• Health Care Delivery

    • "Hey, Doc"

      Answers to Questions You Never Thought To Ask About the New Health Insurance Marketplace

      Physicians are Americans’ most trusted source for information on the Affordable Care Act (ACA), according to a recent national poll, but that's not where they're getting their news. The Texas Medical Association is about to change all of that. TMA’s “Hey, Doc” educational campaign will provide objective and nonpartisan answers to your most frequently asked questions about the new ACA health insurance marketplace. 

  • Top Stories

    • CMS Proposes New Medicare Advantage Network Rules
      The Centers for Medicare & Medicaid Services (CMS) recently announced it is considering new rules aimed at safeguarding Medicare Advantage enrollees when health plans significantly reduce their physician networks. 
    • Act Now! SGR Repeal Closer Than Ever
      There's a light at the end of the SGR tunnel. Or is it a freight train? You can make the difference and help ensure that Congress permanently repeals Medicare's Sustainable Growth Rate (SGR) formula now.
    • ACA Exchange Plans: Questions and Answers for Texas Physicians
      Confused by all you’ve heard about the Affordable Care Act marketplace insurance plans? Do you know whether you're in — or out — of the narrow networks? How will you tell if a patient is on an exchange plan? What happens to you if patients don't make their premium payments? What, if anything, can you do about all of this? TMA answers these and other tough marketplace exchange questions.
    • Marketplace Means Decisions for Doctors
      The opening of the health insurance marketplaces under the Affordable Care Act (ACA) on Jan.1 means you must be vigilant in your dealings with the health insurance companies. Or you could face major problems. For example, do your existing contracts with insurers mean you're already included in an exchange network? And, it's possible you'll have to refund payments to an insurer if a patient who bought coverage in the ACA marketplace doesn't pay his or her premiums.
    • Board Pulls Plan for Pharmacists to Check Diagnoses
      The Texas State Board of Pharmacy (TSBP) quickly killed a proposal that would have required pharmacists to contact the prescribing physician for each new patient with a prescription for a controlled substance.
    • Medicare Data Release Worries Medicine
      The potential release of Medicare physician claims data to the public "can have unintentional, adverse consequences for patients, providers, and the health care system" if not done correctly, the Texas Medical Association, the American Medical Association, and other state medical societies warned federal officials in August.
    • AMA Analyzes Medicare Physician Fee Rule
      The American Medical Association has prepared an eight-page analysis of the government's proposed 2014 Medicare Physician Fee Schedule.
    • SGR Death Throes? Congress Moves Closer to Medicare Pay Fix
      The potential release of Medicare physician claims data to the public "can have unintentional, adverse consequences for patients, providers, and the health care system" if not done correctly, the Texas Medical Association, the American Medical Association, and other state medical societies warned federal officials in August.
    • Medicare Meltdown Fact Sheet: Stop the Medicare Meltdown — repeal the SGR
      Since the turn of the century, nothing has so regularly and completely vexed and frustrated physicians more than our annual game of chicken with Congress over Medicare payments. Medicare patients and military families are never out of danger. Year after year, the specter of congressional action or lack of action threatens to jeopardize health care for Medicare patients. And, because TRICARE rates for military families are based on Medicare, they’re in danger, too.