Announcing TMA PracticeEdge
The Texas Medical Association (TMA) and Blue Cross and Blue Shield of Texas
(BCBSTX) are launching TMA PracticeEdge to help empower a strong base of
independent physicians to provide quality, cost-effective care to their
patients. This first-of-its kind joint effort leverages the strengths of TMA’s
statewide physician membership and BCBSTX’s resources to benefit the entire Texas
health care community, including patients, hospitals, payers, and other
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.
TMB Adopts New Medical Records Rules
Some of the most common, yet vexing, legal issues facing medical practices involve questions about medical records. Maintaining adequate patient records that adhere to legal requirements is vital.
CMS Open Payments Registration, Data Review Now Active
The Centers for Medicare and Medicaid Services (CMS) developed the Open Payments Program to comply with the Physician Payments Sunshine Act, which requires CMS to publicly report data on items of value given annually to physicians and teaching hospitals.
TMB Rules: Telemedicine Requires In-Person Exam First
Texas Medical Board (TMB) rules adopted last week send a message that technology is no substitute for physical patient exams. By voting to require physicians to conduct a face-to-face examination prior to making a diagnosis or prescribing drugs, TMB took a big step to protect patients who receive telemedicine services.
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.
Texas Obesity Rate Grows to 30 Percent of Adults
Although Texas in 2014 improved its overall health ranking among U.S. states from 36th to 31st, according to the United Health Foundation's annual report, the percentage of obese adult Texans — those who have a body mass index of 30 or higher — grew to 30.9 percent.
The Truth About Balance Billing
A pair of newly developed TMA resources examine how insurance plans' network designs and payment decisions are leaving many Texans with "surprise bills" for health care services.
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.
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.
Victory! Congress Finally Repeals Flawed Medicare SGR Formula
Statement of TMA President Austin I. King, MD, on the U.S. Senate vote to approve HR 2, the Medicare Access and CHIP Reauthorization Act, which finally repealed the Medicare Sustainable Growth Rate (SGR) formula.
TMA and TOA: PROKERA Not for Optometrists
TMA and the Texas Ophthalmological Association (TOA) sent a comment letter to the Texas Optometry Board strongly objecting to a proposed rule concerning procedures authorized for therapeutic optometrists. The proposed rule, published in the March 20 edition of the Texas Register, would allow a therapeutic optometrist to "administer, perform, or prescribe ophthalmic devices, procedures, and appropriate medications administered by topical means, to diagnose or treat visual defects, abnormal conditions, or diseases of the human vision system, including the eye and adnexa."
Medicine's Bills Pick Up Speed
With roughly six weeks to go in the Texas Legislature, lawmakers near the finish line in drafting a state budget for the next two years with significant improvements over last session that march the house of medicine closer to accomplishing its goals. With House and Senate committees in full swing as well, TMA is tracking a plethora of bills on the move that could help or hurt medicine's agenda.
CMS Draft Rules Ease Meaningful Use Requirements
Meeting meaningful use criteria may get a little easier for physicians if the Centers for Medicare & Medicaid Services (CMS) adopts draft rules that propose to standardize the 2015 reporting period for the electronic health record (EHR) incentive program to 90 consecutive days.
ACIP Recommends 9-Valent HPV Vaccine; New App Available
In February, the Advisory Committee on Immunization Practices (ACIP) recommended nonavalent human papillomavirus (HPV) vaccine as one of three HPV vaccines that can be used for routine vaccination in men and women. ACIP recommends routine HPV vaccination begin at age 11 or 12. The vaccination series can be started as early as age 9.
DSHS, CDC Issue Listeria Testing, Medical Guidance
The recent Listeria outbreak linked to Blue Bell Ice Cream prompted the Texas Department of State Health Services (DSHS) to issue a health advisory that recommends testing patients who have fever and other symptoms consistent with listeriosis, are at increased risk of invasive listeriosis, and may have been exposed to Listeria through a potentially contaminated product.
Register for TexMed 2015
Register today for TMA's free annual conference, and join thousands of your fellow Texas physicians, as TexMed 2015 arrives in Austin May 1-2 for a weekend of advocacy, education, and collaboration.
Apply for the TMA Leadership College by July 1
TMA is now accepting applications for the TMA Leadership College Class of 2015. The deadline to apply is July 1.
CDC Reports Focus on Texas HPV Vaccination Data
Did you know that in 2013, 85 percent of Texas girls who were unvaccinated against human papillomavirus (HPV) had a missed opportunity for HPV vaccination? And 93 percent of Texas girls could have started the HPV vaccine series if missed opportunities were eliminated. You'll find this and other insightful Texas-specific data in the Centers for Disease Control and Prevention's quarterly HPV vaccination reports.
Are You Game? A Lawn Party Features Activities for Everyone!
Is your interest piqued? A Lawn Party is the TMA Foundation's 22nd annual benefit gala on May 1 at the Hilton Austin, and it will surely be the most talked about event in 2015. In addition to VIP and general guest tickets, tables of eight also are available to enjoy with friends and colleagues at this stylish backyard-inspired party.
Take a Survey to Help Improve HPV Vaccination Rates in Texas
The MD Anderson Cancer Center 2015 Survey for Improving Pediatric HPV Vaccination Rates in Texas will identify barriers and facilitators to increasing human papillomavirus (HPV) vaccination rates in Texas children.
TMA: Veterans Choice Program is Not Working
Statement of Texas Medical Association President Austin I. King, MD, in response to today’s Associated Press report of continued lengthy delays for Texans seeking care from Veterans Affairs health clinics
Annual HEDIS Data Collection Roundup Launches
Health care payment plans started sending letters to physician offices in February to begin this year's annual Healthcare Effectiveness Data and Information Set (HEDIS) data collection process. No two health plans collect their HEDIS data exactly the same way, but most follow similar processes.
Senate Vote Shores Up Texas Physician Pipeline
Texas Medical Association (TMA) President Austin I. King, MD, issued the following statement after the Texas Senate passed Senate Bill 18 by Sen. Jane Nelson (R-Flower Mound) to fund expansion of graduate medical education in Texas, by a unanimous 31-0 vote.
Free CME and Free to Attend — That's TexMed
From Practice Management to Quality and Patient Safety, TexMed 2015 is packed with a variety of continuing medical education tracks — some 80 hours in total. It's all offered May 1-2 at the Austin Convention Center.
Draft Rules Raise Meaningful Use Reporting Bar
The Centers for Medicare and Medicaid Services released proposed rules March 20 that would set higher benchmarks for physicians to prove meaningful use of electronic health records by 2018.
Feds Finally Fess Up to PQRS/eRx Audits
After several requests from TMA for more information about an unusual Medicare audit notification a physician member had received, the Centers for Medicare and Medicaid Services finally posted a fact sheet about the audit on its website late last month.
Meet the Ever-Changing Compliance Challenge
Do you have a compliance plan? A formal, written plan that everyone in your practice understands and follows? Today's practice policy may be tomorrow's violation, and the consequences for a single violation can be high! Following a written compliance plan with built-in reviews is the only way to stay on top of it all.
TEXPAC Leadership Applications Due April 7 at Noon
Applying for appointment to a committee or board is a great way to let the TEXPAC leadership know you want to be more involved in the process. TEXPAC is looking to fill spots on its Executive Committee, Candidate Evaluation Committee, and Board of Directors.
TMAF Health Improvement Grants Now Available
The TMA Foundation (TMAF) is accepting applications for its two health improvement grant programs for 2015-16. County medical societies and TMA Alliance chapters may apply for up to $7,500 in matching funds from the TMAF Medical Community Grant Program. Medical student chapters may apply for up to $3,000 in matching funds from the TMAF Medical Student Community Leadership Grants Program.
Register for This Summer's 3rd Annual Texas Primary Care and Health Home Summit
Join your colleagues from around Texas at the 2015 Texas Primary Care and Health Home Summit June 18-19 in San Antonio at the Marriott Plaza Hotel. This year's theme, Supporting the Quadruple Aim: The Triple Aim of High Value Patient Care and Provider Joy, focuses on emerging trends in primary care, including value-based contracting, building a successful accountable care organization, practices without walls, and direct primary care.
Save the Date(s) for First Tuesdays
First Tuesdays at the Capitol continues next week, and the Family of Medicine needs you to be there.
Recognize a Local Journalist's Excellence in Health Reporting
If you read or hear a great health news story, nominate the reporter for one of TMA's Anson Jones, MD, Awards, which recognize excellence in health journalism in Texas. TMA has honored Texas journalists for excellence in reporting for more than 50 years.
TMA Statement: “Disappointment Is Not Defeat”
TMA Statement on the U.S. Senate’s decision to delay until after its Easter recess consideration of the Medicare and CHIP Reauthorization Act that passed the House of Representatives by an overwhelming margin on Thursday.
New, Under-the-Radar Government Audits Surface
The Centers for Medicare & Medicaid Services has started an audit of the Physician Quality Reporting System and Electronic Prescribing Incentive payment programs through an IT company called Arch Systems. Here's what to expect.
Half of Eligible Professionals Will Face MU 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.
5 Reasons Conservatives Should Support the SGR Repeal
Texas physicians, of course, are applauding the recent announcement from Washington of bipartisan plan to repeal Medicare’s Sustainable Growth Rate (SGR) formula. If history is any guide, the current threatened pay cut – 22.4 percent scheduled to take effect April 1 – won’t take effect. Recent editorials in the Journal and Forbes, and from Americans for Tax Reform, the American Action Forum, and the National Center for Policy Analysis give us five solid reasons real conservatives should embrace this plan and lobby hard for its passage:
TMA Endorses SGR Repeal Bill
TMA Statement on Introduction of SGR Repeal Bill
CMS Rebuffs TMA's Request to Drop Coercive MU Measures
The size of your next Medicare check could very well rest on whether you can get enough of your patients to email you; federal regulators believe that's a sensible way to evaluate your meaningful use (MU) progress. In fact, if you can't get more than 5 percent of your patients to send a "secure message using certified electronic health record technology (CEHRT)," you'll not only lose eligibility for incentive pay, you'll also be penalized.
TMA Asks Feds to Avert ICD-10 Calamity
Describing the Oct. 1 mandatory transition to ICD-10 as a "potential calamity," Texas Medical Association President Austin King, MD, asked the Centers for Medicare & Medicaid Services to consider some moves that would make the transition less risky for physicians and patients.
Are HIEs Valuable?
The Workgroup for Electronic Data Exchange (WEDI) wants to know what stakeholders in the health care delivery community think about the current state of health information exchange (HIE) and has posted a 12-question online survey to solicit feedback. WEDI is a multistakeholder, national nonprofit and a leading authority on health care information technology.
Avoid 2016 Pay Cuts; Meet Next Round of PQRS Deadlines Now
Get help from TMA and the TMF Health Quality Institute to understand and navigate the Physician Quality Report System (PQRS), and get your reporting done.
Come to TexMed 2015 — FREE for All TMA Members!
Register today for TMA's free annual conference, and join thousands of fellow Texas physicians, as TexMed 2015 arrives in Austin May 1-2 for a weekend of advocacy, education, and collaboration.
TMA Foundation Thanks 19 New $10K+ Super Donors
The TMA Foundation honored 19 special donors at TMA's Winter Conference in January for having donated at least $10,000 each to attain the foundation's Major Donor status in 2014.
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.
HPV Vaccine Fights Cervical Cancer, and More
Human papillomavirus (HPV) causes cervical cancer; many people know that. But here’s a surprise: HPV also causes other increasingly common cancers. The good news is there‘s a powerful tool that prevents the virus’ spread and the cancers it causes: The HPV vaccine. It prevents oropharyngeal cancer (a head-neck cancer affecting the throat and tonsils), which is fast becoming the most common cancer caused by HPV, striking more men than women. The vaccine also prevents cervical cancer, which affects only women.
10 Tech Tips to Help Make Your EHR Bloom
Has the notion of converting to an electronic health record (EHR) germinated within your practice? For this big changeover to bear fruit in your practice operations, you need to proceed with care. TMA has tools, guidance, and reference material — most are free — to help you produce your desired results.
Feds Delay Final Medicare Overpayment Rule
The Centers for Medicare & Medicaid Services announced last week it needs another year to finalize rules on reporting and returning Medicare overpayments. First issued three years ago to implement parts of the Affordable Care Act, the proposed rule (better known as the 60-day rule) requires physicians and other health care providers to report and refund overpayments within 60 days from the date the overpayment is identified or the date the corresponding cost report is due.
Measles Outbreak Adds 33 Cases to Reach 154
In response to the growing 2015 measles outbreak, which at press time stood at 154 U.S. cases, the Centers for Disease Control and Prevention has beefed up its website to include resources to help physicians in their practice.
TMA to Congress: Protect Texas Tort Reform Gains
TMA President Austin I. King, MD, reached out this week to the U.S. Congress asking that lawmakers protect hard-won tort reform gains in Texas by not passing federal statutes that could water down or supersede state law.
Good-bye Strips, Hello Chips
Get your practice ready for changeover this year to new microchip-embedded debit and credit cards, or assume liability for any fraudulent transactions.
Avoid 2016 Pay Cuts by Meeting Next Round of PQRS Deadlines Now
Get help from TMA and TMF to understand and navigate the PQRS system and get your reporting done.
Help Your Patients Plan for End-of-Life Care
Join a March 5 live webcast to learn how to talk to your patients about death or incapacity and help them plan for the end of life.
TMAF Grant Funding Hits Record High
Thanks to its generous donors, the TMA Foundation (TMAF) will reach more Texans than ever this year with a record-high $575,000 in grant funds supporting some 24 programs to improve the health of Texans.
Let the Prepping Begin for ICD-10
TMA’s upcoming live seminar series ICD-10: Will You Just Survive, or Will You Thrive? will test your practice’s readiness and prepare you for obstacles during the transition process
TexMed 2015 Registration Is Now Open — and It’s FREE!
Register today for TMA's free annual conference, and join thousands of your fellow Texas physicians, as TexMed 2015 arrives in Austin May 1-2 for a weekend of advocacy, education, and collaboration.
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.
New Leadership, New Money, Familiar Issues
The 2015 Legislature kicked off last month with many new faces, some new money, and familiar issues for the house of medicine.
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.
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.
How to Report Asbestosis and Silicosis
The Texas Department of State Health Services last month released a new form for physicians and health care providers to report suspected or confirmed cases of asbestosis or silicosis as required by state law.
Hard Hats for Little Heads: 200,000 Helmets and Counting
TMA's Hard Hats for Little Heads bike helmet giveaway program reached a huge milestone in 2014 — giving away its 200,000th helmet. Keep the momentum going this year with three great opportunities for a helmet giveaway: Brain Injury Awareness Month in March, Texas Child Safety Month in April, and Bike Month in May.
Set It and Forget It
The TMA Foundation's Pulse Donor program makes your charitable contributions worry free.
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.
How to Meet Mandate for Patients’ Online Access to Medical Records
Many physicians are struggling with the meaningful use Stage 2 measure that stipulates physicians must "provide patients the ability to view online, download, and transmit their health information within four business days of the information being available to the eligible provider (EP)."
TMA Wants ICD-10 Canned
TMA is glad the federal government postponed adoption of the ICD-10 coding system until 2014 but believes it should completely scrap ICD-10 for a more up-to-date coding system. If officials don't do that, then they should delay ICD-10 even longer. That was the message TMA delivered in a letter to U.S. Health and Human Services Secretary Kathleen Sebelius on May 11.
Texas Physicians Urge Lawmakers: “Help Us Care for Our Patients”
state leaders asked for big changes to ensure low-income patients receive
care in the most efficient manner. “The best place to provide care to Medicaid
patients is in our practices — not in expensive emergency departments,” said
Dr. King. “Texas has the power to make needed changes.
Get a Grant for Free Vaccinations in Your Town
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 vaccination events for underserved and uninsured children, adolescents, or adults.
Court Blocks TMB's Emergency Telemedicine Rules
A district court on Jan. 20 issued a temporary restraining order against the Texas Medical Board's newly issued emergency rules that would disallow remote prescribing unless the physician first conducts a face-to-face or in-person physical examination. The court granted the order at the request of one of the nation's largest telemedicine providers who claimed that the board's Jan. 16, emergency rules violate rulemaking procedure.
State Suspends Fluoroscopy Training Requirements
The Texas Department of State Health Services announced Jan. 13 that it will indefinitely delay implementing the radiation safety awareness training requirements for fluoroscopy guided interventional procedures, and will also consider modifying the training requirements rule for physicians.
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.
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’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.
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.
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.
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.
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.
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.
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.
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.
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.
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.