TMA joined with seven state specialty societies in a letter urging Texas House budget writers to take strong action to improve Medicaid. The House Appropriations Subcommittee on Health and Human Services held two days of hearings in April examining the Medicaid program.
Medicaid’s new e-signature capability and its portal for verifying patients’ Medicaid eligibility and accessing their available health information are two ways to help cut down on the busywork in your office.
Achieving the cost-savings we mutually envision will require more than just innovative and clinically sound health care policies. It also will require bold action by the legislature to rebuild theMedicaid physician network, which has steadily eroded over the 16 years largely for one reason:unreasonably low payment rates. Medicaid physician payments average 73 percent of Medicare and 50 percent of commercial payments.
Medicaid is a state- and federally funded health care program that provides low-income patients access to essential health care services. Without Medicaid, millions more Texans would be uninsured: As of June 2014, Medicaid covered nearly 3.8 million Texans. To qualify, patients must have a low income, but being poor doesn’t always mean a patient will qualify for the program. For example, low-income childless adults are not eligible in Texas even if their income meets the state’s Medicaid income requirements. Most Medicaid recipients in Texas are children, pregnant women, or disabled.
Medicaid is restoring physician payments for 50 pediatric eye codes to higher levels paid prior to July 1, 2015. The increase, which takes effect April 1, averages 6.6 percent across all codes.
When San Antonio pulmonologist John Holcomb, MD, treats patients enrolled in both Medicare and Medicaid, he knows he's dealing with a particularly fragile population that has little to no income and is elderly or has a disability. Neither these so-called "dual-eligible" patients nor the physicians treating them have it easy.
Apparently, the state got the message loud and clear: Physicians and patients are overly frustrated with the myriad administrative roadblocks that came along with the expansion of Medicaid managed care in Texas. Thanks to TMA's advocacy during the 2013 legislative session and the successful passage of Senate Bill 1150, relief from Medicaid red tape may finally be in sight.
Got Medicaid or CHIP questions? Call or email the Knowledge Center.
Use These Medicaid Tools to Help Get Paid More Efficiently
Act Now to Avoid Losing Your Medicaid Enrollment Status
VDP Formulary Search
Enhanced Formulary Search
Epocrates Free Subscription Formulary Search