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Texas Immunization Conference Coming Nov. 18-20
Learn some strategies to improve immunization rates across Texas at the 2015 Texas Immunization Conference, which will take place Nov. 18-20 at the Renaissance Austin Hotel. The theme is Promoting a Healthy Texas: Communicate, Educate, and Vaccinate. A discounted early bird registration fee is available until Sept. 15. Regular registration ends Oct. 31.

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

CDC Changes 2015-16 Flu Vaccine Recommendations
Among the Advisory Committee on Immunization Practices' recommendations for the 2015-16 influenza season are changes to the composition of the vaccines and revised recommendations for children. What hasn't changed is the recommendation for a routine annual vaccination for everyone aged 6 months and older who does not have contraindications.

TMA Survey Says Texas Doctors Concerned About ICD-10 Rollout
Most Texas physicians say they are not confident their practices are ready to use the new ICD-10 medical billing and coding system by Oct. 1, according to a new report. A new TMA survey regarding practices' ICD-10 readiness reveals doctors' concerns. Some physicians might even retire early as a result of the anticipated disruption stemming from the overhaul.

Effective Sept. 1: Lower Taxes, Greater Plan Accountability, More
This legislative session, TMA fought tirelessly to ensure physicians can continue to give their patients the best care possible. Several TMA-backed bills become law today.

New Law Expands Access to Naloxone
Senate Bill 1462 by Sen. Royce West (D-Dallas), supported by TMA during the legislative session, gives physicians authority to prescribe the lifesaving opioid antagonist naloxone not only to patients but also to family members or friends of those who may be at risk of an overdose. The law, effective Sept. 1, also allows a person or organization acting under a standing order to distribute an opioid antagonist and allows pharmacies to dispense the drug.

Medicaid Not Jumping at TMA’s 1115 Waiver Ideas
State Medicaid officials offered a lukewarm response to TMA's recommendations to increase physician involvement in Medicaid transformation plans, boost physicians’ Medicaid payment rates, and design a privately-based plan to cover more uninsured, low-income Texas adults.

Register Now for TMA's Fall Conference
Join us for the 2015 TMA Fall Conference at Hyatt Regency Lost Pines Resort and Spa, Sept. 25-26. This free member benefit offers you the opportunity to reconnect with colleagues and TMA staff, as well as hear a recap of this year's legislative session and participate in discussions about Texas health care.

Stay Up to Date on Drug Info With PDR Alerts
Make sure you're receiving U.S. Food and Drug Administration-mandated and product-related patient safety alerts the minute they are issued by registering for Physicians' Desk Reference Drug Alerts. This free service also provides information on drug recalls and approvals.

TMA Opposes TMB Proposal to Revise Disciplinary Sanctions
In a letter to the Texas Medical Board (TMB), TMA outlined its concerns with the board's proposal to revise the standard disciplinary sanctions that apply to violations of the Medical Practice Act. Of particular concern to TMA is the board's proposal to increase the "High Sanction" penalty for a standard of care violation and more than one prior standard-of-care or care-related violation from $3,000 per violation to $7,000 per violation.

DPS Automatically Renewed Current, Active CSR Permits
Senate Bill 195 by Sen. Charles Schwertner, MD (R-Georgetown), and Rep. Myra Crownover (R-Denton) eliminates the controlled substances registration (CSR) permit program, effective Sept. 1, 2016. To implement the change, the Texas Department of Public Safety (DPS) says it automatically renewed all active or current CSRs on Aug. 20, 2015. They will expire on Aug. 31, 2016. DPS adds that it will not mail new certificates with automatic renewals.

TMA Tips on Move to ICD-10
Here's an ICD-10 tip with a short life span, and the more prompt you are in billing insurance, the less it applies to you. But it's likely to apply to at least some of the claims you'll submit immediately after the Oct. 1, 2015, ICD-10 implementation date. TMA has resources to help with the transition.

Don't Miss Out! Medicare Pays for Chronic Care Management
Do you manage patient referrals and care transitions between and among physicians and health care settings? Do you spend time reconciling medication lists and managing prescription refills for your patients? Do you take calls during and after office hours to address patient care needs? If the answer is yes and you're not billing for these types of services, you're missing out on a new CPT code and practice revenue opportunity from Medicare.

TMA White Paper Addresses Copy Fees for Mental Health Records
TMA's newly updated white paper (log-in required) addresses Texas Medical Board rules regarding fees for copying mental health medical records, as well as several situations where special rules for charging for copies apply.

Doctors: Expect Care Disruption From Coding Change



Most Texas physicians say they are not confident their practices are prepared to use the new ICD-10 medical billing and coding system by Oct. 1, according to a new report. 

The ICD-10 Grace Period Up Close
The ICD-10 grace period says that for the first year, Medicare will not deny claims solely on the specificity of the codes as long as you use a valid ICD-10 code from the right family of codes. Let’s parse this statement.

Know a Deserving Minority Medical Student Applicant?
The TMA Minority Scholarship Program has provided scholarships to underrepresented minority medical students since 1998. This scholarship supports TMA's vision, "to improve the health of all Texans," and its long-standing priority of addressing health disparities.

Report Examines New Medicare Payment Systems
A new Medicare Watch List report from The Physicians Foundation examines the implications of the new Medicare Access and CHIP Reauthorization Act and future payment models, established after the elimination of the Sustainable Growth Rate formula.

New Member Benefit Helps With ICD-10 Migration
To help with the transition to ICD-10 on Oct. 1, TMA is offering free access to a powerful new tool offered by e-MDs.

Check Your Meaningful Use Registration Details
Do you remember which email address you provided to the Centers for Medicare & Medicaid Services when you registered for the meaningful use program? If not, now is the time to refresh your memory.

Get Paid to Reduce Heart Attacks and Strokes
The Centers for Medicare & Medicaid Services wants to enroll 720 practices in the Million Hearts: Cardiovascular Disease Risk Reduction Model. This new value-based payment model supports the national Million Hearts initiative, which aims to prevent 1 million heart attacks and strokes.

Save on Travel With TMA's Group Discount Program
With the end of summer drawing near, it's the perfect time to plan a last-minute getaway. Whether your trip is for work or pleasure, you can lock in an extra discount, compliments of your TMA membership. TMA members, friends, and family can access below-market rates on all hotels and car rentals around the world — similar to the leading online travel sites but with an additional discount of 10 percent to 20 percent. On average, TMA members have saved $48.39 per booking!

TMA Student and Resident Loans Available
Need help funding your medical school education or residency training? Consider TMA's educational loan program. TMA offers $4,000 student loans for Texas medical students and $3,000 resident loans at a fixed interest rate of 4.4 percent.

TMA Says Involve Physicians in Medicaid 1115 Waiver
Texas' five-year 1115 Medicaid Transformation Waiver will expire Sept. 30, 2016, unless the government grants a renewal or extension. TMA President Tom Garcia, MD, told Texas Health and Human Services Commission Executive Commissioner Chris Traylor in a letter the association "absolutely supports renewal of the waiver beyond its initial five years," but with more physician involvement.

PQRS and the Value Modifier: How to Get and Understand Your Quality Report
The TMF Health Quality Innovation Network Quality Improvement Organization is hosting an open forum on Quality and Resource Use Reports (QRURs) on Tuesday, July 21, from 12:30 pm to 1:30 pm CDT. This open forum is free and will provide you with information on how to access and better understand your QRUR.

PQRS and the Value Modifier
The TMF Quality Innovation Network Quality Improvement Organization will host more webinars on Quality and Resource Use Reports (QRURs). These open forums are free and will provide you with information to help you interpret your QRUR and improve your performance.

Feds Answer Questions on ICD-10 Flexibilities
The Centers for Medicare & Medicaid Services (CMS) released a "Clarifying Questions and Answers" document to help explain its July 6 announcement of a year's worth of slightly relaxed standards on the new ICD-10 coding system. As questions still appear to outnumber answers, Texas physicians should turn to TMA's extensive set of tools and resources to help prepare for the transition.

Humana Again Terminating Texas Physicians From Medicare Advantage Network
TMA has learned Humana is terminating 422 physicians in 17 Texas counties from its Medicare Advantage Plan network, effective Jan. 1, 2016. Humana sent termination notices to physicians on July 1.

BCBSTX to Drop Individual PPO Plans
The Dallas Morning News reported last month that about 367,000 Texans "will lose their individual health insurance policies next year when BlueCross BlueShield of Texas stops offering its Blue Choice PPO [preferred provider organization] plans." The insurer said it paid out $400 million more in claims in 2014 than it collected in premiums.

TMA Participates in Medical Board Call Coverage Stakeholder Meeting
Last month, during a meeting with telemedicine stakeholders, the Texas Medical Board (TMB) requested insight about the need for rulemaking pertaining to "call coverage" and telemedicine. TMB did not provide any proposed language for discussion. Rather, TMB staff used the open discussion to obtain input and suggestions for future presentation to TMB members as they decide whether to make any revisions to telemedicine call coverage regulations.

Does Your Pharmacy Accept EPCS?
Now that electronic prescribing of controlled substances (EPCS) is legal with the proper e-prescribing software, many physicians are finding out that some of their frequently used pharmacies do not accept EPCS.

Report Reveals Texas Hospitals' Potentially Preventable Complications Data
The Texas Department of State Health Services has released the Potentially Preventable Complications in Texas Calendar Year 2012 Report, which shows that about 6.8 percent of Texas health facility inpatient stays (single patient visit or admission through discharge) in 2012 had at least one potentially preventable complication (PPC).

CMS Posts Full Year of 2014 Open Payments Data Totaling $6.49 Billion
The Centers for Medicare & Medicaid Services (CMS) published 2014 Open Payments data detailing transfers of value by drug and medical device makers to health care professionals. The data include information about 11.4 million financial transactions attributed to more than 600,000 physicians and 1,100 teaching hospitals, totaling $6.49 billion.

Medicaid Transformation Waiver Extension Request Due Sept. 30
Texas’s five-year 1115 Medicaid Transformation Waiver will expire Sept. 30, 2016. To extend or renew the waiver, the Texas Health and Human Services Commission (HHSC) has to submit a request to the Centers for Medicaid and Medicare Services (CMS) by Sept. 30, 2015.

ICD-10 Grace Period Eases Burden But Doesn't Delay Implementation
Last week, the American Medical Association and the Centers for Medicare & Medicaid Services jointly announced elements of a "grace period" for the Oct. 1, 2015, implementation of the ICD-10 medical billing and coding system. This is good news but not the complete deliverance physicians were hoping for.

CMS Announces Plans to Help Doctors Transition to ICD-10
The Centers for Medicare and Medicaid Services (CMS) has answered TMA's call to help doctors dodge disaster by providing some flexibility as physicians shift to the new ICD-10 medical billing and coding system. Recently, physician leaders from California, Florida, and New York joined TMA in sending a letter to Andy Slavitt, acting administrator for the Centers for Medicare & Medicaid Services (CMS), which will roll out the mandatory shift to ICD-10 on Oct. 1. While CMS didn't adopt the two-year, penalty-free grace period TMA and the other medical associations requested, the agency did take steps to alleviate some of the potential burdens physicians may face in 86 days.

Participate in the Medicaid EHR Incentive Program by 2016
Physicians interested in receiving incentives for participation in the Medicaid Electronic Health Record (EHR) incentive program need to begin by adopting, implementing, or upgrading a certified EHR by 2016. It is the last year physicians may begin participation in the program to qualify for an incentive, which pays out until 2021.

HHS Awards Teen Pregnancy Prevention Grants to Six Texas Organizations
The U.S. Department of Health and Human Services Office of Adolescent Health awarded more than $86 million in teen pregnancy prevention grants to nonprofit organizations, school districts, universities, and others. The 81 new grants will serve more than 291,000 youths each year in communities where teen birth rates remain high.

Give a High Five to Outstanding Health Reporting
The measles outbreak, new vaping legislation, a state Ebola action plan, the death of the SGR: These are just a few of the health stories that have made headlines in 2015. If a medical story in your hometown has caught your attention, nominate it for the TMA Anson Jones, MD, Awards for excellence in health reporting.

Apply Now for TMA Foundation Grant Support
TMA Foundation is accepting applications to its 2015-16 Medical Community Grants and Medical Student Leadership Grants programs.

HHSC Seeks Medicaid EHR Review Panel Members
The Texas Health and Human Services Commission (HHSC) is seeking candidates for the Texas Medicaid Electronic Health Record (EHR) Incentive Program Ad Hoc Review panel. Ideal candidates would be familiar with EHR systems and the EHR incentive program.

CDC Provides MERS Virus Evaluation Guidelines
The Centers for Disease Control and Prevention (CDC) hosted a call with doctors on June 11 to brief them with updated information and guidelines for evaluating Middle East Respiratory Syndrome (MERS) virus. The interim guidance doesn't include travel advisories, but concern about the virus has grown since the Republic of Korea reported to the World Health Organization an initial case of laboratory-confirmed MERS-CoV infection on May 20. CDC says it represents the first case in what is now the largest single outbreak of MERS-CoV outside of the Arabian Peninsula.

OIG Focuses Fraud Efforts on Physician Compensation
A recent U.S. Office of Inspector General (OIG) fraud alert warns that physician compensation arrangements may result in significant liability.

Be Part of HIE Planning for Rural Texas
Health information exchanges (HIEs) are active in several regions of Texas. Public HIEs received federal grant funds several years ago to build infrastructure that would allow physicians and other health professionals to share patient information. HIEs also have the ability to query a patient for health information outside a practice so physicians have relevant patient information at the point of care.

Federal Judge Sides with Teladoc, Blocks TMB Telemedicine Rule
Last month, U.S. District Judge Robert Pitman granted Teladoc's request for a temporary restraining order and preliminary injunction that blocks the Texas Medical Board's (TMB's) recently adopted telemedicine rule, which prohibits prescription of dangerous drugs or controlled substances without a "defined physician-patient relationship." That includes a physical examination via face-to-face visit or in-person evaluation, as TMB defines those terms in the rules. TMB adopted the rule on April 10, it and was set to take effect June 3.

Consider West Nile Virus
The TMA Committee on Infectious Diseases encourages physicians to be prepared for cases of West Nile virus in patients. One human case has already been confirmed in Harris County, and recent heavy rains throughout the state could allow for mosquito population increases.

TMB Resource Helps Clarify New Telemedicine Rules
The Texas Medical Board (TMB) adopted rules April 10 concerning telemedicine and requirements for prescribing drugs and controlled substances. But since then, there has been some confusion regarding the impact of the new rules.

Victory! CSR Permit Program to Be Eliminated Next Year
Thanks to TMA advocacy this legislative session, the controlled substances registration permit program will be eliminated, effective Sept. 1, 2016. Senate Bill 195 by Sen. Charles Schwertner, MD (R-Georgetown), and Rep. Myra Crownover (R-Denton) also moves the Prescription Drug Monitoring Program from the Texas Department of Public Safety to the Texas State Board of Pharmacy and broadens physicians' authority to delegate who can access the information.

TMA Tells Feds to Scrap Meaningful Use Rule
TMA's comments to the Centers for Medicare & Medicaid Services on proposed meaningful use Stage 3 rules offer a number of suggestions, including dismantling the program and "adopting reasonable baseline rules that physicians can meet to avoid penalties under the meaningful use program and additional requirements they may meet to receive incentive payments."

TMA, AMA Support Sunshine Act Open Payments Reporting Exclusion
TMA and the American Medical Association want to ensure certain educational programs and materials are excluded from Open Payments System reporting. In a letter, TMA, AMA, and dozens of medical organizations and specialty societies assert their support for HR 293 by Texas Congressman Michael C. Burgess, MD.

Supreme Court Ruling Maintains Six-Year Limit on Damage Claims
A U.S. Supreme Court ruling has physicians who care for patients enrolled in federal health care programs breathing easier. The ruling in KBR v. United States of America Ex Relator Benjamin Carter prevents doctors from facing civil lawsuits for an unlimited period of time and maintains the six-year limitation on damage claims under the False Claims Act.

Revised Student Vaccine Requirements Available
The revised 2015-2016 Texas Minimum State Vaccine Requirements for Students Grade K-12 is now available from the Texas Department of State Health Services Immunization Branch. School administrators, health personnel, and parents will receive letters regarding the revised immunization requirements, which play a vital role in maintaining the health and well-being of Texas students.

Start the PQRS GPRO Registration Process Now
The Physician Value-Physician Quality Reporting System (PV-PQRS) registration system is open through June 30. This registration applies to group practices with two or more eligible professionals interested in participating in the 2015 PQRS program year under the group practice reporting option (GPRO).

DSHS Issues Mumps Health Advisory
Two students attending The University of Texas at Austin were diagnosed with mumps last month. The Texas Department of State Health Services (DSHS) issued a health advisory over concern there may be mumps cases appearing in other parts of the state. The advisory encourages physicians to "consider mumps as a diagnosis for any patients presenting with parotitis, orchitis, or other unexplained glandular swelling."

Delegating and Supervising Prescribing Privileges for APRNs/PAs
New state law governing the delegation and supervision of prescribing privileges for advanced practice registered nurses and physician assistants went into effect Nov. 1.  MembersOnlyRed

Congress Asks CMS to Ensure Smooth ICD-10 Transition
Rep. Kevin Brady (R-The Woodlands) is asking the Centers for Medicare & Medicaid Services (CMS) to reassure physicians that the Oct. 1, 2015, ICD-10 implementation "will not cause widespread disruption." In a letter to CMS Acting Administrator Andy Slavitt, Representative Brady, Rep. Sam Johnson (R-Richardson), and 12 other members of the House Ways and Means Committee outline steps the agency can take to instill confidence and address concerns among physicians and the public.

AMA Provides SGR Repeal Bill Summary, Timeline
The American Medical Association’s Legislative Counsel has prepared documents on the recently enacted Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), also known as HR 2.

Help Patients Prepare for Emergencies, Disasters
Physicians can play a significant role in helping patients prepare and respond to disaster situations. Patients, especially those with fragile health, should be counseled on the importance of having a disaster plan in place for themselves and their families.

Meaningful Use Hardship Exemption Portal Now Open
Physicians who didn't meet meaningful use of electronic health records in 2014 will face a 2-percent penalty in 2016. If you think you are eligible for a 2016 exemption, you must file your exemption request by July 1, 2015.

HHSC Launches Policy Feedback Webpage
The Texas Health and Human Services Commission (HHSC) has a new webpage that features a list of proposed Medicaid policy changes. Via the webpage, physicians and other medical practitioners, program clients, and the general public can give HHSC direct feedback regarding new medical and dental policies or changes to existing policies.

Latest CDC Texas HPV Vaccination Report Focuses on New 9-Valent Vaccine
Did you know that at its February meeting the Advisory Committee on Immunization Practices recommended the 9-valent human papillomavirus (HPV) vaccine as one of three HPV vaccines that can be used for females and one of two vaccines that can be used for males? You'll find details on the new vaccine along with Texas-specific information in the Centers for Disease Control and Prevention's third quarter HPV vaccination report.

Lawmakers Pass Pair of TMA's Priority Immunization Bills
Last week, the Texas House of Representatives gave initial approval to two of TMA's priority immunization bills, both authored by Rep. J.D. Sheffield, DO (R-Gatesville).

Preparing for EHR Divorce
It's said that choosing an electronic health record (EHR) system is like choosing a spouse. While the majority of EHR unions seem destined for happily ever after, that is not the case with all. Physicians should have an exit strategy as they enter the EHR vendor relationship. The best way to do this is to seek mutually agreeable contract terms.

Protect Yourself From Tax Fraud
TMA has heard from a handful of member physicians who recently discovered they're the victims of tax fraud. Unfortunately, this is nothing new. Last year, more than 100 Texas Medical Association members notified the association someone had stolen their Social Security numbers and attempted to claim their tax refunds. The association learned the crime's victims also included physician assistants, advanced practice registered nurses, dentists, podiatrists, and pharmacists. Texas is one of 49 states and the District of Columbia affected by this con. So far, the perpetrators haven’t been caught.

Tax Relief, Medicaid Primary Care Pay Bump in Sight; Scope in Crosshairs
As hearings get under way and lawmakers scramble to fashion a budget at the halfway mark of the 2015 legislative session, graduate medical education funding and tax relief remain a focal point for the legislature, and the House of Medicine has made early progress on both fronts. Lawmakers also heard TMA's call to reinstate the Medicaid-Medicare parity payments for primary care.

Toolkit for Physicians Facing Medical Audits
A pair of upcoming webinars show you how to survive a medical audit and offer tips on preventing an audit in the first place.

Feds to Reduce Meaningful Use Reporting Burden
Responding to pressure from TMA and organized medicine, the Centers for Medicare & Medicaid Services announced Jan. 29 it plans to modify rules for the Electronic Health Record Incentive Programs to reduce the reporting burden on physicians.

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.

Find It, Fix It, Keep It: Patient Protection and Affordable Care Act
Affordable Care Act: Find What’s Missing. Keep What Works. Fix What’s Broken.























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