026 of over 659,000 successful NSA IDR claims won by its members in 2025. Yet, 48% of those IDR determinations were not paid within the 30-day period required by law. The total outstanding of award determinations not paid by the health plans exceeded $245,000,000.
Congress must pass HR 4710 to give CMS the same enforcement authority it has over hospitals and physicians that it does not currently have over health plans, mainly the ability to assess Civil Monetary Penalties (CMPs) for non-compliance with the NSA.
Radiology Associates of North Texas says it will waste over $51M on costs related to No Surprises Act radiologybusiness.com/topics…
Sherif Zaafran, MD retweeted
To be fair, Medicare grossly underpays doctors while paying hospitals close to market rates. So while 300% Medicare charged by a hospital is unacceptable, it’s not the case for physicians. If you don’t believe me, just compare reimbursement rate increases over the last 40 yrs by Medicare for docs vs. hospitals.
Using price transparency data, a union identified egregious pricing at NewYork-Presbyterian Hospital.
@RepBrianFitz cites charges at 358% more than Medicare.
“After this union dropped New York-Presbyterian from their network, they reportedly saved substantial resources.”
Sherif Zaafran, MD retweeted
One of the major problems with Medicare is that prices are set by a political process, not a market process.
And hospitals have a lot of political power.
Since 2016, Medicare hospital base payment rates have risen—30% for inpatient and 26% for outpatient.
Meanwhile, the physician base payment rate has fallen 7%.
These uneven updates create distortions and may fuel consolidation.
Learn more: t2m.io/xpN3h7X
Sherif Zaafran, MD retweeted
#PatientSafety is a team sport! Over the past weekend I represented @ASALifeline at the @APSForg Board meeting, along with ASA members including @TSAPhysicians President @ERebelloMD, APSF board member @szaafran, and ASA Past President and current APSF President Dr. Dan Cole.
Sherif Zaafran, MD retweeted
🪡 🧵I appreciate @EdGainesIII bringing up the healthplans priorities & refuting them. I will expand on his discussion.
1/ AHIP claims it wants to “make health care more affordable.” ahip.org/news/articles/five-…
As a solo independent physician who deals daily with the No Surprises Act (NSA) and IDR, here’s a fact-based, point-by-point response using backing claims— not talking points.
AHIP’s July 30, 2025 article claims Congress should “Stop Private Equity’s Misuse of the No Surprises Act (NSA).” I’m a solo independent physician who works daily inside NSA Independent Dispute Resolution (IDR), and the real problem is health plans’ “No / Low / Slow Pay” after they LOSE binding arbitration, combined with procedural gamesmanship that forces small practices like mine to keep writing obscene checks just to get paid fairly.
CMS reports that as of Nov. 30, 2025, 4,634,956 IDR disputes had been initiated and over 3.2 million payment determinations issued.
cms.gov/nosurprises/policies…
Congressional Research Service reports ~$718 million in IDR fees in 2024 alone, with initiating parties’ offers selected ~85% of the time, which directly contradicts the claim that physicians are abusing arbitration.
congress.gov/crs_external_pr…
The AMA documents that late payment & nonpayment after IDR determinations is widespread, despite the statute requiring timely payment.
ama-assn.org/health-care-adv…
Mixed court decisions on enforcement of NSA IDR determinations is a Red Line that Congress needs to Act to eliminate judicial ambiguity.
govinfo.gov/content/pkg/USCO…
ca5.uscourts.gov/opinions/pu…
Congress already wrote the rule. Now enforce it. Sign on and Vote Yes on
No Surprises Act Enforcement Act (Murphy–Marshall):
House: congress.gov/bill/119th-cong…
Senate: congress.gov/bill/119th-cong…
ahip.org/news/articles/five-…
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Sherif Zaafran, MD retweeted
We thank Governor Greg Abbott for recognizing January 25-31, 2026 as Physician Anesthesiologists week in Texas!
Happy New Year Everyone. May it be blessed with renewed energy, commitment to humanity, and a sense of purpose!
Very special spending it at a place where life begins....in labor and delivery! (with apple cider) – at Spring, TX
I tried to summarize and answer below what the Dr. Bowden case has always been about. Again, the findings of fact were determined by an independent judicial panel.
youtu.be/N-OSn6o08Zs?si=AuX7… – at Spring, TX
The TMB hearing yesterday dealt with a case involving Dr. Bowden. In spite of a lot of posts trying to relitigate the facts, an independent judge determined these findings of fact. We as a medical board cannot change these findings of fact.
youtu.be/RXux0OAeffU?si=9zq1… – at Spring, TX
As a father who sent his kids to camp all the time, I can't imagine the pain that those who have lost loved ones are going through right now.
May God have mercy on all of the beautiful souls that were lost this weekend in this terrible tragedy. They are all angels in heaven now. – at Spring, TX
Sherif Zaafran, MD retweeted
Thank you for alerting us to this. I was made aware of this earlier. This is the response of her employer attached on here. There is no place for politicization. The entire focus needs to be on looking for survivors. Any complaints we may receive will be thoroughly investigated. – at Spring, TX
My heart is filled with sadness with the news of everyone affected by the power of nature and the catastrophic floods.
I pray for the safe return of all those who are still missing. I pray that they are found soon and back in the arms of their families.
yahoo.com/news/catastrophic-… – at Bunker Hill Village, TX
