• Health Insurance

    • The Real Truth About "Surprise Bills"

      A pair of new TMA resources examine how insurance plans' network designs and payment decisions are leaving many Texans with "surprise bills" for health care services.
  • Current Health Insurance Articles

    • TMA: Insurance Merger Would Limit Patient Choice, Raise Cost
      A proposed supersize merger in the Texas health insurance market raises concerns about fewer health care options and higher costs for patients, according to Texas Medical Association’s (TMA’s) Texas Medicine magazine.
    • Bigger Isn't Always Bigger
      As Aetna seeks to acquire Humana Inc. in a $37 billion deal, TMA and physicians across Texas worry the merger would weaken their contract negotiating power with health plans while shrinking already narrow provider networks.
    • AMA, TMA Tell Feds to Speed Up Release of MACRA Funds
      The federal government needs to kick it in gear and release funds for "the development of quality measures and technical assistance to small practices" authorized by the Medicare Access and CHIP Reauthorization Act (MACRA). That's the gist of an Oct. 7 letter from the American Medical Association to Centers for Medicare & Medicaid Services Acting Administrator Andrew Slavitt. TMA signed on to the letter in support of expeditious release of the critical funding.
    • TMA Tells DOJ Aetna-Humana Merger Would Be Bad for Texas
      With a highly concentrated health insurance market in Texas, the acquisition of Humana by Aetna would result in less competition in the state. And that would be bad for physicians and consumers. That's what the Texas Medical Association told William Baer, assistant attorney general in the Department of Justice's Antitrust Division.
    • AMA Analyzes Potential Aetna-Humana, Anthem-Cigna Mergers
      The combined impact of proposed mergers among four of the nation's largest health insurance companies would exceed federal antitrust guidelines designed to preserve competition in as many as 97 metropolitan areas within Texas and 16 other states, according to new special analyses of commercial health insurance markets issued by the American Medical Association.
  • Key Issues

    • TMA: Establish Fair and Transparent Insurance Markets
      While Texas physicians want better access to coverage for their patients, they are frustrated by the confusion and administrative burdens imposed by the federal government’s implementation of insurance exchanges. Significant problems also remain — and potential new ones are developing — with traditional health insurance companies and Texas’ workers’ compensation program. TMA has a plan of attack.
    • Under New Management An Interview With TDI's Newest Boss
      The end of the 2013 session of the legislature marked the beginning of new leadership at the Texas Department of Insurance (TDI) as Gov. Rick Perry appointed Julia Rathgeber to the helm of the agency in late May. The Senate unanimously confirmed that appointment in June.
    • Keep Insurers Honest: TMA: Appeal Your Health Plan Rankings
      In spring 2011, Aetna notified El Paso plastic surgeon Deborah Seelig, MD, it was dropping her from its Aexcel physician network for not meeting certain criteria under the network's physician-ranking program.
    • AMA: Bad Claims Payment Increasing
      It's not your imagination. Most health insurers are getting worse at correctly paying physicians' claims, the American Medical Association says in its fourth annual National Health Insurer Report Card.
  • Texas Advocacy and Communications

    • Ban Virtual Credit Cards
    • 2015 Legislative Testimonies and Letters
      TMA physician leaders are working on behalf of their profession and their patients to improve Texas health care system. During the this legislative session, TMA councils and committees are locking down and promoting health care policies to ensure Texas’ patients have access to affordable and high quality health care. Read TMA’s testimonies, comments, and letters to state lawmakers.
    • ACA Exchange Plans: Q&A for Texas Physicians - Updated December 2014
      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.  MembersOnlyRed
    • Physicians Prepare for Round Two of the ACA Marketplace
      Round two of the Affordable Care Act (ACA) health insurance marketplace launched with far less fanfare than last year's botched rollout. But even as physician practices do their part to adjust and help care for these newly insured, some of the same uncertainties linger. And with potentially new twists ahead, TMA officials once again remind physicians to be mindful in their business practices surrounding exchange plans.
    • TMA Healthy Vision 2020: Establish Fair and Transparent Insurance Markets
      Read TMA’s legislative strategy and recommendation for 2015 and beyond.
    • TMA Develops Tooklit to Help You Challenge Unfair Rankings
      Physician ranking (also known as physician tiering) has traditionally been a profiling methodology used by private insurance companies to steer patients toward lower-cost physicians.
    • 83rd (2013) Legislative Victories
      It took more than six years, but TMA and our state legislators never gave up. Now a new law regulating silent PPOs penalizes unethical third parties who steal and resell physicians’ discounted rates, for commercial and Medicaid contracts. Lawmakers also passed a prompt-pay law for Medicaid HMOs; no more low-pay, slow-pay, no-pay.