Hot Topics

Feds Enact Tougher Standards as Nurses Contract Ebola

Last week, Thomas Eric Duncan, the first known person to develop Ebola in the United States, died at Texas Health Presbyterian Hospital in Dallas.

TMA’s 2015 Legislative Agenda

In unveiling their 2015 Texas legislative agenda, Texas Medical Association (TMA) physicians urge state and federal leaders to enhance the environment in which doctors practice medicine so they can do what they do best — care for patients.



Bone Up on New Medicare Mandates at TMA's Annual Medicare Seminar
Prepare for the gush of Medicare's new 2015 quality measurements, payment formulas, and pay cuts by attending one of TMA's live Medicare 2015 seminars running Feb. 3-25 in cities across the state.

Performance Scores Added to Physician Compare Website
Patients can now look online to see how some physician practices performed on certain Medicare rankings. The Centers for Medicare & Medicaid Services this December posted new performance scores to its Physician Compare website on four quality measures from the 2013 Physician Quality Reporting System program reporting year.

2015 TMA Winter Conference: Leading the Way Through Crisis and Change
The 2015 TMA Winter Conference takes place Jan. 30-31 at the Hyatt Regency in downtown Austin. Physicians and medical students will have the opportunity to conduct TMA business, obtain continuing medical education credit, and network with peers. Join your colleagues and participate in discussions on crisis management, the current legislative session, and changes in the health care landscape.

TMLT Adds $15 Million to Trust Rewards Program
The Texas Medical Liability Trust (TMLT) allocated an additional $15 million this month to its Trust Rewards Program for 2015, bringing the program's total to $165 million. TMLT started the program in 2012 to reward policyholders for their loyalty.

Save the Date(s) for First Tuesdays
First Tuesdays at the Capitol returns next month, and the Family of Medicine needs you to be there.

Medicare Meaningful Use Attestation Deadline Looms
Don't miss out on your Medicare electronic health record (EHR) incentive payment for 2014. The deadline is Feb. 28 at 10:59 pm CT to attest that you met the Medicare EHR meaningful use criteria for 2014. You also must meet this deadline to avoid the 3-percent penalty on Medicare charges in 2017.

Feds Say They Cut Burden of RAC Audits
In response to industry feedback, the Centers for Medicare & Medicaid Services (CMS) last month released 20 improvements to its Recovery Audit Contractors (RAC) program to reduce its burden on physicians, enhance oversight, and increase transparency. The changes take effect when the next recovery auditor contracts are awarded and are listed on the CMS website.

Get Tweeting! Hashtag #TMASMA
Silly as its name sounds, Twitter is a communication tool of choice for the Texas Legislature. Groups that most effectively use this social network to influence the legislative process have trained their supporters to faithfully echo the organizations’ Twitter messages. This tactic substantially increases the groups’ Twitter reach … and impact.

Save 20 Percent on All Online CME This Month Only
TMA members already receive exclusive pricing on all TMA continuing medical education (CME) courses as a membership benefit, but for the entire month of January, the discounts have gotten even bigger – 20 percent bigger! The TMA Education Center offers more than 80 CME courses covering a wide variety of topics, including some 50 offering ethics credit, making it easy to find education that can benefit you and your practice.

Register Today for TexMed 2015, TMA's Premier Annual Event
Join thousands of fellow Texas physicians in Austin May 1-2 for a weekend of advocacy, education, and collaboration at TexMed 2015, TMA's annual conference and largest event of the year. TexMed 2015 offers more than 80 hours of free continuing medical education, special guest speakers, and an extensive gathering of exhibitors to help with every aspect of your practice.

TMA Calls for Tougher HMO Network Adequacy Rules
TMA and 11 state specialty societies filed a 34-page letter with the Texas Department of Insurance, commenting on the network adequacy and out-of-network payment provisions of TDI's informal working draft rule proposal on HMOs. The letter says the draft proposal would reduce the value of HMO products available to consumers and increase consumer out-of-pocket expenses.

Patients Continue to Ask Doctors for Unnecessary Tests, Study Finds
Two-thirds of physicians say they have a great responsibility in making sure their patients do not receive unnecessary tests and procedures; yet even more say American physicians today are ordering these exams every week, a new survey finds.

Pediatrician Suggests You Choose Wisely With Patients
Marylou Buyse, MD, pediatrician and chief medical director of Scott & White Memorial Hospital Health Plan, wants Texas physicians to spark discussion with patients by using Choosing Wisely.

Write to Congress to Ask for Two-Year ICD-10 Delay
Join physicians from across the United States to ask Congress for a two-year delay in ICD-10. Ask Congress to delay the mandatory implementation until October 2017 so you and your colleagues can spend more time on patient care. Your patients deserve it.

TMA, AMA Tell Feds to Expedite RAC Audit Appeals
It’s a terrible idea to announce a 28-month delay in handling appeals just as physicians’ frustration and ire with Medicare recovery audit contractors (RACs) are mounting, TMA, the American Medical Association, and nearly 100 other physician organizations told a federal official. They called for an immediate solution to the appeals hearings backlog that has caused the delay.

Texas Physicians Call on Congress to Fix Medicare Formula Now
Physician leaders from the Texas Medical Association are in Washington today to urge every member of the Texas congressional delegation to cosponsor landmark legislation that would strengthen Medicare by updating the program’s troubled payment system.

CMS Releases Medicare Physician Payment Data
On April 9, the Centers for Medicare & Medicaid Services (CMS) gave the public unprecedented access to physician payments and charges for services and procedures provided to Medicare beneficiaries. The CMS online database contains information on more than 880,000 physicians and other health care professionals who collectively received $77 billion in Medicare Part B payments in 2012.

Congress Patches SGR, Delays ICD-10
Congress has done it again. For the 17th time, lawmakers slapped yet another Band-Aid on Medicare to stave off a 24-percent physician payment cut under the fatally flawed Sustainable Growth Rate (SGR) formula. It sets the next SGR cliff for April 1, 2015.

GME Expansion a Top Priority for Texas Specialty Societies
Winning greater investment in graduate medical education (GME) programs is a 2015 legislative priority for most of the Texas Family of Medicine.

TMA Supports OIG Improvements, Stronger Medicaid HMO Oversight
John Holcomb, MD, a San Antonio pulmonologist and chair of TMA's Select Committee on Medicaid, CHIP, and the Uninsured, testified at the Sunset Advisory Commission last month on proposed changes to the Texas Health and Human Services Commission. On behalf of TMA and four other organizations, Dr. Holcomb testified on concerns with Medicaid HMOs and the HHSC Office of Inspector General (OIG). Comments touched on public health matters, as well.

Are You Receiving a PQRS Penalty in 2015?
Payment adjustments under the Centers for Medicare & Medicaid Services (CMS) Physician Quality Reporting System (PQRS) have begun. CMS is cutting payments by 1.5-percent  under the Medicare Physician Fee Schedule for eligible professionals (EPs) who did not report or satisfactorily participate in the 2013 PQRS program year. Physicians receiving a PQRS payment adjustment who believe the penalty is being applied in error can appeal the determination and request an informal review from CMS now through Feb. 28.

Sign Up Now for TMA Legislative News Hotline
Want to stay fully informed of the latest happenings of the 2015 Texas Legislature? Subscribe today to TMA Legislative News Hotline.

TexMed 2015 Registration Is Now Open. It’s Free!
Register today for TMA's free annual conference, and join thousands of fellow Texas physicians, as TexMed 2015 descends on Austin May 1-2 for a weekend of advocacy, education, and collaboration. TexMed is TMA's largest event of the year, offering more than 80 hours of available continuing medical education (CME), an extensive gathering of exhibitors to help with every aspect of your practice, and since we’re in Austin, a special Thursday event at the Capitol.

Vaccination Event Funding Available From TMA
The Texas Medical Association can help you fund a local shot clinic. TMA’s Be Wise — ImmunizeSM offers grants of up to $2,500 to fund free or low-cost events for children, adolescents, or adults.

New Comp Fee Guideline Conversion Factors Available
The Texas Department of Insurance (TDI) has posted the annual change to the Medical Fee Guideline conversion factors. The most current reimbursement methodologies, models, and values or weights used by the Centers for Medicare & Medicaid Services are the basis of the fee guidelines adopted by the Texas Division of Workers' Compensation (DWC) for non-network services and approved out-of-network services.

Medicare 2015 Fee Schedules Delayed
The American Medical Association reports that Medicare claims-processing contractors removed the 2015 physician fee schedules from their websites in late December. A notice on the sites indicated that technical corrections are being made to the payment rates and that they will be posted no later than Jan. 20, 2015. On Dec. 29, the Centers for Medicare & Medicaid Services issued a related announcement regarding Medicare claims for 2015 dates of service being held for the first two weeks of the year.

Quality and Cost Reports Are Here
This fall, the Centers for Medicare & Medicaid Services (CMS) made quality and cost reports available to physicians and group practices nationwide for the first time. The Quality and Resource Use Reports (QRURs) provide comparative information about the quality and cost of the care you delivered to your Medicare fee-for-service patients during 2013.

Half of Eligible Professionals Will Face Meaningful Use Penalty in 2015
Recent news from the Centers for Medicare & Medicaid Services (CMS) that more than 50 percent of eligible professionals will face penalties under the meaningful use program in 2015 sent shock waves through the medical community.

Court Invalidates Payment Hold for Minor Medicaid Violations
The Texas Third Court of Appeals struck a major blow to the Texas Health & Human Services Commission (HHSC) Office of Inspector General's (OIG's) investigative framework. Judges invalidated rules that allowed the agency to place payment holds on Medicaid physicians for non-fraudulent program violations. The court also declared invalid a rule that allowed OIG to retain a health care professional's funds after termination of the payment hold period.

EHR Contracts Seal the Deal; Consider Having Them Reviewed
TMA’s latest HIT preliminary survey results indicate 68 percent of Texas physicians now use an electronic health record (EHR). Even at critical mass, some practices are still in the market for a replacement, and a few first-time purchasers remain.

AMA Wants Significant Changes to RAC Audits
The American Medical Association cites "bounty hunter-like tactics" and a two-year backlog of Medicare and Medicaid appeals in a letter urging the Centers for Medicare & Medicaid Services (CMS) to make significant changes to the Recovery Audit Program (RAC).

Physicians Receive ACA Grace Period Notice Letters
Some Texas physicians have notified TMA they have received letters from Blue Cross and Blue Shield of Texas (BCBSTX) notifying them that a patient is in the second or third month of the Affordable Care Act (ACA) 90-day grace period. The grace period is triggered once a patient with subsidized marketplace coverage misses a premium payment. Instead of immediately terminating the policy, health plans must give the patient 90 days to catch up.

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.

Earn CME at the Physician Health and Wellness Seminar
Hope in a Changing World is the theme of the Texas Medical Association Committee on Physician Health and Wellness (PHW) Training Seminar and 22nd Annual Retreat Feb. 27-28, 2015, at the Grand Hyatt San Antonio. The conference has been accredited for a maximum of 10 AMA PRA Category 1 Credits™, 8.5 of which have an ethics and/or professional responsibility education designation.

Appeals Court Rules Marriage and Family Therapists Can't Diagnose
The Texas Third District Court of Appeals handed down a favorable decision in TMA's lawsuit against the Texas State Board of Examiners of Marriage and Family Therapists (TSBMFT). The court decided marriage and family therapists cannot diagnose.

Physicians, Med Students: Enter Your Journalism in TMA Awards Competition
Do you write a medical column for your local newspaper, or have you had an article published in a general news outlet? Do you host a health-focused radio show or a segment on local TV news? If so, enter your work in the TMA Anson Jones, MD, Awards contest.

Free Ebola CME from UTHSCSA
The University of Texas Health Science Center at San Antonio is offering an online course titled Ebola Virus Disease: What Should You Know? Update and Demonstration of Donning and Doffing of Personal Protective Equipment. Physicians can earn free 1.0 AMA PRA Category 1 Credit™ upon completion of the course.

Hey, Doc, Can Health Insurance Subsidies Help Me?

This week’s segment in Texas Medical Association’s (TMA’s) “Hey, Doc” health insurance marketplace education campaign answers questions about the tough part — paying for insurance — and how to get assistance. 

Choosing Wisely: Free CME from TMA
Choosing Wisely is an initiative of the ABIM Foundation that promotes conversations among physicians and patients to ensure delivery of the right care at the right time. Due to the popularity of the Choosing Wisely continuing medical education (CME) webinars, TMA will continue to offer the CME bundle to members at no cost for a limited time.

Meaningful Use Audits: Be Prepared
TMA is hearing from physicians who are being audited for meaningful use and some who have had their meaningful use incentive dollars recouped. Don't let this happen to you. Remember: Meaningful use is all or nothing. Physicians must meet all measures for successful attestation. This includes conducting a security risk analysis for HIPAA to ensure protection of patient information.

CMS: How to Report Only Once for PQRS, Meaningful Use, Other Programs
According to the Centers for Medicare & Medicaid Services (CMS), physicians who are beyond their first year of participation in the Medicare electronic health record incentive program have the option to streamline their reporting efforts and report quality data only once for several Medicare quality programs.

New Toolkit Helps Doctors Navigate Medical Audits
The Physicians Advocacy Institute and the American College of Emergency Physicians collaborated to develop the Toolkit for Physicians Facing Medical Audits, which provides practical information and tips to help physicians anticipate medical audits, respond to auditors’ requests for medical records, and appeal erroneous audit findings.

AABB Asks for Blood Collection, Use, Management Data
TMA’s Blood and Tissue Usage Committee encourages Texas physicians to complete a new national survey and inform their hospital blood banks about it.

TMA to CMS: Suspend MU Measures That Force Doctors to Coerce Patients
In a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner, TMA asked CMS to immediately suspend meaningful use core measures 7  and 17 .

Get Up to Speed on New Driving Rules, Medical Restrictions
Physicians play an important role in helping to ensure drivers of all ages are medically fit to get behind the wheel. For the first time since 1991, Texas has updated its driving guidelines, with changes that better reflect advances in medical care in the past 23 years.

You Can Now Pay Online for DPS Schedule II Prescription Pads
The Texas Department of Public Safety (DPS) now allows physicians and nonphysician practitioners with a valid controlled substances registration to order and pay online for their prescription pad orders.

Meaningful Use Requires Reporting Clinical Quality Measures
Physicians must report on nine (of 64) clinical quality measures as part of meaningful use. During Stage 1, this was listed as one of the core measures. For Stage 2, it is no longer listed as a separate measure, but it is still required.

“Hey, Doc”: Where Can I Get Help Signing Up in the Marketplace?
This week, TMA’s “Hey, Doc” education campaign answers Texans’ questions about where they can get help signing up for coverage in the new health insurance marketplace, when they can create an account, and how they can get ready to sign up.

Six Texas Communities Receive Vaccination Grants
Six communities across Texas were awarded grants to help physicians and community organizations provide free and low-cost vaccinations to uninsured and underinsured Texans. The grants totaling more than $11,500 were provided by the Texas Medical Association’s Be Wise — ImmunizeSM  program.

Texas Doctors and Nurses Jointly Prep for Ebola

Thousands of Texas physicians and nurses this evening took part in a joint education program to learn as much as they can about the Ebola virus.

TMA Backs Plan to Revamp Medicaid Fraud Cops
The state's use of freezing payments to physicians suspected of possible Medicaid fraud "has gone beyond the law's intent," according to a 225-page report on the Texas Health and Human Services Commission by the Texas Sunset Advisory Commission. The report describes the HHSC Office of Inspector General (OIG) as an agency with poorly trained staff and little accountability or transparency.

TMA Is Searching for the Top Health News of 2014
The TMA Anson Jones, MD, Awards honor outstanding health journalism, and we need your help to find the best stories of 2014. If you've seen, heard, or read an article that caught your attention, nominate it for an award.

Don’t Let Your Membership Lapse. Renew Today!
Intrusion after intrusion is threatening your practice and the care of your patients as you know it. Fortunately, you can trust TMA and your county medical society to stand by you to address them. Your association advocates relentlessly in Washington and Austin to eliminate red tape and bureaucracy. But even as we work to deliver these legislative fixes, TMA provides first-class solutions to your practice headaches.

FDA Allows Normal Saline Importation to Alleviate Shortage
A critical shortage of 0.9-percent sodium chloride injection (normal saline) that threatens patients' safety prompted the U.S. Food and Drug Administration (FDA) to allow B. Braun Medical Inc., of Bethlehem, Pa., to temporarily distribute the drug in the United States from its manufacturing facility in Germany.

Guard Your Practice Against Employee Theft
Medical practices are especially vulnerable to embezzlement, in part, because they are typically cash businesses. According to a 2009 Medical Group Management Association study, 83 percent of the medical practices polled had been the victim of employee theft or embezzlement. But because medical offices are run by a close-knit staff, it can be hard for a physician to imagine any employees stealing from the practice.

New Deadline to Apply for Meaningful Use Hardship Exception
The Centers for Medicare & Medicaid Services (CMS) will reopen its meaningful use hardship exception application for physicians and hospitals to avoid the 2015 penalty. Following advocacy efforts by the American Medical Association, the new deadline will be Nov. 30. The hardship exception application deadline had been April 1 for hospitals and July 1 for physicians.

Doctors Worried About Nonphysician Entities Providing Medicare Wellness Visits
TMA officials remind physicians they can provide Medicare annual and first-time "Welcome to Medicare" wellness visits to their patients and warn that nonphysician health care entities may be beating doctors to the punch, albeit legally. "Welcome to Medicare" visits occur within a patient's first 12 months of having Medicare Part B coverage.

Judge Sides With Aetna Against Texas Clinics
Aetna is collecting $8.4 million from a small hospital and three clinics after a Texas judge ruled the facilities overbilled the insurer for two years.

FDA Warns Against Using NuVision Pharmacy Sterile Products
The U.S. Food and Drug Administration (FDA) has safety concerns about sterile-use drug products made and distributed by Downing Labs LLC, doing business as NuVision Pharmacy, in Dallas.

New Webinars Offer Guidance on Accurate, Timely Payments
Late payments? Missed revenue? The efficiency of your billing can make or break your practice. By using accurate billing techniques and effective collection strategies you can keep your practice revenue flowing.

Free TMA Publication: Business Basics
Thanks to a generous grant from The Physicians Foundation, you can download Business Basics for Physicians, TMA's newest publication, free.

Get Critical Lab Values on Your Mobile Device via DocbookMD
You no longer have to wait by the fax machine, computer, or electronic health record for lab results. DocbookMD's latest clinical integration with Clinical Pathology Laboratories allows users to report critical lab values directly to the ordering physician's mobile device or laptop at the moment the labs are completed. Critical values will be sent directly to the ordering physicians, wherever they are, to any device the DocbookMD app is running on.

Perform FGIs? Undergo Safety Training by May 1, 2015
Under Texas law, physicians performing fluoroscopically guided interventions (FGI) must undergo safety training. Specifically, by May 1, 2015, physicians have to complete a minimum of 8 hours of AMA PRA Category 1 Credit™ in radiation safety awareness training. For more information, read the Texas Department of State Health Services (DSHS) Questions and Answers document.

Two Deaths From Enterovirus D68 Reported

A four-year-old New Jersey boy died Sept. 25, and a 21-month-old Michigan girl died Oct. 10, making them the first two confirmed deaths from enterovirus D68 (EV-D68). The Centers for Disease Control and Prevention (CDC) confirmed 594 cases of EV-D68 in 43 states, including Texas, as of Oct. 6. 

DSHS Offers Tutorial on Using PEP to Identify, Prevent Rabies
The Texas Department of State Health Services (DSHS) and the Texas Health and Human Services Commission are offering a tutorial titled Identifying Rabies Exposures and Preventing Rabies Through Post-Exposure Prophylaxis.

Upgrade Your EHR by Jan. 1, 2015
If you are participating in the electronic health record (EHR) meaningful use incentive program and haven't upgraded your EHR to the 2014 version yet, be sure to do so by Jan. 1, 2015. Some EHR vendors have already released 2014 certified versions of their products. You can check the certified health product list to see if your vendor has upgraded yet.

TMF to Lead Regional Health Care Improvement Initiatives
TMF Health Quality Institute has been designated the Quality Innovation Network-Quality Improvement Organization by the Centers for Medicare & Medicaid Services for Arkansas, Missouri, Oklahoma, Puerto Rico, and Texas.

TMF Announces 2013-14 Texas Physician Practice Quality Improvement Award Recipients
TMA, the TMF Health Quality Institute, and the Texas Osteopathic Medical Association recognize the 291 recipients of the 2013-14 Texas Physician Practice Quality Improvement Award for their commitment to improving patient care. These practices have demonstrated excellence in health care quality through exemplary performance on national quality priorities.

Physicians Get Green Light to Treat Families for Infectious Diseases
Texas physicians may now prescribe medications and vaccines to close contacts of their patients to prevent the further spread of infectious diseases. The Texas Medical Board announced the change to its rules in the July 25 issue of the Texas Register.

TMA Asks Legislature to Increase Medicaid, CHIP Payments for Physicians
TMA and 17 state specialty societies called on the Legislative Budget Board (LBB) asking for action to increase "utterly inadequate physician payment rates" in Texas Medicaid and the Children's Health Insurance Program. TMA also provided comments to the LBB on funding for exceptional items requested by the Texas Department of State Health Services in its Legislative Appropriations Request.

TMA: CHIP Managed Care Plans Responsible for Out-of-Network Payments
Because federal law prohibits patients covered by the Children's Health Insurance Program (CHIP) from paying anything other than a copay, the state of Texas should require managed care organizations in CHIP to cover the costs for out-of-network physicians. That's the position TMA takes in a formal letter to the Texas Health and Human Services Commission.

Survey Says Physicians Overextended and Overworked
Physicians are at or exceeding full patient capacity and are limiting access to their practices in light of significant changes to the medical practice environment, according to a comprehensive new survey by The Physicians Foundation.

Educate Your Patients on Flu Vaccination
Today is annual Influenza Awareness Day in Texas. The day, designated by the Texas Legislature in 2013, raises public awareness of the health risks associated with influenza and encourages Texans to reduce these risks. One of the safest, most effective ways to reduce transmission of flu is to receive annual flu vaccination, universally recommended for anyone aged 6 months and older.

Are You Choosing Wisely?
The Choosing Wisely® campaign is a no-cost initiative that promotes conversations among physicians and patients about the need, or lack thereof, for many commonly ordered tests or treatments.

What About Hydrocodone Combination Refills?
On Oct. 6, 2014, drugs that contain hydrocodone combinations switch from Schedule III to Schedule II. How will I handle a prescription I write for a hydrocodone combination product on Oct. 5 (while it is still a Schedule III drug), and specify refills?

Nominate a Teacher for Excellence in Science Teaching Award
TMA is giving away $24,000 in cash prizes to great science teachers. Please help spread the word. Three Texas science teachers will receive $5,000 each and an all-expense paid trip to TMA's annual conference for the TMA Ernest and Sarah Butler Awards for Excellence in Science Teaching presentation ceremony in May 2015. Their schools will receive a $2,000 award to use toward the science curriculum. In addition, second-place winners receive $1,000 for their schools.

Training Available for Preventable Adverse Events Reporting
Mandatory reporting of preventable adverse events occurring at Texas health care facilities, including general hospitals and ambulatory surgery centers, will begin Jan. 1, 2015. Amendments to the Texas Health and Safety Code during the 2013 legislative session require reporting by health care facilities to the Texas Department of State Health Services (DSHS) for public posting on the DSHS website.

Get Your Practice in Shape With TMA’s Business Boot Camp
In this tough business climate of rising costs and falling payments, two-thirds of Texas physicians report having trouble covering payroll and other practice expenses because of slow pay, low pay, or no pay from insurers and government payers. It is now more imperative than ever to closely manage your practice's finances, minimize waste, and collect every bit of income you are due.

TMA Opposes Bill to Expand Audiologists' Scope
TMA and more than 110 national organizations, state and local medical associations, and state and local specialty societies delivered a clear message to members of the U.S. Congress: Oppose any efforts to give audiologists direct, unlimited access to Medicare patients without a physician referral and to include audiologists in the definition of physician. The groups outlined their opposition to House Resolution 5304 in a letter to Congress last month.

DSHS Alert Urges Doctors to Report Respiratory Illness Outbreaks
The Texas Department of State Health Services (DSHS) has issued a health alert since learning nine residents of North and East Texas tested positive for enterovirus D68 at a Centers for Disease Control and Prevention laboratory.

Broadband Access Needed for EHR Incentive Programs
Physicians living in rural areas may struggle with some of the meaningful use measures, especially if their patients cannot access the information required. For this reason, there is an exclusion related to broadband access. TMA has received calls about how physicians can find out if they are eligible for this exclusion.

DSHS Offers Local Health Authority Training Module
Physicians who have been appointed as a local health authority (LHA) or have an interest in the role can now access online training from the Texas Department of State Health Services Division for Regional and Local Health Services. The LHA training module debuted online in August. The module, developed based on feedback obtained in a statewide survey of LHAs, provides an overview of authorities' roles and responsibilities.

TMA Knowledge Center Offers Current Medical Diagnosis & Treatment 2015
To deliver the best care to your patients, turn to the No. 1 annually updated guide in internal medicine and clinical practice, Current Medical Diagnosis & Treatment 2015. The latest edition is now available in AccessMedicine, a database offered as a member-only benefit through the TMA Knowledge Center.

Take TMA's Texas Physician Survey
TMA's 2014 Texas Physician Survey is under way. Complete the survey, and provide TMA with your opinion on and experience related to health care issues. Your feedback helps support the association's policy development and political focus.

Do You Choose Wisely?
TMA wants to know if you have implemented the Choosing Wisely® recommendations in your practice.

Fight the Flu With Tools From TMA
Flu season is just around the corner, and TMA's Be Wise — Immunize program has tools you can use to protect yourself, your staff, and your patients:

DSHS Provides Interim Guidance on Enterovirus D68
A recent outbreak of enterorvirus D68 (EV-D68) is affecting children in six states throughout the Midwest. The Centers for Disease Control and Prevention reports that as of Sept. 10, 84 people had been confirmed to have respiratory illness caused by EV-D68.

TDI FAQs Address 90-Day Grace Period, Prompt Pay
The Texas Department of Insurance (TDI) has updated its FAQs for Health Carriers to include information about the federal 90-day grace period granted to patients with subsidized ACA health insurance marketplace coverage and about prompt payment of claims.

New Option for Providing LARCs to Medicaid, TWHP Patients
Physicians now have a new option for providing select long-acting reversible contraceptives (LARCs) to their Medicaid or Texas Women’s Health Program (TWHP) patients. Effective Aug. 1, the Texas Health and Human Services Commission added Mirena and Skyla to the Medicaid drug and device formulary, allowing physicians the option of writing a prescription for the devices instead of buying and billing, as they had to do before the change.

CMS Sets ICD-10 Testing Dates
The Centers for Medicare & Medicaid Services (CMS) has instructed Medicare administrative contractors to promote three specific testing weeks with health professionals and to provide data and statistics to CMS that demonstrate readiness for the ICD-10 transition.

TMA Comments on TDI Draft Rules for Independent Review Organizations
TMA told the Texas Department of Insurance (TDI) in a letter that the association will oppose any potential fee increases affecting physicians involved in a review of an independent review organization (IRO). TMA provided comments Aug. 15 on TDI's informal draft rules for IROs.

New CMS Rule Slightly Modifies EHR Program
The Centers for Medicare and Medicaid Services (CMS) recently published a final rule designed to give physicians more flexibility with the floundering electronic health record (EHR) incentive program. While TMA appreciates that CMS recognized the need for modification, the association says CMS did not go far enough and did not heed most of TMA's suggested comments.

Massive HIPAA Breach Affects 4.5 Million Patients
In just the past month, 18 Texas medical centers were part of a massive nationwide HIPAA breach that included the data of 4.5 million patients. The penalties, lawsuits, and negative publicity to follow are sure to take a staggering financial toll. Texas physicians should take proactive steps to implement processes that secure patient data and mitigate risk.

TMA Practice Consulting Helps You Maintain a Healthy Practice
Getting paid for your services accurately and on time is the key to preserving the viability of your practice. By maintaining efficient processes and carefully monitoring each step in the revenue cycle, you can minimize future problems, ensure sufficient cash flow, improve collection rates, and increase staff productivity.

Critical Congenital Heart Disease Reporting Now Mandatory
Beginning Sept. 1, reporting of critical congenital heart disease (CCHD) is mandatory in Texas. House Bill 740, which passed in the 2013 legislative session, added CCHD to the required Texas newborn screening panel. The Texas Department of State Health Services has developed rules for CCHD screening.

TMA Opposes Nurse Practitioner Plan
Proposed new rules regulating the scope of practice of advanced practice registered nurses (APRNs) would illegally allow APRNs to make medical diagnoses, and they ignore key tenets of a new state law, the Texas Medical Association and nine other state medical societies wrote in a formal comment letter to the Texas State Board of Nursing.

STAR+PLUS Expands to Rural Areas
On Sept. 1, the STAR+PLUS Medicaid managed care program expanded to 164 rural counties not currently participating in the model. The expansion requires elderly patients eligible for Medicaid long-term services and supports (LTCSS) and adult patients with disabilities to enroll in a STAR+PLUS plan. Children with disabilities may enroll voluntarily.

Congress Passes VA Overhaul
On Thursday, Congress approved a widespread overhaul of the embattled Department of Veterans Affairs (VA). TMA has been calling on the nation's leaders to clear existing bureaucratic landmines — slow payment and lack of interaction between the VA and the private sector, for instance — so private-sector physicians can help get veterans the timely care they need.























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