Brittani Bilse

wife. mom. @TexasHHSC #1115waiver strategist.

[Brittani Bilse @brittanibilse]

Texas hospital and MCO revenue forecasts should treat the Medicaid caseload spike as over.

[Bill Ackman @BillAckman]

Incredible.

[Barchart @Barchart]

BREAKING 🚨: Commercial Real Estate

Office Delinquency Rates have soared to their highest level in history, surpassing even the peak of the Global Financial Crisis 👀

[Tom Oliverson, M.D. @TomOliverson]

79% of Texans want to know the cost before receiving nonemergency care. As a physician, I couldn’t agree more.

Patients deserve to know what care will cost upfront. That’s what we’re working toward in the House Select Committee on Health Care Affordability. #txlege

Read more: https://t.co/1757QGef5m

[Fmr. Rep. Jason Isaac @ISAACforEnergy]

The price of diesel is too high.

But the answer is NOT an export diesel ban. As I explained to @parisapodaca for @DailyCaller, an export ban is another Washington gimmick that ignores the real problem.

America needs more refining capacity, NOT less.

[Brittani Bilse @brittanibilse]

1115 Waiver trended approvals by @CMSGov:
Louisiana Reentry
Minnesota Reentry
Nevada Reentry Services

[Brittani Bilse @brittanibilse]

Medicaid 1115 Waiver Budget Neutrality is changing, impacting revenue forecasts. https://t.co/iD8RiYhlCt

[HRSA @HRSAgov]

This #TelehealthAwarenessWeek, HRSA is announcing nearly $19 million to expand the reach of telehealth & innovative technologies in rural communities and other areas with limited access to care.

Learn more: https://t.co/N4lWyAjt02

[John Arnold @johnarnold]

2008 was an oil crisis. 2026 is a refining crisis.

2008 (peak)
Oil = $147
Diesel = $4.76 retail
Gasoline = $4.16 retail

Today
Oil = $95
Diesel = $6.53 retail
Gasoline = $4.52 retail

[Dr. Oz CMS @DrOzCMS]

Medicare has been paying about 16% more for laboratory services than private insurers. That needs to change.

CMS plans to better align 2027 laboratory payment rates with private-sector rates — which would be estimated to save taxpayers over $1 BILLION annually once the reductions are fully phased in, lowering Medicare patients’ premium costs.

Protecting Medicare means rooting out waste wherever we find it.

Learn more: https://t.co/Vn2oA0HrpY

[Dr. Oz CMS @DrOzCMS]

The @CMSinnovates Center, led by Abe Sutton, is translating bold ideas into nationwide impact.

With all 50 states, Washington, D.C., and Puerto Rico participating in the GENEROUS Medicaid model, millions of Americans will gain access to lower prescription drug prices — while taxpayers are projected to save nearly $65 BILLION over the next decade.

A win for the American people thanks to @POTUS’s leadership.

[Brandon Waltens @bwaltens]

BREAKING: @GregAbbott_TX directs TCEQ to HALT all data center permits until ERCOT audit is complete

[Dr. Oz CMS @DrOzCMS]

A better deal on prescription drugs for Medicaid—and taxpayers.

Through the GENEROUS program, participating drug manufacturers will provide Most Favored Nation pricing on drugs included in the model—projected to save $5.2 BILLION every year.

When we bring the healthcare system together, we can make medicines more affordable and taxpayer dollars go further.

[Office of County Judge Tim O'Hare @TarrantCoJudge]

Join us on October 1st at Will Rogers Coliseum in Fort Worth from 9-1 for the Empowering Seniors Expo, a free Health and Wellness Expo for seniors and caregivers. Come one, come all!

[Comptroller Don Huffines @DonHuffines]

With state revenue up 4.8%, Texas continues to see strong economic growth.

More growth should mean more tax relief for taxpayers, not bigger government.

[Dan Diamond @ddiamond]

New:

Officials battled over NIH in the Oval Office today, per ppl familiar.

RUSS VOUGHT criticized NIH "woke" spending and floated exec order to review grants.

JAY BHATTACHARYA defended his agency.

TRUMP appeared to side with Vought.

w @rbeggin

https://t.co/Jq0tG1XMem

[Sebastian Caliri @SebastianCaliri]

Is an indigenous drumming circle medicine? Does it help patients with anything? Who knows, but in California Medicaid pays $826 for each session.

It’s almost as if Medicaid is abused by states to pay off miscellaneous favored groups and organizations.

H/t to the great @DrDiGiorgio for reminding me about this one.

This is a solvable problem, but first CMS needs to get states sending data back to Washington. In violation of rules and regs, many states do not remit appropriate data on Medicaid spending today which lets them get away misuse of your tax dollars.

[Sebastian Caliri @SebastianCaliri]

Last week we heard about a Nigerian prince who stole $30M from Medicaid to build a castle. If you think that’s bad, just wait until you hear about the completely legal ways to abuse Medicaid.

States can use something called “1115 waivers” to pursue policy objectives most Americans have no idea Medicaid is funding - including paying providers based on racial-disparity metrics. Brian reports on $21B worth of race-based payments here.

This is still just the tip of the iceberg. We spent about $1T on Medicaid in 2025 but for all that money, many beneficiaries can’t access rudimentary care. It’s not so mysterious when you consider just how much is siphoned off by fraud, the nonprofit-industrial complex, and other pet projects of state officials.

Why can’t we get a handle on this? Partly because of how states remit very limited data to CMS on Medicaid spending. There is a way to fix this.

[Brittani Bilse @brittanibilse]

@CMSGov approved @TexasHHSC Medicaid State Directed Payment Programs with details in the letter outlining issues still open:

[The Kobeissi Letter @KobeissiLetter]

BREAKING: Exxon Mobil has shut down one of the largest diesel refineries in the Midwest, which produces ~11 million gallons of gasoline and diesel fuel per day, due to outage issues.

This comes as diesel prices have already surged nearly 90% this year and the US has entered peak diesel demand season.

We expect to see diesel prices push toward $7.00/gallon.