Stories written by Alisa Pierce

Novitas Solutions Warns of Top 10 Medicare Claims Errors - 04/15/2024

Novitas Solutions, the Medicare administrative contractor for Texas, has released a top 10 list of errors made between January and March 2024 physicians should be aware of to mitigate billing problems in their practices.

Cigna Launches Digital Newsroom for Payer Updates - 04/12/2024

Physicians and practice staff looking for updates from one of Texas’ major payers, Cigna Healthcare, can now refer to the company’s new digital newsroom.

Shielding the Gold Card Law: TMA Fights to Guarantee Gold Card is Implemented as Intended - 04/09/2024

Texans earned one of its most prolific victories with its prior auth exemption law but still fights to guarantee it's implemented as intended.

Medicare May Seek Payment Recoupment for 2023 Claims - 04/09/2024

A new report by the Government Accountability Office shows physicians may face possible recoupments – or additional payment – for claims filed in 2023 as a result of over and underpayments by Medicare, Medicaid, and other federal programs.

Postpartum Coverage Extension Brings Payment Complexities - 04/05/2024

As the 12-month postpartum coverage Texas legislature approved took effect March 1, physicians and their practice staff should take note of subsequent payment complexities, Texas Medical Association experts caution.

Speaking Their Language: TMA Experts Fight for Physicians’ Best Interests - 04/01/2024

Texas Medical Association experts communicate with payers on behalf of physicians’ best interests.

Still Beating: Rick Snyder, MD, “Won't Stop Knocking on Legislators' Doors” - 04/01/2024

Despite the end of his term, outgoing TMA President Rick Snyder, MD, “won't stop knocking on legislators' doors anytime soon.”

Aetna Set to Pay Medicare Advantage G2211 Claims - 03/27/2024

The list of health plans providing payment for Medicare’s new add-on “G” code continues to grow with Aetna as the latest insurer to cover G2211 for Medicare Advantage claims Aetna confirmed with Texas Medical Association coding experts that its Medicare Advantage claims platform was updated in March to allow payment for the code, used to document the coordination of care for patients with complex or serious conditions. For now, the plan’s policy is only accessible through a physician’s Aetna portal.

HHS Removes Home Address Telemedicine Requirement After TMA’s Urging - 03/18/2024

The U.S. Department of Health & Human Services will allow for the submission of a post office box or personal mailbox, offered by a private delivery service as a practice location address, when a physician does not have a physical location other than their home address, heeding the Texas Medical Association’s call.

UPDATE: Cyberattack Disrupts Payment and Revenue Cycle Management - 03/12/2024

Physicians using Change Healthcare – a health care technology company that is part of Optum and owned by UnitedHealth Group – may experience claims disruptions after the company experienced a cyberattack on Feb. 21.

CMS Announces Flexibilities Following Cyberattack - 03/12/2024

The Centers for Medicare & Medicaid Services announced several flexibilities that aim to help physicians in the wake of the cyberattack against Change Healthcare, which upset payment and revenue cycle management operations in pharmacies and health systems across the country.

Physicians May Face Lower Payment as CMS Resumes Lab Data Collection - 03/11/2024

The Centers for Medicare & Medicaid Services will continue to collect data from physician-owned laboratories to inform private payer rates despite pushback from the Texas Medical Association.

TMA Develops New AI Education - 03/10/2024

Responding to significant interest from members after a 2023 standing-room-only TexMed event, the Texas Medical Association has developed a free webinar for members to learn how to integrate augmented or artificial intelligence technology, including ChatGPT, into patient care.

Party With a Purpose - 03/05/2024

The Texas Medical Association Foundation’s (TMAF’s) 31st annual gala, Wonderland, will feature designs and décor inspired by Lewis Carroll’s classic story Alice’s Adventures in Wonderland.

Telemedicine Flexibilities Preserved in Medicare Fee Schedule - 03/05/2024

The 2024 Medicare physician fee schedule (MPFS) extended several pandemic-era telehealth flexibilities, many of which impact physicians who treat rural patients and those with behavioral health needs.

Coding Changes in Fee Schedule Promote More Accurate Payment for Complex Visits - 03/05/2024

The 2024 Medicare physician fee schedule allows physicians to list G2211 in addition to codes used in office or outpatient visits for new or established patients (i.e., 99202-99215). Physicians also can use it for telehealth visits.

Novitas Makes Mass Payment Adjustment for Telehealth Claims - 02/27/2024

Thanks to the vigilance of the Texas Medical Association’s payment specialists, Medicare administrative contractor Novitas Solutions updated its system to ensure all claims billed with place of service (POS) code 10 will be paid correctly.

Texas BookShare: The program puts a novel twist on promoting healthy living to youth - 02/14/2024

Since 2021, BookShare has aimed to place big ideas into little hands across Texas by providing funding for books and promoting community collaboration along the way. Today the program has grown to encompass seven counties across Texas and has given away more than 5,000 health-related books to children in Texas.

Virtual Scribes Enhanced Relationships Between Patients and Physicians - 02/13/2024

At a time when physicians face burnout often due to administrative stress, two new studies from Boston’s Brigham and Women’s Hospital and Massachusetts General Hospital found virtual scribes cut physician burden by 16% and enhanced relationships between patients and 60% of physicians.

Feds Require AI Transparency, Define Info-Blocking Exceptions - 02/05/2024

First-of-their-kind transparency regulations established by the U.S. Department of Health and Human Services aim to help physicians determine the safety of artificial intelligence technology. The new rule also established a new information blocking exception and implemented a 21st Century Cures Act requirement for health IT developers. Read more.

AMA President-Elect Acclaims TMA Advocacy for Scope, Prior Auth Wins - 01/30/2024

Texas physicians’ advocacy accomplishments both in the state and alongside the American Medical Association earned praise from AMA’s president-elect at the Texas Medical Association’s Leadership Summit on Jan. 27.

Novitas Solutions Names Top Ten Medicare Claims Errors - 01/17/2024

Novitas Solutions, the Medicare administrative contractor for Texas, has cautioned physicians to be aware of the top 10 most common claim submission errors made in 2023.

Information-Blocking Disincentives Unfairly Penalize Practices, TMA Tells Feds - 01/16/2024

The Texas Medical Association and others in organized medicine are pushing back on proposed federal information-blocking rules to establish “disincentives,” financial and otherwise, that could discourage Medicare participation and compromise sensitive patient-physician discussions, among other concerns.

Putting Patient Care Before Paperwork: TMA Addresses Burnout - 01/05/2024

The Texas Medical Association offers practical tips to address administrative burdens driving burnout.

Added Security: Free Tool Helps Practices Comply with the HIPAA Security Rule - 01/05/2024

Federal officials updated a free tool to help small and medium-sized practices comply with the HIPAA Security Rule.