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Congress Takes Up Medicine's Plea on SGR, IPAB
TMA officials are optimistic about proposals to reform Medicare's physician payment system this year, a top goal for the association's federal legislative agenda.
Is the Price Right? Texas Debates Publicly Posting Physician Fees
The discussions were prompted in part by the emergence of new benefit plans – so-called consumer-directed health plans – that offer lower monthly premiums with higher deductibles to incentivize patients to more judiciously choose their care.
TMA: Expand Coverage and Reform Medicaid
TMA’s Border Health Caucus called on Lt. Gov. David Dewhurst and House Speaker Joe Straus to stop the cuts in dual-eligible payments before another disastrous January rolls around.
State Now Paying Dual-Eligibles' Medicare Deductible
The Texas Health and Human Services Commission (HHSC) restored the Medicare Part B deductible payment on Jan. 25 for patients eligible for both Medicare and Medicaid, also known as "dual eligibles."
Guility 'Til Proven Innocent: State Toughens Medicaid Fraud Rules
TMA fears the new rules to prevent Medicaid fraud will make the state presume that physicians are crooks. That's exactly what happened to Austin's Carousel Pediatrics. The practice is fighting to keep its doors open.
Patients Like Their Doctors
Americans are very happy with their primary care physicians, according to a new national survey conducted by The Physicians Foundation.
The Supreme Court's decision upholding the Patient Protection and Affordable Care Act may not help the uninsured in Texas as much as many people think, even if the state does expand the Medicaid system. There simply may not be enough physicians to care for the thousands of patients who would be added to the rolls.
Dual Eligibles: Medical Emergency
Until January of this year, the federal government (Medicare) paid 80 percent of a "dual-eligible" patients visit to a doctor. The other 20 percent of the cost was paid by Texas Medicaid. The sate Medicaid program also paid the Medicare deductible for these patients. This year the Medicare deductible is $140. Under the new guidelines, which went into effect Jan. 1, 2012, Texas Medicaid no longer pays the physician the patient's 20-percent coinsurance. Nor does Medicaid pay the full $140 annual deductible if Medicare's payment for a service exceeds Medicaid's allowable.
House Repeals IPAB; Bill's Future Doubtful
In what appears to be a futile gesture, the U.S. House of Representatives passed legislation abolishing the Independent Payment Advisory Board (IPAB), a 15-member panel appointed by the president that would recommend cuts in Medicare payment fees to physicians if federal spending on health care reaches certain levels.
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.
A Portrait of Texas Physicians - Findings from Our 2010 Surveys
Employed or contracted physicians are primarily employed by other physicians or physician group practices. While t
he percentage of physicians employed by hospitals is increasing in recent years, few physicians start in this type of environment.
In response to the ongoing problems with the Medicare fee schedule, approximately half of physicians are considering renegotiating or terminating some health plan contracts, changing their status to Medicare non-participating, or formally opting out of Medicare and requiring direct patient payment.
Health System Reform
Respondents believe under the new health care reform plan, the quality of health care will get worse (67 percent).They also believe the cost of health care will go up (78 percent). The majority are disappointed, anxious, confused, and/or angry about the new health reforms.
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