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Act Now SGR Repeal Closer Than Ever
The “SGR Repeal and Medicare Provider Payment Modernization Act of 2014” (H.R. 4014/S. 2000), was introduced in the U.S. Senate and House of Representatives. Its author is U.S. Rep. Michael Burgess, MD (R-Lewisville). It features the handiwork of Rep. Kevin Brady (R-The Woodlands). And it has the support of key congressional leaders from both parties and in both chambers. “We may not get this opportunity again,” said TMA President Stephen L. Brotherton, MD. “Take action now to support permanent SGR repeal.”
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.
Make an August House Call on Your Senators and Representative
This month, members of Congress will be home for the August recess. TMA urges physicians to make appointments with your U.S. representatives in August to share medicine's prescription for federal health care changes.
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
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.
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
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.
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.
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